Management Strategies for Pediatric Burns During the COVID-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic has been challenging global health, in many countries all non-urgent medical treatments were postponed in order to focus health systems, workforce and other resources on crucial treatments for COVID-19 patients. The pediatric cases are a minority of all COVID-19 patients and might present atypically. Due to an increase in pediatric burn cases we decided to establish an outpatient pre-hospital clinic as an intermediate "station", in order to triage pediatric burn patients into those who present at our hospital, and those treated via telemedicine. We divided our tactics into environmental and patient management both in hospitalized and outpatient patients, also medical staff management including preventive care, surgery, and bedside procedures. We found that patients and their escorts waited longer before arriving to the Emergency Room, apparently trying to avoid the hospital visit. A higher proportion of patients was hospitalized during the pandemic (4.5% in 2020, compared to 2.6% and 2.0% in 2019 and 2018, respectively). However, the length of stay was similar to routine periods, the surgery rate and length of follow up until healing was similar to that of the same month in previous years. We assume that these factors reflect treatment quality, which was not affected, due to the use of telemedicine, and that our treatment standards were maintained. It is important to have a good regulation system of prevention and care, including the tactics described below.