• Jennifer R DeFazio, Anastasia Kahan, Erica M Fallon, Cornelia Griggs, Sandra Kabagambe, Jeffrey Zitsman, William Middlesworth, Steven Stylianos, and Vincent Duron.
• Division of Pediatric Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York-Presbyterian Morgan Stanley Children's Hospital, New York, NY, United States. Electronic address: Jd3402@cumc.columbia.edu.
• J. Pediatr. Surg. 2020 Aug 1; 55 (8): 1427-1430.

ObjectiveDuring the COVID-19 pandemic, experience-based guidelines are needed in the pediatric population in order to deliver high quality care in a new way that keeps patients and healthcare workers safe and maximizes hospital resource utilization.BackgroundThe COVID-19 pandemic has created an unprecedented strain on national health care resources, particularly in New York City, the epicenter of the outbreak in the United States. Prudent allocation of surgical resources during the pandemic quickly became essential, and there is an unprecedented need to weigh the risks of operating versus delaying intervention in our pediatric patients.MethodsHere we describe our experience in surgical decision-making in the pediatric surgical population at Morgan Stanley Children's Hospital of New York-Presbyterian (MSCHONY), which has served as a major urban catchment area for COVID-19 positive pediatric patients. We describe how we have adjusted our current treatment of multiple facets of pediatric surgery including oncology, trauma, minimally invasive procedures, and extracorporeal membrane oxygenation (ECMO).ConclusionsOur pediatric surgery department had to creatively and expeditiously adjust our protocols, guidelines, and workforce to not only serve our pediatric population but merge ourselves with our adult hospital system during the COVID pandemic.Type Of StudyClinical research paper LEVEL OF EVIDENCE: Level V.Copyright © 2020 Elsevier Inc. All rights reserved.

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