Emergency Care For Children Research Articles

Healthcare Workers' Perceptions of On-Site Childcare.

Measures taken by healthcare organizations to address COVID-19 highlighted the long-standing lack of childcare infrastructure required to support healthcare workers. This study, designed to provide evidence to support operations at an academic medical center, looked at the influence that in-house and emergency childcare could have on the retention, recruitment, and productivity of healthcare workers. This study also outlined the implications that childcare, or its lack, has for healthcare organizations during and after the COVID-19 pandemic. We conducted a 35-question electronic employee survey (under institutional review board approval) during pandemic-induced public school closures, which included both quantitative and qualitative (write-in) questions. The survey results showed that weekday on-site childcare was very or extremely important to more than half of survey respondents, the majority of whom were staff members (28%) or physicians (25%), followed by administrators (15%), researchers (12%), others (10%), nurses (5%), educators (2%), and residents (1%). Sixty percent of respondents reported that emergency on-site childcare was extremely important (34%) or very important (26%). Almost half (49%) reported that emergency childcare needs have disrupted their work in the past year, including canceling of clinics or surgical cases. Analysis of qualitative comments via a strategy based on coding and categorization showed that, when asked how childcare influences their work choices, employees responded that childcare availability has limited the hours or times they could work, that lack of childcare has prevented career growth, that they left a previous job or will leave their current job because of childcare needs, or that they stayed at a previous job or have remained in their current job longer because of the availability of childcare. Although data from this mixed-methods study support findings in the literature that there is a need for in-house and emergency childcare, the data suggest that current employees at this academic medical center do not currently expect it, likely because such childcare is not generally available at most academic institutions. With increased rates of burnout and healthcare workers leaving the field since COVID-19, offering in-house and emergency childcare provides hospital systems with new opportunities to retain and recruit physicians, nurses, and staff, as well as to improve their well-being and productivity.

Die Situation der Ärztinnen und Ärzte in Akutkrankenhäusern während der zweiten Welle der SARS-CoV-2-Pandemie: eine Onlinebefragung

BackgroundThe SARS-CoV-2 pandemic has an impact on the wellbeing of health care workers. The influence of a work-related sense of coherence as well as perceived organizational support on the level of burnout and the intention to leave the job is largely unknown, especially for physicians in German hospitals. MethodIn December 2020 and January 2021, physicians of 81 hospitals in Hessian (Germany) participated in an online survey using the BAT (Burnout Assessment Tool), Work-SoC (Work-related Sense of Coherence), the POS-s (Perceived Organizational SUPPORT – short version) and literature-based items based. ResultsOf 181 physicians, 34% showed a moderate or high burnout level, 21% would leave the job after the pandemic. The higher the work-SoC (β = −0.560; p < 0.001) and the higher the POS-s (β = −0.125; p < 0.05), the lower the burnout level. Not being able to care sufficiently for their patients has a negative impact on the sense of coherence. 46.4% reported that they did not feel sufficiently prepared by their employer during the pandemic. They wished to have support in the form of the mindfulness and resilience trainings (45%), emergency childcare (41%) and a crisis counselor in their team (32%). ConclusionRegardless of the pandemic, health-promoting work conditions have to be developed that facilitate coherent work and prevent “moral injuries” or enable physicians to deal with them.

Challenges of the COVID-19 Pandemic for the Work–Family Balance of Pediatric Surgeons

The COVID-19 pandemic has been a great challenge, especially for families. We aimed to analyze the impact of the pandemic on childcare for and the work–family balance of pediatric surgeons in Germany. An anonymized questionnaire on the working and familial situation before and during the COVID-19 pandemic was sent to the members of the German Society of Pediatric Surgery and trainees in pediatric surgery (April–July 2021). One-hundred-fifty-three participants (59% female) completed the questionnaire. A total of 16% of the males and 62% of the females worked part-time. Most (68%) had underage children. During the COVID-19 pandemic, 36% reported a decrease in patients and interventions, and 55% reported an increase in the organizational work-related burden. Childcare for underage children during lockdown was organized mainly with the help of institutional emergency childcare (45%), staying home (34%), one parent working from a home office (33%), or staying home by themselves (34%). Before the lockdown, 54% reported a good work–family balance. During the lockdown, this worsened by 42%. Most of the families had to organize themselves. Different means such as a home office, flexible working hours, and different models for childcare can help to improve the situation.

