Personal protective equipment in the paediatric emergency department during the COVID-19 pandemic: Estimating requirements based on staff numbers and patient presentations.

OBJECTIVE: To estimate the personal protective equipment (PPE) required in a paediatric ED during the COVID-19 pandemic comparing the use per patient to use per patient zone, based on the NSW Clinical Excellence Commission (CEC) guidelines in place at the time of the study. METHODS: A retrospective case note review of all patients and staff present in the ED of The Children's Hospital at Westmead, Sydney, Australia in the 24 h period of Sunday 5 April 2020. The primary outcome of PPE estimates was generated from identifying the number of patient contacts and aerosol generating procedures (AGPs) performed per patient as well as the number of staff on shift. RESULTS: One hundred patients attended the ED (50% of usual) and all were included in the study. For a low-risk community environment allocating PPE per patient contact required 48 face shields, 382 surgical masks, 48 N95 masks and 430 gowns for the day, increasing to 430 face shields, 331 surgical masks, 430 N95 masks and 761 gowns in a high-risk community environment. Allocating PPE using zoning reduces the requirement to 48 face shields, 192 surgical masks, 48 N95 masks and 204 gowns, increasing to 196 face shields, 96 surgical masks, 196 N95 masks and 292 gowns per day in a high-risk community environment. CONCLUSION: This study has demonstrated the considerable requirement for PPE in a paediatric ED, which varies according to presentation type and the background prevalence of COVID-19 in the community.