Development of pediatric surgical decision-making guidelines for COVID-19 in a New York City children's hospital

Space: StayCurrentMD Author: Jennifer R. DeFazio, Anastasia Kahan, Erica M. Fallon, Cornelia Griggs, Sandra Kabagambe, Jeffrey Zitsman, William Middlesworth, Steven Stylianos, Vincent Duron Published:

Author / Expert

Jennifer R. DeFazio, Anastasia Kahan, Erica M. Fallon, Cornelia Griggs, Sandra Kabagambe, Jeffrey Zitsman, William Middlesworth, Steven Stylianos, Vincent Duron

Topic overview

Abstract

Objective

During the COVID-19 pandemic, experience-based guidelines are needed in the pediatric population in order to deliver high quality care in a new way that keeps patients and healthcare workers safe and maximizes hospital resource utilization.

Background

The COVID-19 pandemic has created an unprecedented strain on national health care resources, particularly in New York City, the epicenter of the outbreak in the United States. Prudent allocation of surgical resources during the pandemic quickly became essential, and there is an unprecedented need to weigh the risks of operating versus delaying intervention in our pediatric patients.

Methods

Here we describe our experience in surgical decision-making in the pediatric surgical population at Morgan Stanley Children's Hospital of New York-Presbyterian (MSCHONY), which has served as a major urban catchment area for COVID-19 positive pediatric patients. We describe how we have adjusted our current treatment of multiple facets of pediatric surgery including oncology, trauma, minimally invasive procedures, and extracorporeal membrane oxygenation (ECMO).

Conclusions

Our pediatric surgery department had to creatively and expeditiously adjust our protocols, guidelines, and workforce to not only serve our pediatric population but merge ourselves with our adult hospital system during the COVID pandemic.

Type of study

Clinical research paper

Level of evidence

Level V

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