Seattle Children’s has added the following information to our Provider FAQs – COVID-19.
1. Seattle Children’s has updated its COVID-19 testing guidelines
Seattle Children’s has updated its guidelines for testing pediatric patients for the coronavirus, in accordance with guidance from Public Health – Seattle & King County and uncertainty in the testing supply chain. We will continue to update our guidelines as the situation changes.
Seattle Children’s is now testing the following for COVID-19:
- Admitted patients with any respiratory symptoms or fever of unclear etiology
- ED/Urgent care/Ambulatory patients with:
- Acute respiratory symptoms with or without fever AND who fall into ANY ONE of the following groups:
- Other underlying medical conditions that place a patient at high risk for complications from a viral respiratory illness, such as immune compromised state, chronic cardiac conditions, chronic pulmonary conditions, diabetes, etc.
- Patients frequently cared for at SCH and anticipated to have multiple visits at SCH in the following 2 weeks
- Patients involved in an illness cluster in a care facility or institution (e.g., those who live in a long-term care facility)
- Pre-BMT patients will be tested per SCCA protocol.
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Seattle Children’s has added the following information to our Provider FAQs – COVID-19.
Temporarily Canceling Elective Surgeries and Procedures
Based on new Centers for Disease Control and Prevention (CDC) recommendations for Seattle-King, Pierce and Snohomish County, Seattle Children’s will cancel all elective surgeries and procedures until further notice. The temporary cancellation of elective surgeries has gone into effect and we have been calling patient families to notify them. PCPs will be notified through our standard channels. We will continue to perform urgent surgeries and procedures during this time. We understand canceling surgeries will have a major impact on the lives of patients and families and appreciate your support while our community is going through this public health emergency.
Q: Will there be changes to ambulatory visits?
A: In response to the updated CDC recommendations, we are reaching out to families to offer telephone (i.e. non-video) or telehealth appointments, or cancel non-urgent ambulatory appointments that can be safely postponed. We will limit all new schedules to urgent and medically necessary clinic visits.
Q: Does Seattle Children’s offer drive-through testing for staff with symptoms of COVID-19?
A: On March 13, Seattle Children’s began offering testing for workforce members who have symptoms of COVID-19 (fever, cough, difficulty breathing). At this time testing is available to Seattle Children’s workforce who have a badge. Read full post »
Seattle Children’s has added the following information to our Provider FAQs – COVID-19.
If families have questions about the coronavirus, please have them call Seattle Children’s only if their question relates specifically to an upcoming appointment with us.
Thank you for your partnership.
Q: Who is being tested for COVID-19?
A: Current capacity for testing is limited. Seattle Children’s is testing the following for COVID-19:
- Admitted patients with any respiratory symptoms or fever of unclear etiology
- ED/Urgent care patients with acute respiratory symptoms or fever of unclear etiology with high risk travel or a known COVID-19 exposure
- Seattle Children’s ambulatory patients with acute respiratory symptoms or fever of unclear etiology and high risk travel or a known COVID-19 exposure.
The following may be tested for COVID-19:
- ED/urgent care patients: with acute respiratory symptoms or fever of unclear etiology
- Seattle Children’s ambulatory patients not meeting the above, but who fall into the following categories:
- New respiratory symptoms (cough or shortness of breath, with or without fever) AND being in ANY ONE of the following groups:
- Other underlying medical conditions that place a patient at high risk for complications from a viral respiratory illness, such as immune compromised state, chronic cardiac conditions, chronic pulmonary conditions, diabetes, etc.
- Patients frequently cared for at SCH and anticipated to have multiple visits at SCH in the following 2 weeks
Seattle Children’s guidelines for testing will be updated as the situation changes. Read full post »
We know this is a rapidly changing situation and we will continue to provide updated information about how Seattle Children’s is preparing and managing COVID-19, and how we can support primary care providers.
Are there any changes to Seattle Children’s outpatient radiology services?
We are continuing to offer a full range of imaging services including walk-in diagnostic outpatient x-ray in Bellevue, Federal Way, Everett, and Seattle. All families will be asked a series of screening questions before they enter the building. Families who present with respiratory symptoms or influenza-like illness will be put in strict isolation. We may consider less investigative studies when applicable.
When should PCPs send patients to Seattle Children’s Emergency Department (or not)?
Please only send your patients to Seattle Children’s Emergency Department if they are sufficiently ill to need emergent treatment (i.e. they meet criteria for being admitted). Please call our ED Communications Center first at 206-987-8899.
Patients with non-emergent respiratory symptoms and concern for COVID-19 should call Public Health – Seattle & King County and quarantine at home.
Who is being tested for COVID-19?
Current capacity for testing is limited. Ambulatory or admitted patients qualify for testing if they meet the current CDC definition of PUI, which currently (as of 3/4/20) includes relevant travel exposure, contact with a known COVID case, and those admitted with fever and lower respiratory tract infection. Results typically take between 24 to 48 hours.
Is Seattle Children’s able to test for COVID-19?
