Recent Research
Data sets available
Did you know EMSC has data sets available? Learn about pediatric readiness data here and clinical research data here.
ED Pediatric Readiness research
Looking for ED Pediatric Readiness-specific research? View a curated and categorized list of selected publications here.
The work of the EMSC Program is rooted in the latest scientific evidence. Below, explore the most recent EMSC-related research. (Many but not necessarily all of the publications include EMSC authors or coauthors.)
- Scott L Weiss •
- Julie C Fitzgerald •
- Benjamin L Laskin •
- Ruchi Singh •
- Amanda S Artis •
- Ananya Vohra •
- Elena Tsemberis •
- Emem Kierian •
- Kristen C Lau •
- Atzael B Campos •
- Christopher Hickey •
- Katie L Hayes •
- Daniel Singleton •
- Elliot Long •
- Franz E Babl •
- Stuart R Dalziel •
- Graham C Thompson •
- Stephen B Freedman •
- Michelle Eckerle •
- Robert W Hickey •
- Jing Huang •
- Nathan Kuppermann •
- Fran Balamuth •
- Pragmatic Pediatric Trial of Balanced vs. Normal Saline Fluid in Sepsis (PRoMPT BOLUS) Investigators of the Pediatric Emergency Care Applied Research Network (PECARN), Pediatric Emergency Research Canada (PERC), and Pediatric Research in Emergency Departments International Collaborative (PREDICT) Networks
No abstract...
- Joanna S Cohen •
- Priyal Patel •
- Amanda Finney •
- Meilin Zheng •
- Oluwakemi Badaki •
- Laura Prichett
Autism is an independent risk factor for having a prolonged ED stay, for boarding in the ED, and for prolonged ED boarding when presenting to the ED with a mental health crisis that requires hospitalization....
- Todd A Florin •
- Ron Reeder •
- Lilliam Ambroggio •
- Richard M Ruddy •
- Samir S Shah •
- Allison Cator •
- Matthew J Lipshaw •
- Geoffrey A Capraro •
- Laura F Sartori •
- Amy Y Cheng •
- Leah Tzimenatos •
- Patrick S Walsh •
- Claudia R Morris •
- Chris A Rees •
- Son H McLaren •
- Tamar R Lubell •
- Chari D Larsen •
- Justin Moher •
- Eileen J Klein •
- Shubhada Hooli •
- Nathan Kuppermann •
- Pediatric Emergency Care Applied Research Network (PECARN) PedCAPS Investigators
INTRODUCTION: Community-acquired pneumonia (CAP) is a frequent and costly cause of pediatric emergency department (ED) visits and hospitalizations. Previous prognostic tools for CAP are limited by small samples, single-center or retrospective designs, lack of generalizability to ED settings, lack of...
- Tahir K Hameed •
- Salma H Almadani •
- Walaa A Shahin •
- Husam I Ardah •
- Walaa A Almaghrabi •
- Mohammed A Alhabdan •
- Ahmed M Alfaidi •
- Asma M Abuthamerah •
- Manar M Alahmadi •
- Malik H Almalki •
- Mona A Aldabbagh
SBIs are common in our population, and the PECARN prediction rule performed well in classifying febrile infants at low risk for SBIs. The prediction rule was very accurate in ruling out IBIs, with no misclassified cases in infants 3 weeks...
- Mohammed Alsabri •
- Israa Magdy Ata •
- Joseph Alhaddad •
- Eslam Abady •
- Muhammad Azan Shahid •
- Aanal Patel •
- Dalia Atef Abouda •
- Sohaila Mohamed Mohamed Abdelbar •
- Victor N Oboli •
- Muhammad Waseem •
- Luis L Gamboa
This review offers valuable insights for clinicians and policymakers dedicated to reducing preventable pediatric mortality in low-resource settings....
- Alexander Keister •
- Shannon W Stephens •
- Kathleen Adelgais •
- Nichole Bosson •
- Kathleen Brown •
- Cara Elsholz •
- Gregory W Faris •
- Jennifer Frey •
- Marianne Gausche-Hill •
- Sara F Goldkind •
- Matthew Hansen •
- Kammy Jacobsen •
- Julie C Leonard •
- Daniel K Nishijima •
- Amber D Rice •
- Mohsen Saidinejad •
- Manish I Shah •
- Doug Swanson •
- John M VanBuren •
- Wendi-Jo Wendt •
- Matthew Wilkinson •
- Henry E Wang
Demographic differences may exist between digital survey respondents and their targeted communities. Study teams should account for these factors when utilizing such platforms for EFIC CC....
- Chris A Rees •
- Dunia Hatabah •
- Rawan Korman •
- Fahd Ahmad •
- Gladstone Airewele •
- Bolanle Akinsola •
- Noor Alzraikat •
- Nitya Bakshi •
- David C Brousseau •
- Kathleen Brown •
- Andrew D Campbell •
- T Charles Casper •
- Todd P Chang •
- Corrie E Chumpitazi •
- Daniel Cohen •
- Keli D Coleman •
- Andrea T Cruz •
- Christopher Denton •
- Angela Ellison •
- Melanie E Fields •
- Monica Harding •
- Sara Leibovich •
- Allison Remiker •
- Nidhi V Singh •
- Alexis A Thompson •
- Elliott Vichinsky •
- Anthony Villella •
- Bridget Wynn •
- Carlton Dampier •
- Claudia R Morris •
- Pediatric Emergency Care Research Network (PECARN)
Analysis of the placebo cohort in the STArT trial shows that patient characteristics and hospital site strongly influence time-to-crisis-resolution and total opioid use in children and young adults with sickle cell disease, highlighting the need to account for these factors...