Assessing national action through emergency paid leave to mitigate the impact of COVID-19-related school closures on working families in 182 countries.

In April 2020, nearly 1.6 billion learners were out of school. While a growing body of literature has documented the detrimental impact of these closures on children, less attention has been devoted to the steps countries took to mitigate the impact of these closures on working families. Paid leave is recognized as an important policy tool to enable working parents the time they need to respond to family needs without risking job or income loss. This article uses a novel data set to assess whether countries had policies in place prior to the pandemic to respond to increased care needs and the extent to which policies were introduced or expanded during the pandemic to fill the gap. Only 48 countries had policies in place prior to the pandemic that could be used to respond to the care needs created by school and childcare center closures. In the vast majority of these countries, the duration of leave in these policies was too short to meet the care needs of the pandemic or relied on parents reserving extended parental leave options. Only 36 countries passed new legislation during the pandemic, but the majority of those that did covered the full duration of closures. As countries continue to face COVID-19 and consider how to better prepare for the next pandemic, emergency childcare paid leave policies should be part of pandemic preparedness frameworks to prevent further exacerbating inequalities. The policies introduced during the pandemic offer a wide range of approaches for countries to identify feasible solutions.

Disparities and implicit bias in the management of low-risk febrile infants: a mixed methods study protocol

IntroductionThe management of low-risk febrile infants presents a model population for exploring how implicit racial bias promotes inequitable emergency care for children who belong to racial, ethnic and language minority...

Essential work and emergency childcare: identifying gender differences in COVID-19 effects on labour demand and supply

AbstractWe examine whether the COVID-19 crisis affects women and men differently in terms of employment, working hours, and hourly wages, and whether the effects are demand or supply driven. COVID-19 impacts are studied using administrative data on all Dutch employees up to December 2020, focussing on the national lockdowns and emergency childcare for essential workers in the Netherlands. First, the impact of COVID-19 is much larger for non-essential workers than for essential workers. Although female non-essential workers are more affected than male non-essential workers, on average, women and men are equally affected, because more women than men are essential workers. Second, the impact for partnered essential workers with young children, both men and women, is not larger than for others. Third, single-parent essential workers respond with relatively large reductions in labour supply, suggesting emergency childcare was insufficient for them. Overall, labour demand effects appear larger than labour supply effects.

Parents under stress: Evaluating emergency childcare policies during the first COVID-19 lockdown in Germany

What are the effects of school and daycare facility closures during the COVID-19 pandemic on parental well-being and parenting behavior? Can emergency childcare policies during a pandemic mitigate increases in parental stress and negative parenting behavior? To answer these questions, this study leverages cross-state variation in emergency childcare eligibility rules during the first COVID-19 lockdown in Germany and draws on unique data from the 2019 and 2020 waves of the German AID:A family panel. Employing a triple-differences approach we identify short- to medium-term intention-to-treat effects and find that while emergency care policies did not considerably affect parents’ life satisfaction, partnership satisfaction or mental health, they have been effective in diminishing harsh parenting behavior. We find partly gendered effects, specifically on paternal parenting behavior. Our results suggest that decreasing parental well-being likely constitutes a general effect of the pandemic, whereas the observed increase in negative and potentially harmful parenting behavior is largely directly caused by school and daycare facility closures.

COVID-19 management at one of the largest hospitals in Germany: Concept, evaluation and adaptation.

ContextThe LMU University Hospital is among the largest healthcare facilities in Germany. The measures implemented prior to and during the first pandemic wave of COVID-19, were evaluated in preparation of a second pandemic wave. This paper presents the pandemic management concept, evaluation and adaptation of LMU University Hospital.MethodsBetween July and September 2020 the disaster management team of LMU University Hospital conducted a mixed-method evaluation of the hospital’s pandemic management. A workshop series based on the After Action Review working group format was organized to examine the management structure, decision-making processes, documentation, and crisis preparedness response for a second COVID-19 wave. Further, the satisfaction of employees with the hospital’s COVID-19 management was examined through an anonymous survey.ResultsThe workshop series highlighted a need for structural and operational adaptation of the COVID-19 management at LMU University Hospital. The results of the employee survey (N = 2182) provided positive feedback for the measures taken during the first pandemic wave. Specific actions were derived concerning the availability of personal protective equipment and emergency childcare services. A key outcome of both evaluation activities was the identified need for further improvement in communication between stakeholders. All changes were adopted prior to the second pandemic wave.

