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Coronavirus Updates May 22, 2020: Updates on Pre-operative Screening and Memorial Day Testing Hours

1. Pre-operative Testing at Seattle Children’s: What Happens When Patients Live Far Away or Cannot Get Tested in Time

We are screening all pre-operative patients for COVID-19. This includes patients who will have a procedure in an operating room and those who need anesthesia in Radiology. Families who have a procedure or surgery scheduled receive a reminder call 72 hours before surgery from the pre-procedure nurses. These tests need to be collected 24 to 72 hours prior to surgery and are being offered at our drive-through testing location at our Sand Point Learning Center (SPLC) north of the hospital, or during an in-person appointment at one of our four urgent care locations in Bellevue, Everett, Federal Way and Seattle. Learn more about testing at Seattle Children’s.

When 24 Hour Tests are Necessary

Requests for testing within 24 hours may come up for cases that are added last minute. These families can come to Seattle to have their testing performed within the 24 hour period. Results from external facilities should be faxed to the Seattle Children’s Pre-Anesthesia COVID-19 testing line at 206-987-2060 by 5 p.m. the day before procedure.

We understand that timely testing is not widely available outside the Seattle area. Perioperative Services will be working with families traveling from further away to help coordinate early arrival to the Seattle area to allow testing. Read full post »

Update on Air Pressure and Monitoring in our ORs

We are writing to update you on the work happening in our main campus operating rooms (ORs).

As we previously shared with you, in 2019, we temporarily closed 10 ORs in order to install a new rooftop air handling unit, as well as in-room HEPA filtration systems. HEPA is an extremely effective filtration system that removes more than 99.97% of particles from the air passing through the filter. Since re-opening our ORs in February 2020, we have conducted continuous air pressure monitoring and daily air testing, and validated that the new air handling unit and HEPA filtration systems are functioning as expected.

Providing safe, quality care is our top priority at Seattle Children’s. As we stated before reopening our ORs, we are committed to taking swift and necessary action – including closing ORs – in the event of unexpected test results. In May, routine air tests detected low levels of fungal spores in several ORs and an equipment storage room. Daily testing has not detected any Aspergillus fumigatus spores, which is the species of Aspergillus associated with our previously confirmed 14 Aspergillus surgical site infections. Air testing did detect very low levels of Aspergillus versicolor spores, which is generally not associated with causing surgical site infections. Nevertheless, the air test results prompted us to evaluate the environment and OR air pressures, which revealed unexpected air pressure findings.

Based on these results, we decided to proceed with a more expansive evaluation of the impacted spaces in collaboration with external engineering experts. We anticipate several ORs will be closed for several weeks while the evaluation is underway.

Seattle Children’s shared this information with the Washington State Department of Health on May 12.

A majority of our ORs are open and we are performing surgeries both on main campus and at our Bellevue Clinic and Surgery Center.

Due to our limited room availability during this evaluation, we will need to reschedule a very small number of surgeries; our scheduling team will be in touch with families whose surgeries may be impacted .

If you have an urgent clinical concern, please call the Provider-to-Provider Consulting Line at 206-987-7777.

If you would like to speak with someone on the Seattle Children’s leadership team directly, please contact Dr. Ruth McDonald, Vice President, Associate Chief Medical Officer.

Drive-Through Testing for Community Pediatric Patients Is Now Available at Seattle Children’s

Beginning today, May 11, we will offer COVID-19 nasal swab testing to symptomatic community pediatric patients (non-Seattle Children’s patients) at our Sand Point Learning Center drive-through test site and at our urgent care sites in Seattle, Bellevue, Everett and Federal Way. Tests will be provided during their normal hours of operation.

We are excited to offer this important service to our community. Full details are on our website.

How to order a test

1. Fill out a SARS-CoV-2 COVID lab requisition to order testing for your patient. Send the form via:

1. Facsys to COVID-19FamilyCallCenter@seattlechildrens.org

OR

2. Enter order into CIS, or fax to 206-985-3111 or 866-985-3111 (toll-free)

OR

3.  A paper copy that the family can bring with them to their appointment (not preferred; appointment scheduling may take longer)

2. Instruct your patient to call 206-987-2100 to schedule their appointment. Scheduling is only available once the testing order is received. If your patient calls to schedule their appointment and the order has not been received, your patient will be instructed to contact you.

Read full post »

Symptoms Mimicking Kawasaki Disease in Children With COVID-19

Although children don’t typically fall seriously ill from the new coronavirus, doctors in Europe are now expressing concern that children with COVID-19 have developed mysterious symptoms that mimic those appearing with Kawasaki disease.