- Sriram Ramgopal
Children brought to pediatric hospitals by EMS more frequently presented with higher acuity of illness and/or injury, as suggested by multiple clinical outcomes. These findings underscore the importance of targeted clinical strategies and resource planning for this higher-risk population....
- Leah Marie Seften •
- Anya Cutler •
- Jay Kerecman •
- Ann Boomer •
- Alexa Craig •
- Leah Mallory •
- Allison Zanno •
- Misty Melendi
Level I/II hospitals need support in accessing critical resources, both physical resources and pathways for accessing neonatal specialists, including appropriate equipment and increasing the availability of teleconsultations. Educational and clinical support is needed to improve neonatal readiness, which may help...
- Elizabeth R Alpern •
- Halden F Scott •
- Fran Balamuth •
- James M Chamberlain •
- Holly Depinet •
- Lalit Bajaj •
- Norma-Jean E Simon •
- Camille P Carter •
- Cara Elsholz •
- Michael Webb •
- Diego Campos •
- Sara J Deakyne Davies •
- Lawrence J Cook •
- Lyle Ungar •
- Robert Grundmeier •
- PECARN PED Screen Study Group
CONCLUSIONS AND RELEVANCE: Using a large multicenter population, models were developed and validated with high AUROC to predict the future development of sepsis based on EHR data collected in the ED. The models achieved positive likelihood ratios to predict sepsis...
- Cheuk Kwok •
- Jamie Marliere •
- Shaye Busse •
- April Taniguchi •
- Kamal Chavda •
- Andrea Rivera-Sepulveda
This study aimed to evaluate the impact of a triage-based blunt trauma assessment (best practice advisory) on Pediatric Emergency Care Applied Research Network (PECARN)-guided recommendations and actual head computed tomography (CT) use in children <18 years old presenting with head...
- James M Chamberlain •
- Norma-Jean E Simon •
- Lalit Bajaj •
- Evaline Alessandrini •
- Robert W Grundmeier •
- Marc Gorelick •
- Blake Nielsen •
- Cody S Olsen •
- Sriram Ramgopal •
- Joseph J Zorc •
- Cara Elsholz •
- Lawrence J Cook •
- Elizabeth R Alpern •
- PECARN Registry Study Group
We demonstrate the feasibility of providing quality performance report cards to hospital leaders using EHR data. We found mixed results in terms of the effectiveness of improving site-level metrics. Future efforts may facilitate further refinement of these interventions prior to...
- Scott L Weiss •
- Fran Balamuth •
- Elliot Long •
- Graham C Thompson •
- Katie L Hayes •
- Hannah Katcoff •
- Marlena Cook •
- Elena Tsemberis •
- Christopher P Hickey •
- Amanda Williams •
- Sarah Williamson-Urquhart •
- Meredith L Borland •
- Stuart R Dalziel •
- Ben Gelbart •
- Stephen B Freedman •
- Franz E Babl •
- Jing Huang •
- Nathan Kuppermann •
- Pragmatic Pediatric Trial of Balanced Versus Normal Saline Fluid in Sepsis (PRoMPT BOLUS) Investigators of the PECARN, PERC, and PREDICT Networks
No abstract...
- Etimbuk Umana •
- Hannah Norman-Bruce •
- Clare Mills •
- Oenone Rodgers •
- Hannah Mitchell •
- Lisa McFetridge •
- Gareth McKeeman •
- Steve Foster •
- Michael Barrett •
- Damian Roland •
- Mark D Lyttle •
- Chris Watson •
- Thomas Waterfield •
- Paediatric Emergency Research in the UK and Ireland (PERUKI)
Both PECARN and Step-by-Step CDAs demonstrated high sensitivity for detecting IBI in our cohort. While specificity was relatively low, these tools could potentially identify a subset of low-risk infants suitable for less intensive management....
- Anne-Cécile Chiollaz •
- Virginie Pouillard •
- Michelle Seiler •
- Céline Habre •
- Fabrizio Romano •
- Céline Ritter Schenk •
- Fabian Spigariol •
- Christian Korff •
- Fabienne Maréchal •
- Verena Wyss •
- Lyssia Gruaz •
- Joan Montaner •
- Sergio Manzano •
- Jean-Charles Sanchez •
- t-BIOMAP investigators and participants
Mild traumatic brain injury (mTBI) in children is a public health concern resulting in one of the main causes of pediatric emergency department (PED) visits. However, the acute care of mTBI patients remains challenging due to the limited use of...
- Allan M Joseph •
- Kristin N Ray •
- Kristen S Kurland •
- Hilary A Hewes •
- Kathleen M Brown •
- Billie S Davis •
- Jeremy M Kahn
Pediatric access to high readiness EDs modestly declined over time, but some areas saw meaningful improvements. Excluding staffing-related readiness, which may have been affected by the COVID-19 pandemic, an increase in access was observed. Future work should examine regions with...
- Jonathan R Eisenberg •
- Ashley A Foster •
- Rachel Crady •
- Katherine Remick •
- Kristina Brumme •
- Hilary A Hewes
The presence of both a pediatric ED space and all hospital inpatient pediatric capabilities is associated with the highest WPRS. Having pediatric ED space is associated with higher WPRS than any specific pediatric inpatient unit....
- Alexandria J Wiersma •
- Blake Nielsen •
- Michael Webb •
- Elizabeth Alpern •
- David C Brousseau •
- James M Chamberlain •
- Joseph J Zorc •
- Lynn Babcock •
- Theresa Frey •
- Julie C Leonard •
- Samina Ali •
- Bradley J Barney •
- Amy L Drendel •
- PECARN IMPROVE and PECARN Registry Study Groups
Children with long bone fractures used nonpharmacologic interventions more frequently and for a longer duration than analgesic medications. Increasing age and pain severity at discharge were associated with greater use. Interventional studies are needed to provide evidence-informed recommendations for these...