Pediatric Emergency Medicine Physicians' Perspectives on Emergency Care of Children With Medical Complexity: A Multi-institution Mixed-Methods Assessment.

Children with medical complexity (CMC) compose 1% of the pediatric population but account for 20% of pediatric emergency department (ED) visits. Previous descriptions of challenges and interventions to ensure quality of care are limited. Our objective was to elicit pediatric emergency medicine (PEM) physicians' perspectives on challenges and opportunities for improvement of emergency care of CMC, with a focus on emergency information forms (EIFs). We conducted a web-based survey of PEM physicians participating the American Academy of Pediatrics Section on Emergency Medicine Survey listserv. The survey was designed using an expert panel, and subsequently piloted and revised to an 18-item survey. Data were analyzed with descriptive statistics. One hundred fifty-one of 495 respondents (30%) completed the survey. Most respondents (62.9%) reported caring for >10 CMC per month. Whereas overall medical fragility and time constraints were major contributors to the challenges of caring for CMC in the ED, communication with known providers and shared care plans were identified as particularly helpful. Most respondents did not report routine use of EIFs. Anticipated emergencies/action plan was deemed the most important component of EIFs. Most PEM physicians view the care for CMC in the ED as challenging despite practicing in high-resource environments. Further research is needed to develop and implement strategies to improve care of CMC in the ED. Understanding experiences of providers in general ED settings is also an important next step given that 80% of CMC present for emergency care outside of major children's hospitals.

Paediatric Critical Care or Emergency Care: What Information Must A Good Strategy Contain?

This write up on critical care and emergency care of children: What must a good strategy contain? surrounds issues of what a critical care package should be even in resource poor settings. Paediatric critical care consists of identification of children at risk of dying or having adverse outcomes, and in need of intensive monitoring and provision of appropriate interventions. Emergency care is defined by the World Health Organization (WHO) as care for the acutely ill and injured delivered by frontline providers who manage medical, surgical, and obstetric emergencies, relying on early recognition and resuscitation. In developing countries, majority of mortalities occur due to infectious diseases which are treatable and have potential for full recovery if appropriate definitive care as well as intensive care is given to those who come critically ill. In Cameroon, maternal, child and adolescent related diseases account for 18.3% of the burden of disease and 14.4% of deaths. Some of these deaths could be prevented if there are adequate paeditric critical care facilities to handle the critically ill children. However, paediatric critical care services are largely unavailable in most developing countries 23. The objectives of this seminar are to describe the nursing strategies used in the critical and emergency care of children, outline parent’s expectations of the critical care/emergency care of their children by nurses and lastly to describe healthcare managers’ responsibilities in critical care/emergency care of children. It has been observed that nursing strategies include monitoring, assessment, vital sign monitoring, ventilatory management, medication administration, intravenous insertion and infusion, central line care, catheters care, maintenance of a running record of the patient’s status, performance of cardiopulmonary resuscitation and other lifesaving techniques. Parent’s expectations include guidance, reassurance and timely and comprehensive information on the progress and prognosis of critically ill children; open visitation policy and involvement in their child’s care 8, while healthcare managers’ responsibilities were found to be ensuring adequate skill and knowledge among emergency services providers, and availability of pediatric critical care medications, equipment, and supplies. The results can be used to implement good critical care strategies and hence better care outcomes.

Higher paediatric readiness in emergency departments and trauma centres with a paediatrician on-site

