Francisco Gonzalez, MD and Noah Kondamudi, MD, MBA, FAAP, FACEP
This article is intended to be a brief primer about COVID-19 illness among children with a focus on emergency department management. For readers that would like more in depth information, we refer them to these recently published review articles [1, 2, 3]
So far, over 3.4 million cases of pediatric COVID-19 cases have been reported in the U.S for a prevalence of 4525/100,000 children, out of which approximately 0.1-2.2% resulted in hospitalization and 0.04% resulted in death4. As cases of SARS CoV-2 infections continue to overwhelm hospitals and emergency departments around the country, it is important for emergency physicians to recognize signs and symptoms of this disease, cohort cases to avoid endangering staff and other patients, distinguish which individuals require testing, and ultimately manage them appropriately.read more
In my 4th year of medical school, a boy drowned in the lake near my house. It was a shocking event at the time because my perception had been that drowning was a rare tragedy, more abundant and dramatized on television than in reality. However, during my training, I have learned that drowning remains a significant cause of death in children. Although mortality rates have been trending downward in recent years, CDC data from 2019 shows that drowning is still the leading cause of accidental injury death in children aged one to four and remains one of the top three leading causes of accidental injury death in children of all ages over one year. Children under the age of 14 account for one out of every five drowning deaths and there are approximately ten deaths per day due to drowning. It is important to note that these reported numbers relate to mortality rate alone and do not include morbidity from drowning such as neurological deficits or sequelae from a drowning event. The full extent of injury secondary to submersion is difficult to know as data gathering is challenging due to misinformation that persists surrounding drowning among the public, government agencies and even the medical community.read more
As I drove home from my last overnight shift in the emergency department, I was weary, eager to commence my “at-home” COVID-doffing routine. Annoyed, as each red light posed a barrier between me and sleep, I caught a glimpse of the majestic sunrise peeking over the horizon. I paused to take in the beauty and reflect on the parallel in my life. After persevering through the bleak “night” of 2020, many of us are weary, exhausted, and perhaps even a bit annoyed. But I encourage you to take a moment and reflect on the positive highlights of 2020, and express gratitude and hope for the new horizon that 2021 brings.
Among the many things I am grateful for, I am thankful for the support and camaraderie of the ACEP organization. While the Pediatric Section officers and I had different plans for 2020, supported by amazing members like yourselves, we were able to pivot and are proud of our accomplishments.
In April 2020, amidst all the uncertainty surrounding the novel coronavirus, the PEM section hosted a very informative webinar, COVID19: The Pediatric Perspective. It featured distinguished panelists from three regions (New York, Washington State, and California), which were highly impacted by the novel coronavirus. More than 300 attendees were present during the webinar, and a wide variety of topics were discussed.
Despite COVID-19’s preeminent position at the forefront of everyone’s minds, we still had to manage other common pediatric complaints in the Emergency Department. To provide ongoing, seasonally appropriate educational material, the microsite editors posted information about orthopedic trauma, caustic ingestions, and firecracker and blast injuries. You can find these and other great articles on our microsite: ACEP’s PEM Microsite | Quality Care for Kids Everywhere!
My simple, personal mantra on some of the darker days of 2020 was “I love my job!” And yes, we think PEM is a great specialty! The section officers wanted to support residents who were interested pursuing it as a career. As such, we hosted a webinar in early fall with PEM Fellowship program directors from varied institutions who answered key questions and provided sage advice to the many residents who attended the session. The discussion was so rich, we ran out of time! Check out a few excerpts from the Q &A at our twitter – @PedsACEP.
One of the highlights of my academic year has always been traveling to the annual ACEP Scientific Assembly. It is a time to catch up with dear friends, embrace new collaborations and learn information to aid my clinical practice. This year, “Unconventional” did not disappoint. If you missed the PEM section meeting, you missed a treat! We celebrated our E-Images winners (to be highlighted on our microsite soon—stay tuned!), did virtual yoga, and had engaging discussions on topics ranging from financial fitness to faculty development and networking. We ended the meeting with a timely mini plenary, “Self-Care for Essential Workers.”
While we cannot discount the blessings of 2020, I, like many of you, am relieved to have it behind me. So, what is on the horizon? As we march into 2021, the PEM section is looking forward to providing you with more educational content and additional ways to engage and network with colleagues. Please let us know how we can best serve you. Finally, I would like to close by introducing you to our new section liaison and administrator, Stephanie Wauson—welcome to the team Stephanie!read more