- Fredrik Wickbom •
- Sarah Thornberg •
- Jorge Sotoca Fernandez •
- Rasmus Silfver •
- Niklas Marklund •
- Johan Undén •
- Scandinavian Neurotrauma Committee
BACKGROUND: Multiple clinical practice guidelines and head computed tomography decision rules exist for emergency department (ED) triage of children with traumatic brain injury (TBI). These vary in structure, aim, target cohort, and outcomes, yet are used clinically in similar populations....
- Ioannis Orfanos •
- Sanne Vrijlandt •
- Eline van der Walle •
- Chantal D Tan •
- Daan Nieboer •
- Tobias Alfvén •
- Jorge Sotoca Fernandez •
- Matilda Elliver •
- Kristina Elfving •
- Federico Martinón-Torres •
- Benno Kohlmaier •
- Werner Zenz •
- Marieke Emonts •
- Ruud Gerard Nijman •
- Enitan Carrol •
- Erik Eklund •
- Henriette A Moll •
- Rianne Oostenbrink
The PECARN rule demonstrated high NPV (similar to the derivation cohort) and high potential in ruling out SBIs in two new European cohorts. The rule maintained good performance with CRP instead of PCT, supporting the potential use of CRP in...
- Jennifer L Reed •
- Chella A Palmer •
- T Charles Casper •
- Erin M Augustine •
- Andrea T Cruz •
- Cara L Elsholz •
- Cynthia J Mollen •
- Michelle L Pickett •
- Sarah K Schmidt •
- Kristin S Stukus •
- Monika K Goyal
CONCLUSIONS AND RELEVANCE: In this comparative effectiveness trial, a targeted or universally offered screening tool in pediatric emergency departments was associated with higher detection rates than usual care, with targeted screening identifying higher rates of infections at the population level....
- Kenneth A Michelson •
- Joseph A Grubenhoff
Few EDs have sufficient pediatric volumes to reliably measure diagnostic accuracy generally, and even fewer can do so for individual conditions. Aggregation of EDs could improve power to measure misdiagnosis....
- Ibrahim Gwarzo •
- Keli D Coleman •
- Kenneth McKinley •
- Angela M Ellison •
- Elizabeth R Alpern •
- Jacqueline Corboy •
- Selena Hariharan •
- Irina Topoz •
- Morgan Wurtz •
- Blake Nielsen •
- Lawrence J Cook •
- Claudia R Morris •
- Amanda M Brandow •
- Andrew D Campbell •
- Robert I Liem •
- Rachelle Nuss •
- Charles T Quinn •
- Alexis A Thompson •
- Anthony Villella •
- Allison A King •
- Ana Baumann •
- Warren Frankenberger •
- David C Brousseau
CONCLUSIONS AND RELEVANCE: This cross-sectional study found that timely receipt of opioids was associated with a reduction in hospitalizations for SCD pain. The largest decrease in hospitalization was achieved with the first dose within 60 minutes and the second dose...
Prediction Rule to Identify Febrile Infants 61-90 Days at Low Risk for Invasive Bacterial Infections
- Paul L Aronson •
- Prashant Mahajan •
- Huong D Meeks •
- Blake Nielsen •
- Cody S Olsen •
- T Charles Casper •
- Robert W Grundmeier •
- Nathan Kuppermann •
- PECARN Registry Working Group
We derived 2 accurate clinical prediction rules to identify febrile infants aged 61-90 days at low risk of IBIs when urine and blood testing are obtained. Prospective validation is needed....
- Remzi Çetinkaya •
- Ali Cankut Tatlıparmak •
- Mehmet Özel •
- Sarper Yilmaz
In this CT-based cohort of infants under 3 months, CHALICE achieved the best balance by detecting all TBI cases with fewer scans than PECARN. CATCH missed two TBIs despite modest CT reduction. Multivariable modeling and dimensionality reduction supported integrated, data-driven...
- Lorin R Browne •
- Caleb E Ward •
- Monica Harding •
- Lawrence J Cook •
- Kathleen M Adelgais •
- Fahd A Ahmad •
- Rebecca Burger •
- Pradip P Chaudhari •
- Daniel J Corwin •
- Nicolaus W Glomb •
- Nathan Kuppermann •
- Lois K Lee •
- Jeffrey R Leonard •
- Sylvia Owusu-Ansah •
- Lauren C Riney •
- Alexander J Rogers •
- Daniel M Rubalcava •
- Robert E Sapien •
- Matthew A Szadkowski •
- Leah Tzimenatos •
- Kenneth Yen •
- Julie C Leonard
The PECARN CSI prediction rule based on EMS clinician observations had good accuracy for CSI in children experiencing blunt trauma. Application of the prediction rule to our EMS patient population would have reduced both SMR and longboard use....
- Christie J Bruno •
- Thomas Balga •
- Megan Gray •
- Lindsay C Johnston •
- Marc A Auerbach
EDs had most of the equipment required for newborn resuscitation. There were significant deviations from evidence-based NRP guidelines, specifically not prioritizing effective ventilation and starting chest compressions prematurely. There is continued need to develop and sustain NRP skills in EDs,...
- Amy Berardinelli •
- Katelyn Howell •
- Margaret Allen •
- Laurie Engler •
- Prabi Rajbhandari •
- Daniel Goldstein
This QI project successfully engaged staff in understanding the importance of using a safe discharge scoring tool in the perianesthesia environment. The integration of Phase I and Phase II discharge scoring tools in adult and pediatric perianesthesia departments worldwide can...