On the Pulse asked Dr. Michael Portman, pediatric cardiologist and director of the Kawasaki Disease Clinic at Seattle Children’s, to help break this emerging issue down for parents and caregivers.

Read “Kawasaki Disease in Children With COVID-19” in On The Pulse.

Read full post »

Coronavirus Updates – May 6, 2020

1.  Abuse at Home: Harm Reduction Strategies During the COVID-19 Pandemic Workshop

When: Wednesday, May 6, 2020, 3:30 to 4:10 p.m.

Where: WebEx. Phone number: 650-479-3207. Access code: 282 103 292

Description: Staying at home is not a safe option for everyone. Data suggests intimate partner violence and child abuse are increasing during this time of social distancing and quarantine. Seattle Children’s Odessa Brown Clinic will conduct a 40-minute online workshop to discuss the current state of intimate partner violence and child abuse, trends and strategies to increase safety at home.

There will be a QR code for a survey at the end of the training. Attendees will receive a CE certificate from the event manager after submitting the survey. Read full post »

New Referral Guidelines and PCP Resources for Ophthalmology

Our Ophthalmology program has released updated referral guidelines and resources for patient care, including a vetted list of pediatric eye care providers in Washington.

The new information is intended to help our Ophthalmology program focus on seeing patients who cannot find equivalent care in the community and reduce the long wait times in our clinic — currently about five months for patients with nonurgent conditions. Read full post »

Telemedicine Appointments Available for Speech, Occupational and Physical Therapy

Seattle Children’s is now offering telemedicine appointments for physical therapy (PT), occupational therapy (OT) and speech-language pathology (SLP). While it may not be intuitive that these services can be provided via telemedicine, in fact they work well in many situations. Our therapists often combine telemedicine with periodic in-person visits, which is a format that is widely used nationally and is effective for both patients and therapists.

Patients who need to be seen in person and/or use our specialized equipment rooms will still be provided with in-person appointments at our locations in Seattle, Bellevue, Everett and Federal Way, when it is safe to do so or when those appointments are considered urgent. Read full post »

Rescheduled to 2021: 16th Annual Pediatric Bioethics Conference

To help minimize the unintentional spread of COVID-19, the 16th Annual Pediatric Bioethics Conference, hosted by the Treuman Katz Center for Pediatric Bioethics, has been rescheduled to next year: July 23 and July 24, 2021. The conference theme will remain the same — “Pushing the Limits: Children, Athletics and Ethics.” For more information, visit the Pediatric Bioethics Conference page.

COVID-19 Update for Referring Providers – April 28, 2020

Guidance on When to Obtain a Second Test for SARS-CoV2

Guidance on who should be tested for SARS-CoV-2 has been updated to include information on when providers should consider sending a second test from patients who have had one test that is negative.  Generally speaking, a second test should be reserved for patients for whom there is a high level of concern for COVID-19.

Rationale for obtaining a 2nd testing during a course of illness:

  • Well-designed PCR tests for SARS-CoV2 have high analytical sensitivity, but clinical sensitivity is unknown due to lack of clinical gold standard.
  • Clinical sensitivity is dependent on where the patient is in the course of their illness and the associated viral load (viral load decreases later in the course of illness).
  • SARS-CoV2 appears to have anatomical tropism. For instance, in general, shedding persists for longer in lower respiratory tract specimens and as a result, lower respiratory tract specimens have higher sensitivity than upper respiratory tract specimens.
  • Our testing strategy at Seattle Children’s calls for utilizing upper respiratory tract specimens as the primary specimen because it is not always possible and is often not easy to obtain a lower tract specimen from a pediatric patient.
  • However, when suspicion for SARS-CoV2 disease (COVID-19) is high, consideration should be given to obtaining a second test and preferably from the lower respiratory tract if possible.

Read full post »

Seattle Children’s Treatment Guidelines for COVID-19

A multidisciplinary group of physicians at Seattle Children’s has developed a management guideline for patients with SARS-CoV-2 infection. Although there is no treatment with proven efficacy for COVID-19, this guidance will help with risk stratification and outlines evaluation and treatment approaches that should be considered. Current evidence for various investigational agents is also included. This guidance was developed with resources and capabilities at Seattle Children’s in mind. It will be updated periodically as more evidence becomes available.

The guidelines are currently being used by a multidisciplinary group at Seattle Children’s who review and discuss each patient before making recommendations based on current guidelines. These are general guidelines; as with most guidelines, clinical correlation is required. Read full post »