Background: Critically ill and injured children are frequently admitted to mixed adult/paediatric emergency departments and trauma centres. Children constitute a smaller proportion of patients in these facilities, thus leading to the risk of poor quality of paediatric emergency care being provided. Studies show that day-to-day readiness for the emergency care of children affect paediatric patient safety and is associated with a reduced risk of mortality among critically ill children. This study aimed to assess the level of paediatric readiness in Danish emergency departments and trauma centres. We hypothesised that trauma centres had a higher paediatric readiness than emergency departments.&#x0D; Methods: From November 2020 to January 2021, a nationwide survey was conducted in all 18 Danish emergency departments and four trauma centres. The questionnaire was a Danish translation of the 2013 American assessment of paediatric readiness provided by the National Pediatric Readiness Project. Facility chief physicians were approached by phone and for those willing to participate, the questionnaire was e-mailed for completion by designated healthcare professionals working in the emergency department or trauma centre. Primary outcome was paediatric readiness, which was assessed using the weighted paediatric readiness score based on a scale from 0-100. A score of 100 points indicated full compliance with the 2009 American Guidelines for Care of Children in the Emergency Department. The weighted paediatric readiness score was presented as median with interquartile range (IQR). Our hypothesis was tested using the Mann-Whitney U test, and a P-value of less than 0.05 was considered statistically significant.&#x0D; Results: A total of 13 emergency departments and three trauma centres replied resulting in a response rate of 73%. There was no significant difference in weighted paediatric readiness scores between emergency departments, median (IQR) 70.0 (56.1-78.2) and trauma centres 75.6 (70.9-78.4); (P = 0.42). Facilities with a paediatrician on-site 24/7 (n=12) had higher paediatric readiness scores 75.5 (67.7-78.8) than four facilities without an on-site paediatrician 53.8 (44.9-63.1); (P = 0.02).&#x0D; Conclusion: Trauma centres did not have a higher paediatric readiness than emergency departments. However, we found a higher paediatric readiness in facilities with a paediatrician on-site.

Coronavirus disease 2019 and radiation oncology\u2014survey on the impact of the severe acute respiratory syndrome coronavirus 2 pandemic on health care professionals in radiation oncology

BackgroundThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has changed the lives of most humans worldwide. The aim of this study was to evaluate the impact of the SARS-CoV‑2 pandemic on health care professionals (HCPs) in radiation oncology facilities.MethodsWe distributed an online survey to HCPs in radiation oncology (physicians, medical physics experts, radiology assistants/radiation therapists, nurses, and administrative personnel). The survey was completed by 334 participants between May 23 and June 9, 2020.ResultsIn 66.2% of the cases, HCPs reported a shortage of protective clothing. The protective measures were regarded as very reasonable by 47.4%, while 0.8% regarded them as not reasonable (rather reasonable: 44.0%; less reasonable 7.8%). 29.0% of the participants had children who needed care. The most frequently used care options were public emergency childcare (36.1%) and private childcare (e.g. relatives/friends). HCPs reported about additional work burden (fully agreed: 27.2%, rather agreed: 34.4%, less agreed: 28.2%, not agreed: 10.2%), and reduced work satisfaction (fully agreed: 11.7%, rather agreed: 29.6%, less agreed: 39.8%, not agreed: 18.9%). 12.9% and 29.0% of the participants were fully or rather mentally strained (less mentally strained: 44.0%, not mentally strained: 14.1%).ConclusionWe must learn from this pandemic how to prepare for further outbreaks and similar conditions. This includes the vast availability of protective clothing and efficient tracing of infection chains among the HCPs, but also secured childcare programs and experienced mental health support are crucial. Further, work satisfaction and appreciation by employers is essential.

Impact of the 2020 French lockdown due to the SARS-CoV-2 pandemic on emergency consultations for pediatric burns in a regional referral hospital

IntroductionSARS-CoV-2 pandemic required the establishment of total lockdown in France from March 17 to May 11, 2020. We analyzed the impact of this lockdown on the pediatric burn population consulting in our burn unit during this period compared to data from previous years in order to analyze our model of emergency care for children burned during this unprecedented situation.Material and methodsWe carried out a retrospective single-center study by reviewing files concerning emergency consultations for children burns during the total lockdown in France in 2020 (COVID group) compared to the same weeks of 2018 and 2019 (no-COVID group).ResultsWe find a significant decrease in the number of consultations (P = 0.02) during the confinement period. In the “COVID” group, we found a significant increase in burn to the hand (P = 0.03) and lower limbs (P = 0.03). The other criteria evaluated did not find any difference between the groups. Assessment of a possible rebound effect within 2 weeks of total lockdown found an increased incidence of the children burn consultation, an increased number of older children and mainly male.ConclusionThe decrease in the number of consultations alerts us to a potential increase in the functional sequelae of burns in these patients at risk. Longer-term follow-up will allow us to assess the consequences of this lockdown on this particularly at-risk population.

Hot Off the Press: Addressing gender inequities: Creation of a multi-institutional consortium of women physicians in academic emergency medicine.