- Cindy G Roskind •
- David Schnadower •
- Alexander J Rogers •
- T Charles Casper •
- Phillip I Tarr •
- Adam C Levine •
- Seema R Bhatt •
- Serge Gouin •
- Prashant Mahajan •
- Cheryl Vance •
- Katrina F Hurley •
- Jesse G Norris •
- Elizabeth C Powell •
- Ken J Farion •
- Robert E Sapien •
- Karen J O'Connell •
- Naveen Poonai •
- Suzanne Schuh •
- Stephen B Freedman •
- Pediatric Emergency Research Canada (PERC) and the Pediatric Emergency Care Applied Research Network (PECARN)
CONCLUSIONS: We describe the clinical course of viral and bacterial pathogens. Although statistically significant, differences in symptom severity across pathogens were not clinically meaningful for distinguishing between them based on symptoms alone.
- Sara Alsuwais •
- Charlotte Kennedy •
- Silvia Bressan •
- Mark Lyttle •
- Richard Body
Traumatic brain injury (TBI) affects an estimated 330,000 to 500,000 children annually in England and Wales and represents a significant burden on healthcare systems. Presentations range from mild to severe, and each case presents unique challenges to the Emergency Department...
- Pedro Abreu •
- Dalila Forte •
- Miguel Correia •
- Mário Matos •
- Amets Sagarribay
This study reinforces the usefulness of PECARN rule guiding CT scans prescription and patients´ management. Parietal/temporal/occipital scalp haematoma, being under 3 months of age and having more than two vomits are associated traumatic CT findings. Preventable head trauma frequency underlines...
- Vishal Naik •
- Pranshu Bhardwaj •
- Sriram Ramgopal
More than two-thirds of children transported to the ED by air are either discharged from the ED or within 48 h of admission. Race, ethnicity, payer status, low triage acuity, and missing vital sign information were associated with ED discharge....
- Sydney E Jeffs •
- Cathlyn K Medina •
- Parker Frankiewicz •
- Steven W Thornton •
- Elizabeth Horne •
- Smith Ngeve •
- Tara Thomason •
- Delaney Anani-Wolf •
- Catherine B Beckhorn •
- Delaney James •
- Rachel Hobbs •
- Remi Hueckel •
- Corrie E Chumpitazi •
- Erin R Hanlin •
- Rachel O'Brian •
- Elisabeth T Tracy •
- Emily Greenwald
INTRODUCTION: Existing mass casualty incident (MCI) simulations rely on high-fidelity patient simulators, which are cost-prohibitive and often exclude pediatric patients. To address the need for deployable, low-fidelity pediatric MCI simulations, we developed and evaluated a cost-conscious model to teach the...
- Gwendolyn C Hooley •
- Julia N Magana •
- Jason M Woods •
- Shyam Sivasankar •
- Lauren VonHoltz •
- Anita R Schmidt •
- Todd P Chang •
- Michelle Lin
Our logic model roadmap, based on our practical multiyear experience and data-driven strategies, can serve as a guide for research organizations or medical institutions aiming to incorporate Twitter or other social media platforms for research dissemination....
- Fahd A Ahmad •
- Lorin R Browne •
- Nicolaus W Glomb •
- Monica Harding •
- Lawrence J Cook •
- Rebecca K Burger •
- Pradip P Chaudhari •
- Alexander J Rogers •
- Caleb E Ward •
- Daniel Rubalcava •
- Kenneth Yen •
- Nathan Kuppermann •
- Julie C Leonard
We identified moderate to substantial agreement between EM providers and surgeons for clinical findings that comprise the PECARN Cervical Spine Injury Prediction Rule. Agreement between providers during shared decision-making will strengthen the use of the prediction rule and may lead...
- Jennifer A Hoffmann •
- Ashley A Foster •
- Christopher J Gable •
- Kristen E Carlin •
- Alba Pergjika •
- Kimberly Burkhart •
- Theresa R Schultz •
- Sara Mullins •
- Desiree Edemba •
- Mohsen Saidinejad
Approximately 1 in 3 pediatric mental health ED visits resulting in admission or transfer exceeded 12 hours. Differences in boarding by race, ethnicity, and insurance type reflect inequities in access to psychiatric services. To reduce ED boarding, attention is needed...
- Paul L Aronson •
- Prashant Mahajan •
- Blake Nielsen •
- Cody S Olsen •
- Huong D Meeks •
- Robert W Grundmeier •
- Nathan Kuppermann •
- PECARN Registry Working Group
The prevalence of bacterial infections is lower in respiratory virus-positive febrile infants aged 61 to 90 days. These findings may help inform use of respiratory viral testing in the evaluation for UTIs, bacteremia, and meningitis in this age group....
- Micaela K Gomez •
- Elizabeth C Wood •
- Maximilian Peter Forssten •
- Timothy K Williams •
- Sebastian Peter Forssten Md •
- Babak Sarani •
- Shahin Mohseni •
- Lucas P Neff
Gunshot wounds in children pose unique clinical challenges. Majority of cases are cared for at ATCs. Analysis of best available data did not demonstrate a benefit to managing these patients at a PTC. Conversely, ATCs were not superior, despite managing...
- Matthew S Marks •
- Anna Liveris •
- Stephen M Blumberg •
- Srinivas H Reddy •
- James A Meltzer
Traumatic pancreatitis is uncommon but associated with significant morbidity and mortality. Pancreatic enzyme testing is not ordered consistently. Computed tomography misses about a quarter of cases of pancreatitis. Utilizing the PECARN prediction rule can help identify children at risk for...
