ABSTRACT
Introduction At the onset of the Covid-19 pandemic, hospital educational activities were halted in order to focus on healthcare delivery and maintain social distancing. As a response to this disruption, BSPGHAN trainees set up the BSPGHAN Education Series, a twice- weekly virtual learning programme. The core objective of this programme was to deliver high quality paediatric gastroenterology, hepatology and nutrition (PGHAN) teaching during the pandemic. In this study, we analysed the attendances and feedback received from the education series, in order to guide future directions. Methods We reviewed the Zoom meeting attendance logs and Survey Monkey feedback forms for the BSPGHAN Education Series from April 2020 to December 2020. Results In nine months, a total of 55 talks were delivered by 43 speakers. 23 (41.8%) sessions were gastroenterologythemed, 25 (45.4%) were hepatology-themed and 7 (12.7%) were nutrition-themed. Thirteen paediatrics gastroenterology units (12 in the UK and 1 in the United States) and all 3 UK tertiary paediatric liver centres contributed to the talks. The highest contributing centres were Birmingham Children's Hospital (20 sessions), followed by King's College Hospital (9 sessions) and Leeds Children's Hospital (7 sessions). Attendance logs and feedback forms were available for 53 sessions. A total of 2369 attendances were logged, with a median of 41 attendees per session (IQR 31-54). Attendees from 22 countries have participated in these sessions. A total of 810 survey feedback forms were received, with a median of 14 forms received per session (IQR 10-18). 32% were filled in by PGHAN Grid trainees, 23% by consultants, 15% by clinical fellows. Allied Health Professionals (AHPs) comprised 6% of feedback returns. 54% of survey feedback respondents accessed the teaching sessions from home. An average of 98% (95% CI 96.3-99.2) survey respondents strongly agreed/agreed that the sessions were relevant to their learning. 97% (95% CI 96-98.7) of survey respondents strongly agreed/agreed that the sessions delivered were of high quality. Discussion The BSPGHAN series has been a positive initiative arising from the pandemic, providing access to high quality PGHAN education when local availability was paused, and giving a platform for the society internationally. Our report shows that the BSPGHAN Education Series has been wellreceived by attendees. The virtual sessions are more accessible compared to in-person teaching sessions, as evidenced by the high percentage of feedback respondents accessing the sessions from home. Looking ahead, the BSPGHAN Education Group, set up in October 2020, will play a vital role in the further development of the Education Series. Sessions are recorded and made available to BSPGHAN members on the BSPGHAN websitefurther work may include creating online learning modules centred around these recordings. AHP involvement is an area for development- for 2021, we hope to include more topics that will be relevant to their interests.
ABSTRACT
Purpose: The Coronavirus 2019 (COVID-19) pandemic impacted adult out-of-hospital arrest (OHCA) outcomes in the United States. The impact of the pandemic on pediatric OHCA is unknown. Materials and methods: An analysis of the Cardiac Arrest Registry to Enhance Survival for non-traumatic pediatric OHCAs (≤18 years) was conducted. Outcomes during 3 pandemic surge periods in 2020 (March 16 to May 15, July 1 to August 15, and October 16 to December 31) were compared to the same time periods pre-pandemic in 2019. The primary outcomes were overall survival and neurologically favorable survival, defined as a cerebral performance score of 1 or 2 at the time of hospital discharge. Age groups included infants (<1 year), children (1 to 11 years), and adolescents (≥12 years). Results: A total of 1381 pandemic surge period arrests were compared to 1274 pre-pandemic arrests. There was an increase in OHCAs in adolescents (pandemic 26.6% [368/1381], pre-pandemic 22.4% [286/1274], p = 0.01). Therewere no differences in OHCAs by sex, race/ethnicity, witness status, location, initial rhythm, bystander CPR rates or bystander AED use. There were no differences in overall survival during the pandemic surge periods in 2020 (10.6% [147/ 1381]), as compared to the same months in 2019 (9.7% [123/1274], p = 0.40) or in neurologically favorable survival (2020: 8.9% [123/1381] vs. 2019: 7.3% [93/1274], p = 0.13). Conclusions: During the COVID-19 pandemic surge periods in 2020, pediatric OHCA survival rates in the United Stateswere similar to the rates of pediatric OHCA pre-pandemic. Further study is warranted to determine if pediatric survival for OHCA was affected during the delta and omicron COVID-19 surges in 2021.
ABSTRACT
Background: Regional variations in the impact of the coronavirus disease-2019 (COVID-19) pandemic on out-of-hospital cardiac arrest (OHCA) have been reported. We aimed to examine differences in the community response, emergency medical services (EMS) interventions, and outcomes of OHCA, in Singapore (population 5.7 million) and Atlanta (population 4.16 million), before and during the pandemic. Methods: Using prospectively collected Singapore Pan-Asian Resuscitation Outcomes Study (PAROS) and Atlanta Cardiac Arrest Registry to Enhance Survival (CARES) data, we compared EMS-treated adult OHCAs (≥18 years) during the pandemic period (17weeks from the date of first confirmed COVID-19 case) and pre-pandemic period (corresponding weeks in 2019). The primary outcome was pre-hospital return of spontaneous circulation (ROSC). We reported adjusted odds ratios (aOR) for OHCA characteristics, pre-hospital interventions, and outcomes using binary logistic regression. Results: Of the 3987 EMS-treated OHCAs (overall median age 69 years, 60.1% males) in Singapore and Atlanta, 2084 occurred during the pandemic and 1903 during the pre-pandemic period. Compared with Atlanta, OHCA cases in Singapore were older (median age 72 vs 66 years), received more bystander interventions (65.1% vs 41.4% received cardiopulmonary resuscitation (CPR) and 28.4% vs 10.1% had automated external defibrillator application), yet observed less pre-hospital ROSC (11.3% vs 27.1%). When compared with the pre-pandemic period, the likelihood of residential OHCAs doubled in both cities during the pandemic;in Singapore, OHCAs were more likely to be witnessed (aOR 1.95, 95% confidence interval (CI), 1.59-2.39) yet less likely to receive CPR (aOR 0.81, 95% CI, 0.65-0.99) during the pandemic. OHCAs occurring during the pandemic, compared with pre-pandemic, were less likely to be transported in Singapore and Atlanta (aOR 0.50, 95% CI, 0.42%-0.85%, and 0.36, 95% CI, 0.26-0.50, respectively), without significant differences in overall pre-hospital ROSC. Conclusion: Changes in OHCA characteristics and pre-hospital interventions during the pandemic were likely collateral consequences, with regional variations partly reflecting differences in systems of care and other sociocultural factors. These highlight opportunities for public education and the need for further study into lower transport rates during the pandemic.