Pediatric emergency department crowding during multiple resuscitation events.

Authors

Elizabeth C Lendrum, Nathan Timm, Melissa Williams, Laura Kemp, Yin Zhang, Holly R Hanson

Published in

The American journal of emergency medicine. Volume 110. Pages 290-293. Aug 31, 2026. Epub Aug 31, 2026.

Abstract

Multiple, simultaneous resuscitations in pediatric emergency departments (PEDs) strain resources and exacerbate crowding. In 2015, our pediatric institution implemented a Multiple Resuscitation Activation (MRA) to coordinate team response. The impact of MRAs on PED crowding remains unclear.
Evaluate whether MRAs are associated with changes in PED crowding and patient census.
A retrospective cohort study was conducted at a tertiary pediatric level one trauma center from January 2023 to December 2024. MRA events were matched 1:2 with non-activation control periods by time of day and calendar proximity. Crowding was measured using the Pediatric Emergency Department Overcrowding Scale (PEDOCS) at baseline and at 1 and 2 h after activation (or matched control time). Difference-in-differences analyses were used to compare changes in PEDOCS and patient census between activation and control periods.
Thirteen MRAs involving 59 patients were identified, with a median activation duration of 73 min. Although PEDOCS scores and patient census increased following MRAs, these changes were not significantly different from those in matched control periods. The difference-in-differences estimate for PEDOCS was 6.0 points (95% CI, -15.4 to 27.4) at 1 h and 7.8 points (95% CI, -13.6 to 29.2) at 2 h. Corresponding estimates for patient census were 2 patients (95% CI, -17 to 21) and 6 patients (95% CI, -16 to 28).
MRAs were not associated with significant increases in PED crowding or patient census compared with matched non-activation control periods. These findings suggest that coordinated response systems may help mitigate the operational impact of multiple simultaneous resuscitations.

PMID:
42697098
Bibliographic data and abstract were imported from PubMed on 05 Sep 2026.

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