- Lauren M Ameden •
- Elizabeth R Alpern •
- Monika K Goyal •
- Lawrence J Cook •
- Katie A Donnelly •
- with the FACTS Consortium and the PECARN Registry Study Group
Nonpowder firearms remain a source of preventable injuries in children and involve substantial health care resources. Most commonly, these injuries are inflicted by children and are accidental, though assaults also account for at least 1 in 7 injuries. These data...
- Heather Tilley •
- Anthony Enderby •
- Elizabeth VanWert •
- Sara Choi
Higher levels of pediatric readiness provide an opportunity to improve outcomes for pediatric patients across the US. Medication errors, behavioral health emergencies, and substance use are some of the most pertinent issues affecting pediatric patients seeking emergency care today. By...
- Corrie E McDaniel •
- Mark Ralston Daniel •
- Seneca D Freyleue •
- Edouard Seryozhenkov •
- Amit Peled •
- Harsha Amaravadi •
- Niharika Malla •
- JoAnna K Leyenaar
CONCLUSIONS AND RELEVANCE: In this cross-sectional study of commonly used datasets, reporting of pediatric service provision varied significantly. As these datasets inform pediatric health care policy, these results may guide approaches to optimize service line definitions....
- Ann R Johnson •
- Naomi O Riches •
- John M VanBuren •
- Ana E Corona •
- Kammy Jacobsen •
- Shu Yang •
- Manish I Shah •
- Pediatric Emergency Care Applied Research Network (PECARN) PediDOSE Study Investigators
CONCLUSIONS: Parent interviews added to our understanding beyond the themes identified in the consultation interviews. The theme of therapeutic misconception was not found in the consultation interviews, possibly due to the child's emergency medical care being theoretical. With modest accommodations, collection of additional demographic and follow-up interview data can successfully assess key elements of community consultation efficacy for EFIC trials.
- Keli D Coleman •
- Kenneth McKinley •
- Angela M Ellison •
- Elizabeth R Alpern •
- Selena Hariharan •
- Irina Topoz •
- Morgan Wurtz •
- Blake Nielsen •
- Lawrence J Cook •
- Claudia R Morris •
- Amanda M Brandow •
- Andrew D Campbell •
- Robert I Liem •
- Rachelle Nuss •
- Charles T Quinn •
- Alexis A Thompson •
- Anthony Villella •
- Allison A King •
- Ana Baumann •
- Warren Frankenberger •
- David C Brousseau •
- PECARN Registry Working Group
Rapid treatment and frequent reassessment of pain are key components of treatment guidelines for acute sickle cell disease (SCD) pain. Few studies, however, report the associations between emergency department (ED) pain scores, number of ED opioid doses, receipt of an...
- Natalie Phillips •
- Geoffrey N Askin •
- Gavin A Davis •
- Sharon O'Brien •
- Meredith L Borland •
- Amanda Williams •
- Amit Kochar •
- Blessy John-Denny •
- Sarah Watson •
- Shane George •
- Michelle Davison •
- Stuart Dalziel •
- Eunicia Tan •
- Shu-Ling Chong •
- Simon Craig •
- Arjun Rao •
- Susan M Donath •
- Chris J Selman •
- Stacy Goergen •
- Catherine L Wilson •
- Sonia Singh •
- Nathan Kuppermann •
- Julie C Leonard •
- Franz E Babl
INTRODUCTION: Paediatric cervical spine injury (CSI) is uncommon but can have devastating consequences. Many children, however, present to emergency departments (EDs) for the assessment of possible CSI. While imaging can be used to determine the presence of injuries, these tests...
- Ashley A Foster •
- Jonathan Eisenberg •
- Rachel Crady •
- Hilary A Hewes •
- Katherine E Remick
No abstract...
- Judy A Beal
No abstract...
- Lisa Hill •
- Robin Goodman •
- Lisa Gray •
- Michelle Moegling •
- Rachel Crady •
- Joanna Saucedo •
- Hilary A Hewes
INTRODUCTION: Children present to emergency departments regardless of their readiness to care for pediatric patients. The National Pediatric Readiness Project is an initiative to improve pediatric emergency care. Increased National Pediatric Readiness Project scores have been associated with decreased mortality....
- Christine Aspiotes •
- Hilary Hewes •
- Rachel Crady •
- Katherine Remick •
- Stephen Janofsky •
- Joyce Li
Hospitals that lost a PECC in 2021 compared to 2013 had a lower overall aWPRS and in individual domains, suggesting the importance of a PECC in pediatric readiness initiatives....
- Gabriele Savioli •
- Iride Francesca Ceresa •
- Andrea Piccioni •
- Yaroslava Longhitano •
- Raymond Planinsic •
- Michele Dorfsman •
- Antonio Voza •
- Federica Manzoni •
- Giorgia Caputo •
- Abdelouahab Bellou •
- Luigi La Via •
- Christian Zanza
The adoption of the PECARNE algorithm led to fewer brain computed tomography scans with good clinical outcomes without increasing crowding....
- Daniel S Tsze •
- Rebecca K Burger •
- Eileen J Klein •
- Todd P Chang •
- Neil G Uspal •
- Alessandra Guiner-da Silva •
- Lorin R Browne •
- Keli D Coleman •
- Corrie E Chumpitazi •
- Amy L Drendel •
- PECARN Analgesia and Sedation Working Group
The 10 research questions identified as highest priority can inform future work by researchers, funders, policy makers, and other key decision makers who aim to meaningfully advance the management of pain in children cared for in the emergency care setting....
