National preparedness survey of pediatric intensive care units with simulation centers during the coronavirus pandemic

Table 4 Preparedness efforts by pediatric intensive care units

Practice change/Innovations	n (%)
Concerns related to the current COVID-19 clinical practice
Lack of clinical guidelines/protocols	5 (22.73)
Changes in guidelines/protocols	11 (50.00)
Lack of PPE training	3 (13.64)
Physician staff shortage
RN staff shortage	2 (9.09)
Other staff shortage	1 (4.55)
Shortage in equipment/supplies	8 (36.36)
Patient surge and crowding	5 (22.73)
Other	5 (22.73)
Implementation of COVID focused airway management training
Yes	18 (81.82)
No	3 (13.64)
Unsure
Practice innovations for airway management
Caring for patients with suspected or confirmed COVID in negative pressure room	14 (63.64)
Using video laryngoscopy only for intubation	15 (68.18)
Decreased clinical care team numbers at bedside	19 (86.36)a
Incorporating new methods of communication between team members	16 (72.73)a
Implementing airway management checklists	15 (68.18)
Using telemedicine/video technology	9 (40.91)
Other	2 (9.09)
Intubation of suspected or confirmed COVID patients
By anesthesiologist who responds as part of the Airway Team	5 (22.73)
Anesthesiologist or other dedicated airway provider who is called if intubation is required	7 (31.82)
Attending physician unless the patient is suspected of having a difficult airway	12 (54.55)
Attending physician or fellow	7 (31.82)
Any appropriately trained member of the team
Other	8 (36.36)
Implementation of COVID focused cardiac arrest management training
Yes	15 (68.18)
No	6 (27.27)
Unsure
Practice innovations for cardiac arrest management
Caring for patients with suspected or confirmed COVID in negative pressure rooms only	13 (59.09)
Changing CPR practices	10 (45.45)
Decreased clinical care team numbers at bedside	16 (72.73)a
Incorporating new methods of communication between team members	15 (68.18)a
Using telemedicine/video technology	7 (31.82)
Other	4 (18.18)
Implementation of surge capacity management training
Yes	8 (36.36)
No	13 (59.09)
Unsure
How does your PICU keep all providers updated regarding COVID preparedness activities?
Mass e-mails	20 (90.91)a
Regular in-person huddle/meetings	11 (50.00)
Virtual conferences/meetings	17 (77.27)a
Simulation-based	9 (40.91)
Other

^aP < 0.05.

COVID: Coronavirus disease; CPR: Cardiopulmonary resuscitation; PPE: Personal protective equipment; PICU: Pediatric intensive care unit; RN: Registered nurse.