The viral respiratory panel used at Seattle Children’s does not detect COVID-19. We are sending our COVID-19 panels to the University of Washington for testing and receiving results back in 24-48 hours. Current capacity is limited.
COVID-19 testing is available only for our inpatients with respiratory symptoms and patients who meet the CDC testing criteria.
Additional Resources
If your patient has questions or is concerned about COVID-19, please refer to these resources from Washington State Department of Health:
For additional information to support families, see:
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PCPs Play a Critical Role in Pandemic Response
Seattle Children’s anticipates a massive response will be required by healthcare providers on all fronts to respond to COVID-19. Hospitals, ERs and urgent cares will be strained to capacity to treat the sickest patients; their ability to keep up and save lives will depend in large part on primary care providers having capacity and resources to treat less acute patients throughout our communities.
What you can do:
- Prepare your clinics immediately to see low acuity respiratory patients.
- Divide your flow so that patients with and without respiratory symptoms are seen in separate spaces.
- Consider a front door v. back door check in process.
- Consider seeing symptomatic kids in their cars and/or asking them to remain in cars until a room is ready for them.
- Be creative in this crisis situation to minimize in-person patient visits for suspected COVID; use phones, video apps, etc. to see patients and help limit the spread of the virus.
- Do not automatically redirect patients with respiratory symptoms to urgent care or emergency departments. Manage as much patient care as possible without sending patients to urgent care or the ED.
- If you experience an increased demand for respiratory visits, consider canceling planned non-urgent patient visits, such as well-child care. Limit well-child appointments to immunizations only, to free up appointments for respiratory patients.
- Isolate non-emergent respiratory patients with quarantine at home.
- Consider coordinating with other clinics to become a larger outpatient system for triaging and managing patients.
- Focus now on procuring the personal protective equipment (PPE) needed by your staff, including gloves, masks, eye shields or goggles (not eyeglasses), and gowns.
- Stay up-to-date on the CDCs guidance on evaluating and reporting Persons Under Investigation (PUI).
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Constipation is incredibly common in the pediatric population. It affects up to 30% of children, accounts for 3-5% of general pediatric outpatient visits and up to a quarter of all pediatric gastroenterology visits. This represents significant cost to our healthcare system.
Peak prevalence of constipation occurs during preschool years. Painful stooling during this time can lead to withholding of stool. This can lead to harder, less frequent stools, which further reinforces the withholding cycle. Starting daycare or grade school often restricts access to the bathroom and it is common for our patients to avoid stooling in these environments. Other factors that can lead to constipation include diets without enough fruits, vegetables and fiber, inadequate water intake and a lack of physical exercise.
Constipation is a frustrating experience for both children and parents. It often takes a dedicated, long-term, multifactorial approach consisting of behavioral, lifestyle and medication management.
At Seattle Children’s, we use the Rome IV criteria to define constipation in children. There are separate definitions for children older and younger than 4 years old. Our detailed practical clinical protocol for constipation evaluation and treatment, which includes an algorithm, is found here. Read full post »
New referral guidelines are now available from Seattle Children’s Neurosciences Center, along with new resources to help manage patients with tic and headache in primary care.
The current wait time for new patients with non-urgent headache or tic is about 3 months. As Seattle Children’s continues its effort to improve access to specialty care for children who most need it, the headache and tic resources from Neurosciences are intended to help patients with these conditions find appropriate care with their primary physician and avoid the longer waits to see a specialist.
Please visit the Neurosciences “Refer a Patient” webpage. Read full post »
As announced last week in a special Provider News bulletin, Seattle Children’s has re-opened the operating rooms (ORs) on the hospital campus that were previously closed for installation of a new air handling system and in-room HEPA filtration systems in each OR. We are taking a thoughtful approach to rescheduling surgeries that were postponed due to the closure, including reviewing surgeries on a daily basis to assess urgency and priority.
For surgery referrals, please follow our normal referral process. Read full post »
Ocean Pharmacy Now Open 24 Hours
On Feb. 24, the hours of our Ocean Pharmacy expanded to 24 hours a day, seven days a week. The goal of this expansion is to enhance the continuity of care patients receive at Seattle Children’s. Patient families can now avoid the hassle of finding a late-night pharmacy after being discharged from the Emergency Department. The expanded hours will also help improve daytime turnaround times for inpatient and surgery center discharges.
Ocean Pharmacy is not open to the general public. Read full post »
Seattle Children’s has updated the clinical standard work pathway for Urinary Tract Infection (UTI). For more information, please reference our Urinary Tract Infection CSW Pathway.
The pathway first went live in December 2011 and completed its last periodic review in April 2015. After a review of synthesized medical literature and consensus on the recommendations, the pathway team updated the care algorithm. This was an extensive revision that included the following changes:
- Shortened IV antibiotic duration for infants 0-1 month of age with E. coli UTI
- Shortened IV antibiotic duration for bacteremic E. coli UTI
- Shortened total antibiotic duration for children 2 months of age and older
- Criteria for obtaining a renal bladder ultrasound (RBUS)
- Criteria for obtaining a voiding cystourethrogram (VCUG)
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