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J Pediatr ; 222: 22-27, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32380026

RESUMEN

OBJECTIVE: To describe the rapid implementation of an adult coronavirus disease 2019 (COVID-19) unit using pediatric physician and nurse providers in a children's hospital and to examine the characteristics and outcomes of the first 100 adult patients admitted. STUDY DESIGN: We describe our approach to surge-in-place at a children's hospital to meet the local demands of the COVID-19 pandemic. Instead of redeploying pediatric providers to work with internist-led teams throughout a medical center, pediatric physicians and nurses organized and staffed a 40-bed adult COVID-19 treatment unit within a children's hospital. We adapted internal medicine protocols, developed screening criteria to select appropriate patients for admission, and reorganized staffing and equipment to accommodate adult patients with COVID-19. We used patient counts and descriptive statistics to report sociodemographic, system, and clinical outcomes. RESULTS: The median patient age was 46 years; 69% were male. On admission, 78 (78%) required oxygen supplementation. During hospitalization, 13 (13%) eventually were intubated. Of the first 100 patients, 14 are still admitted to a medical unit, 6 are in the intensive care unit, 74 have been discharged, 4 died after transfer to the intensive care unit, and 2 died on the unit. The median length of stay for discharged or deceased patients was 4 days (IQR 2, 7). CONCLUSIONS: Our pediatric team screened, admitted, and cared for hospitalized adults by leveraging the familiarity of our system, adaptability of our staff, and high-quality infrastructure. This experience may be informative for other healthcare systems that will be redeploying pediatric providers and nurses to address a regional COVID-19 surge elsewhere.


Asunto(s)
Infecciones por Coronavirus/terapia , Cuidados Críticos/organización & administración , Hospitales Pediátricos/organización & administración , Unidades de Cuidados Intensivos/organización & administración , Neumonía Viral/terapia , Capacidad de Reacción/estadística & datos numéricos , Adulto , Betacoronavirus , COVID-19 , Cuidados Críticos/normas , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Medicina Interna/normas , Masculino , Persona de Mediana Edad , Ciudad de Nueva York , Evaluación de Resultado en la Atención de Salud , Pandemias , Respiración Artificial , SARS-CoV-2
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