- Scott L Weiss •
- Julie C Fitzgerald •
- Benjamin L Laskin •
- Ruchi Singh •
- Amanda S Artis •
- Ananya Vohra •
- Elena Tsemberis •
- Emem Kierian •
- Kristen C Lau •
- Atzael B Campos •
- Christopher Hickey •
- Katie L Hayes •
- Daniel Singleton •
- Elliot Long •
- Franz E Babl •
- Stuart R Dalziel •
- Graham C Thompson •
- Stephen B Freedman •
- Michelle Eckerle •
- Robert W Hickey •
- Jing Huang •
- Nathan Kuppermann •
- Fran Balamuth •
- Pragmatic Pediatric Trial of Balanced vs. Normal Saline Fluid in Sepsis (PRoMPT BOLUS) Investigators of the Pediatric Emergency Care Applied Research Network (PECARN), Pediatric Emergency Research Canada (PERC), and Pediatric Research in Emergency Departments International Collaborative (PREDICT) Networks
Although kidney injury biomarkers mirrored serum creatinine in children with septic shock, elevated Ur-NGAL identified a subset with subclinical AKI with fewer hospital-free days despite no/stage 1 AKI by creatinine. Children receiving greater than 100 mL/kg fluid had greater odds...
- Allison B Frederick •
- Adam M Vogel •
- Regan F Williams •
- Jingwen Zhang •
- Eunice Y Huang •
- Kate B Savoie •
- Matthew T Santore •
- Kuojen Tsao •
- Richard A Falcone •
- Melvin S Dassinger •
- Jeffrey H Haynes •
- Robert T Russell •
- Bindi J Naik-Mathuria •
- Shawn D St Peter •
- David P Mooney •
- Chinwendu Onwubiko •
- Martin L Blakely •
- Christian J Streck
Although the PECARN prediction rule has excellent NPV for identifying patients with intra-abdominal injuries needing an acute intervention, it fails to detect some children with clinically impactful intra-abdominal injuries that required additional management. The addition of trauma bay laboratories and...
- Micaela K Gomez •
- Lucas P Neff
Pediatric hemorrhagic shock is a life-threatening condition associated with significant morbidity and mortality. While extensive literature guides resuscitation practices in adults, evidence for pediatric patients is evolving. The management of hemorrhagic shock in children is further complicated by their anatomic...
- Anna L DeVeaux •
- Carla Hall-Moore •
- Nurmohammad Shaikh •
- Meghan Wallace •
- Carey-Ann D Burnham •
- David Schnadower •
- Nathan Kuppermann •
- Prashant Mahajan •
- Octavio Ramilo •
- Phillip I Tarr •
- Gautam Dantas •
- Drew J Schwartz
The intestine plausibly serves as a reservoir for EBI pathogens in a subset of febrile term infants, prompting consideration of new opportunities for surveillance and EBI prevention among colonized, pre-symptomatic infants. Video Abstract....
- Michelle Pintea •
- Anna Lin •
- Julie Shelton •
- Rachel Charney •
- Sarita Chung
Comprehensive planning for family reunification following a disaster is complex and often underdeveloped, especially in hospitals. The 2013 and subsequent 2021 National Pediatric Readiness Project revealed less than half of hospitals had disaster plans that addressed the needs of children....
- Tara F Corcoran •
- Sriram Ramgopal •
- Jennifer A Hoffmann •
- Kenneth A Michelson
Low-value testing occurred in one fifth of ED visits for children with a study condition. The relationship of ED volume to low-value testing was inconsistent across conditions....
- Michael D Johnson •
- Bashar S Shihabuddin •
- Bradley J Barney •
- Mengtao Dai •
- Toni Harbour •
- Yeojin Jung •
- Kameron N Clinton •
- Breanna Vance •
- Madison Reilly •
- Joseph J Zorc •
- IMPACT‐ED Collaborators of the Pediatric Emergency Care Applied Research Network (PECARN)
Most anticipated blood pressure measurements and blood samples were obtained. Hypotension occurred at rates similar to previous reports. Lower-than-expected enrollment (related to low patient volumes) and timely delivery of study drug will require consideration for a larger trial....
- Caleb E Ward •
- Lorin R Browne •
- Alexander J Rogers •
- Monica Harding •
- Lawrence J Cook •
- Robert E Sapien •
- Kathleen M Adelgais •
- Leah Tzimenatos •
- Fahd A Ahmad •
- Sylvia Owusu-Ansah •
- Julie C Leonard •
- Pediatric Emergency Care Applied Research Network (PECARN) Cervical Spine (C-Spine) Study Group
Of children transported by EMS after blunt trauma in this study, 41.5% had SMR placed, while only 1.6% had CSIs. Factors associated with SMR placement included patient demographics, mechanism of injury, history, and examination findings. Many of these factors are...
- Aaron E Kornblith •
- Chandan Singh •
- Johanna C Innes •
- Todd P Chang •
- Kathleen M Adelgais •
- Maija Holsti •
- Joy Kim •
- Bradford McClain •
- Daniel K Nishijima •
- Steffanie Rodgers •
- Manish I Shah •
- Harold K Simon •
- John M VanBuren •
- Caleb E Ward •
- Catherine R Counts
Large language models (LLMs) can improve text analysis efficiency in healthcare. This study explores the application of LLMs to analyze patient perspectives within the exception from informed consent (EFIC) process, which waives consent in emergency research. Our objective is to...