Hot Off the Press: Addressing gender inequities: Creation of a multi-institutional consortium of women physicians in academic emergency medicine.

The Impact of COVID-19 Pandemic on Medical Doctors' Work-Family Balance at German University Clinics.

The measures taken to cope with the COVID-19 pandemic by governments worldwide have vast consequences on all areas of life. To assess the impact of the COVID-19 pandemic on long-term career development, we evaluated the work-family balance of medical doctors at nine German university clinics. The results indicate a severely disturbed work-family balance, which was mostly due to insufficient childcare, based on restrictions in school operations and childcare. Despite the newly created emergency childcare options, aiming to ensure the functioning of the “systematically important” professional groups, medical doctors feel that they are not sufficiently supported by the measures taken by local governments. Women, in particular, see their professional development at risk. Our results underline that proper and flexible childcare is essential for the career advancement of female medical doctors and is particularly important in times of crises such as the current COVID-19 pandemic. At university medicine clinics, increased work time flexibility and optimized schooling and childcare are needed to promote the career development of female as well as male medical doctors in the early stage of their careers.

Utilisation of Children's Emergency Care Services During Epidemics and Pandemics: A Systematic Review

Utilisation of Children's Emergency Care Services During Epidemics and Pandemics: A Systematic Review

Capturing the Lived Experiences of Women with Lymphoma in Pregnancy: An Australasian Lymphoma Alliance Study

Background: Lymphoma in pregnancy is a rare and challenging diagnosis that complicates approximately 1:6000 pregnancies. Diagnostic delay occurs frequently, as lymphoma-related symptoms may be mistakenly attributed to the pregnancy itself, and diagnostic investigations postponed or omitted. Lymphoma in pregnancy poses a series of unique therapeutic, social, and ethical challenges to the patient, her family, and the medical professionals involved. This is largely due to a paucity of published management guidelines, with current evidence based on modest case series and expert opinion. In this study we endeavoured to understand women's lived experiences during this challenging time. We performed semi-structured interviews with women previously treated for lymphoma in pregnancy, to identify both gaps in care delivery and valued interventions with the aim of informing future models of care.Methods: We retrospectively identified patients from twelve sites in Australia and New Zealand aged ≥18 years of age diagnosed with Hodgkin (HL) or non-Hodgkin lymphoma (NHL) during pregnancy or within 12 months postpartum, between 1 January 2009 and 31 December 2020. Baseline demographic characteristics, treatment details, and outcomes were collected, and semi-structured interviews were conducted via telephone with those who provided informed consent. Thematic analysis was performed using QSR Int NVivo 12 Pro (March 2020, USA) to quantify salient themes. The initial 5 transcripts were independently coded by two investigators who then reached a consensus on pre-determined codes. These codes were applied to the rest of the transcripts by one coder. The frequency of pre-determined themes was determined via descriptive statistics.Results: A total of 29 women were interviewed. Baseline demographic characteristics are documented in Table 1. The majority were diagnosed during pregnancy (14%, 28% and 17% in the 1 st, 2 nd and 3rd trimesters respectively), while 41% were diagnosed post-partum. HL was the most frequent diagnosis (48%) followed by diffuse large B cell lymphoma and primary mediastinal lymphoma (14% each). More than 90% of women received chemotherapy with 28% receiving combined modality chemoradiotherapy. Sixty-nine percent commenced chemotherapy during pregnancy (17%, 28% and 14% in the 1 st, 2 nd and 3rd trimesters respectively) and 41% commencing postpartum. In the 28% of patients who received radiotherapy, this was administered post-partum.A summary of themes identified and their frequency across the 29 transcripts are shown in Figures 1-3. Diagnostic delay attributed to pregnancy was reported by 41%. 21% of the women reported fatigue, breathlessness, weight change and musculoskeletal pain, which they felt healthcare practitioners found difficult to interpret in the context of pregnancy/postpartum period. Women recalled that their chief concerns at diagnosis were the welfare of their unborn child (41%) and a fear of dying (27%). Over half of the women (55%) reported perceived communication breakdown between health practitioners and patients. They also felt there was a lack of sensitivity in discussions around fertility preservation (45%), teratogenicity of treatment (31%), termination of pregnancy (14%) and cessation of breast-feeding (14%). Valued interventions included financial/logistic assistance from charity organisations (48%), a personal support network (45%), clinical psychology referral (31%) and emergency childcare (10%). Patients also found shared patient experiences (31%) and support groups (17%) beneficial in their treatment journey.Conclusion: To our knowledge this is the first report capturing the lived experiences of survivors of lymphoma during pregnancy. This provides us a unique opportunity to consider our management, psychosocial supports, and delivery of care to meet the needs of these women. Areas for development in future care models include increased patient advocacy, educational materials, economic, psychosocial, and childcare supports. Above all, there is scope for improved, tailored communication between health practitioners and patients, with sensitivity around embryotoxicity, pregnancy termination and adverse outcomes to foster autonomy, build trust and improve maternal wellbeing. [Display omitted] DisclosuresGreenwood: Jazz Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees; Servier: Membership on an entity's Board of Directors or advisory committees, Research Funding; Pfizer: Membership on an entity's Board of Directors or advisory committees; Amgen: Membership on an entity's Board of Directors or advisory committees, Research Funding. Gangatharan: Astrazeneca: Other: Educational Conference Funding. Hamad: Novartis: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau.

