Pediatric anesthesia during the coronavirus disease epidemic - One pediatric surgical hospital's rapid transition back to care.

Abstract

Shriners Hospitals for Children - Northern California provides highly specialized pediatric surgical care. The rapid spread of coronavirus disease 2019 (COVID-19) required timely suspension of our elective surgeries. Mitigating disease spread and protecting patients and staff became paramount. Because pediatric patients in particular carry and may spread SARS-CoV-2 while asymptomatic, and due to the large amount of respiratory aerosols produced during airway manipulation, an unprecedented risk of provider infection came to exist. Surgical cases were tiered based on urgency and only emergent or urgent cases proceeded using airborne precaution personal protective equipment (PPE)1 . Furthermore, asymptomatic patients infected with SARS-CoV-2 undergoing surgery have higher postoperative morbidity and mortality2 . However, surgery in children is rarely completely elective and could not be postponed indefinitely. The ability to resume pediatric surgical care during this pandemic would only be possible if a completely new path was forged.