- Molly Greenshields •
- Michael C Monuteaux •
- Kate Dorney •
- Angelica Garcia •
- Lois K Lee •
- Caitlin A Farrell
Among children receiving EMS care after drowning, 23.9% were critically ill, and predictors of critical illness included male sex, young age, and nonurban locations. Using national EMS data is a novel approach to inform prehospital and emergency department preparedness to...
- Anne-Cécile Chiollaz •
- Virginie Pouillard •
- Michelle Seiler •
- Céline Habre •
- Fabrizio Romano •
- Céline Ritter Schenck •
- Fabian Spigariol •
- Christian Korff •
- Fabienne Maréchal •
- Verena Wyss •
- Lyssia Gruaz •
- Joan Montaner •
- Jean-Charles Sanchez •
- Sergio Manzano
NfL and NTproBNP were described for the first time in children suffering mTBI. Their performances were comparable to well-known biomarkers, such as S100b, GFAP, or HFABP, with the benefit of already being used in routine tests for other diseases. Further...
- Jennifer F Anders •
- Camille Anderson •
- Cynthia Wright-Johnson •
- Karen J O'Connell
Prehospital high-performance cardiopulmonary resuscitation (CPR) has demonstrated remarkable improvements in the survival of adult patients after out-of-hospital cardiac arrest (OHCA). With a goal to improve pediatric survival rates, Maryland Emergency Medical Services (EMS) for Children created a pediatric-specific high-performance CPR...
- Caroline Melhado •
- Canaan Hancock •
- Haoyu Wang •
- Maya M Eldin •
- Nicholas George •
- Jennifer A Miller •
- Katherine E Remick •
- Bhavin Patel •
- Brian K Yorkgitis •
- Lisa Gray •
- Michael W Dingeldein •
- Hilary A Hewes •
- Katie W Russell •
- Michael L Nance •
- Aaron R Jensen
These findings suggest that access to pediatric trauma center care is limited, even with air ambulance transport. Ensuring pediatric readiness at all high-level adult trauma centers may substantially improve access to early high-quality initial resuscitative trauma care for children....
- Karen Roush
Better staffing and equipment would save lives and costs, studies find....
- Türker Demirtakan •
- Semra Işık •
- Tugay Usta •
- Ahmed Edizer •
- Serkan Doğan
This study demonstrates the potential effectiveness of telemedicine in monitoring children with concussions, especially in regions with diverse socioeconomic backgrounds and overcrowded metropolitan hospitals....
- Deanna Dahl-Grove •
- Sarita Chung •
- Ronald Ruffing •
- Mary E Fallat •
- Michael Dingeldein •
- Jennifer H Aldrink •
- Mauricio Antonio Escobar
Disaster events such as weather events and mass casualty events are increasing in frequency and severity. Caring for children during a surge requires a regional approach given limited pediatric inpatient capacity and expertise. During the 2024 American Academy of Pediatrics...
- Sonia Y Jarrett •
- Andrew Redfern •
- Joyce Li •
- Camilo E Gutierrez •
- Priyanka Patel •
- Olurotimi Akinola •
- Michelle L Niescierenko
To date, this is the first assessment tool dedicated to the comprehensive evaluation of pediatric emergency care in LMICs. This pilot provides a first approach to evaluate pediatric emergency healthcare capabilities in the hospital setting with future directions to improve...
- Cosby G Arnold •
- Paul Ishimine •
- Kevan A McCarten-Gibbs •
- Kenneth Yen •
- Nisa Atigapramoj •
- Mohamed Badawy •
- Irma T Ugalde •
- Pradip P Chaudhari •
- Jeffrey S Upperman •
- Nathan Kuppermann •
- James F Holmes
Few children with blunt torso trauma and one or two PECARN predictor variables present have IAI^(AI). Those with GCS score <14, however, are at highest risk for IAI^(AI)....
- Michelle J Alletag •
- Shruti Kant •
- Wendy L Van Ittersum •
- Theresa A Walls •
- Erin E Montgomery •
- Hannah L Anderson •
- Mark S Mannenbach •
- Marc A Auerbach
Understanding the key drivers of all collaborators is instrumental in successfully implementing large-scale educational and quality initiatives like the ImPACTS program....
- Joseph E Rower •
- Michael D Johnson •
- Joseph J Zorc •
- Bashar Shihabuddin •
- Mengtao Dai •
- Bradley J Barney •
- Yaron Finkelstein
Pediatric asthma exacerbations represent a significant cause of emergency department use and hospitalizations. Despite available treatment options, many children's exacerbations are refractory to standard therapies and require adjunct treatments. The Intravenous Magnesium: Prompt use for Asthma in Children Treated in...
- Maha A Alzahrani •
- Manal F Alharbi
Background/Objectives: Preparing families to support children after hospital discharge is crucial, particularly due to the fragile health of pediatric patients and the care required at home. In this study, the aim was to assess the readiness for hospital discharge among...
- Rachel Rivero •
- Isabelle L Curran •
- Zane Hellmann •
- Madeleine Carroll •
- Matthew Hornick •
- Daniel Solomon •
- Michael DiLuna •
- Patricia Morrell •
- Emily Christison-Lagay
BACKGROUND: The Pediatric Emergency Care Applied Research Network (PECARN) guidelines provide an algorithm to select patients with mild head trauma at highest risk for clinically important traumatic brain injury (ciTBI) in whom computed tomography (CT) would facilitate management. Failure to...
- Margaret E Samuels-Kalow •
- Rebecca E Cash •
- Kenneth A Michelson •
- Courtney Benjamin Wolk •
- Katherine E Remick •
- Stephanie S Loo •
- Maeve F Swanton •
- Elizabeth R Alpern •
- Kori S Zachrison •
- Carlos A Camargo
CONCLUSIONS AND RELEVANCE: The presence of a PECC was not consistently associated with quality-of-care measures. The presence of a PECC was variably associated with performance on imaging utilization measures, suggesting a potential influence of PECCs on clinical care processes. Additional...