Schulich students for emergency childcare: Results of a community initiative during COVID-19

The coronavirus disease (COVID-19) pandemic led to the abrupt suspension of many businesses and services in Ontario including schools and childcare centres. This resulted in many parents struggling to identify options for childcare, including frontline healthcare workers (HCWs). A volunteer initiative composed of medical and dental students was developed to provide emergency childcare support to HCWs in Southwestern Ontario. Experts in areas of public health, law, and bioethics were consulted to minimize the risks associated with participation and develop a clear policy to prioritize the health and safety of all participants. Social media was utilized to recruit volunteers and HCWs who were matched on a first-come, first-served basis. 59 medical and dental students were recruited to provide emergency support for 21 HCWs within the unique safety and ethical conditions posed by COVID-19. By reflecting on the strengths of this initiative and the challenges faced during its completion, key areas of improvement were identified that should be addressed in future initiatives of a similar nature.

Paediatric emergency care at an academic referral hospital in Mozambique.

BackgroundImproved emergency care of children with acute illness or injuries is needed for countries in Africa to continue to reduce childhood mortality rates. Quality improvement efforts will depend on robust baseline data, but little has been published on the breadth and severity of paediatric illness seen in Mozambique.MethodsThis was a retrospective review of routinely collected provider shift summary data from the Paediatric Emergency Department (PED) at Hospital Central de Maputo (HCM), the principal academic and referral hospital in the country. All children 0–14 years of age seen in the 12-month period from August 2018–July 2019 were included. Descriptive statistical analyses were performed.ResultsData from 346 days and 64,966 patient encounters were analyzed. The large majority of patients (96.4%) presented directly to the PED without referral from a lower level facility. An average of 188 patients was seen per day, with significant seasonal variation peaking in March (292 patients/day). The most common diagnoses were upper respiratory infections (URI), gastroenteritis, asthma, and dermatologic problems. The highest acuity diagnoses were neurologic problems (59%), asthma (57%), and neonatal diagnoses (50%). Diagnoses with the largest proportion of admissions included neurologic problems, malaria, and neonatal diagnoses. Rapid malaria antigen tests were the most commonly ordered laboratory test across all diagnostic categories; full blood count (FBC) and chemistries were also commonly ordered. Urinalysis and HIV testing were rarely done in the PED.ConclusionThis epidemiologic profile of illness seen in the HCM PED will allow for improved resource utilisation. We identified opportunities for evidence-based care algorithms for common diagnoses such as respiratory illness to improve patient care and flow. The PED may also be able to optimize laboratory and radiology evaluation for patients and develop standardized admission criteria by diagnosis.

Diagnosis and Acute Management of COVID-19 and Multisystem Inflammatory Syndrome in Children.

Most children with coronavirus disease 2019 (COVID-19) infection are asymptomatic or have mild disease. About 5% of infected children will develop severe or critical disease. Rapid identification and treatment are essential for children who are critically ill with signs and symptoms of respiratory failure, septic shock, and multisystem inflammatory syndrome in children. This article is intended for pediatricians, pediatric emergency physicians, and individuals involved in the emergency care of children. It reviews the current epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children, summarizes key aspects of clinical assessment including identification of high-risk patients and manifestations of severe disease, and provides an overview of COVID-19 management in the emergency department based on clinical severity.