- Paul L Aronson •
- Nathan Kuppermann •
- Prashant Mahajan •
- Blake Nielsen •
- Cody S Olsen •
- Huong D Meeks •
- Robert W Grundmeier •
- PECARN Registry Working Group
This highly accurate NLP algorithm can identify febrile infants without documented fevers in the ED to facilitate their inclusion in large studies using EHR data....
- Antoine Puravet •
- Charlotte Oris •
- Bruno Pereira •
- Samy Kahouadji •
- Philippe Gonzalo •
- Damien Masson •
- Julie Durif •
- Catherine Sarret •
- Vincent Sapin •
- Damien Bouvier
BACKGROUND: Many children with mild traumatic brain injury (mTBI), defined by a Glasgow Coma Scale (GCS) score between 13 and 15, undergo hospitalisation or cranial CT (CCT) scans despite the absence of clinically important traumatic brain injury (ciTBI; ie, hospitalisation...
- Kenneth W Gow •
- Mary E Fallat •
- Jonathan E Kohler
Pediatric readiness is essential to the care of children in rural areas. When pediatric specialty care is not immediately accessible, rural clinicians may be required to care for ill or injured children for extended periods of time. Having established programs...
- Sarah K Schmidt •
- Judith W Dexheimer •
- Joseph J Zorc •
- Chella A Palmer •
- T Charles Casper •
- Kristin S Stukus •
- Michelle L Pickett •
- Cynthia J Mollen •
- Cara L Elsholz •
- Andrea T Cruz •
- Erin M Augustine •
- Monika K Goyal •
- Jennifer L Reed
Successful deployment of patient-facing screeners with integrated electronic CDS across multiple healthcare institutions is feasible. A combination of different types of IT and informatics expertise with local knowledge of clinical workflows is essential to success....
- A Kyle Cecil •
- Julianne M Cyr •
- Hussein Ahmad •
- Angela Strain •
- Alexander B Requarth •
- Jane H Brice
EMS responded to a vast variety of drug misuse among pediatric patients including prescription medications, alcohol, marijuana, and illicit drugs. Accidental ingestions occurred exclusively in infant/preschool ages and intent for recreation or self-harm primarily occurred in adolescents. By increasing awareness...
State and National Estimates of the Cost of Emergency Department Pediatric Readiness and Lives Saved
- Craig D Newgard •
- Amber Lin •
- Jeremy D Goldhaber-Fiebert •
- Katherine E Remick •
- Marianne Gausche-Hill •
- Randall S Burd •
- Susan Malveau •
- Jennifer N B Cook •
- Peter C Jenkins •
- Stefanie G Ames •
- N Clay Mann •
- Nina E Glass •
- Hilary A Hewes •
- Mary Fallat •
- Apoorva Salvi •
- Brendan G Carr •
- K John McConnell •
- Caroline Q Stephens •
- Rachel Ford •
- Marc A Auerbach •
- Sean Babcock •
- Nathan Kuppermann
CONCLUSIONS AND RELEVANCE: In this cohort study, raising all EDs to high pediatric readiness was estimated to prevent more than one-quarter of deaths among children receiving emergency services, with modest financial investment. State and national policies that raise ED pediatric...
- Laura G Burke •
- Jeanette I Beaute •
- Kenneth A Michelson
No abstract...
- Nick Lesyk •
- Scott W Kirkland •
- Cristina Villa-Roel •
- Sandra Campbell •
- Lynette D Krebs •
- Bill Sevcik •
- Nana Owusu Essel •
- Brian H Rowe
Implementing interventions in EDs with high baseline CT ordering using complex interventions was more likely to reduce head imaging in children with mTBIs. Including the PECARN decision rule in the intervention strategy decreased orders by a median of 27%. Further...
- Christopher Weyant •
- Amber Lin •
- Craig D Newgard •
- Nathan Kuppermann •
- Marianne Gausche-Hill •
- Katherine E Remick •
- Hilary A Hewes •
- Randall S Burd •
- N Clay Mann •
- Stefanie G Ames •
- Brendan G Carr •
- Susan Malveau •
- K John McConnell •
- Jennifer N B Cook •
- Jeremy D Goldhaber-Fiebert
The quality of emergency department (ED) care for children in the US is highly variable. The National Pediatric Readiness Project aims to improve survival for children receiving emergency services. We conducted a cost-effectiveness analysis of increasing ED pediatric readiness, using...
- Donna C Koo •
- Jennifer Xie •
- Mitchell R Price •
- Samuel Z Soffer •
- Lawrence Bodenstein
In pediatric patients, the risk of ciTBI after TDS is low. TDS should not be treated as a free fall in risk assessment....
- Niccolò Parri •
- Martina Giacalone •
- Marco Greco •
- Arianna Aceti •
- Ersilia Lucenteforte •
- Iuri Corsini •
- NeonATal Injury preVention rEsearch (NATIVE) group
Severe neonatal head injuries are rare, and most neonatal head injuries have a favourable outcome, making observation a suitable approach, while remaining vigilant for signs of non-accidental injuries....
- Kathryn Kothari •
- Manish I Shah •
- Andrea L Genovesi •
- Marianne Gausche-Hill •
- Sylvia Owusu-Ansah •
- Hilary Hewes •
- Brian Moore •
- Katherine Remick
The inaugural PPRP Assessment was open access May through July 2024, and the results will be used to guide future PPRP efforts....
- Jeremy Perlman
New American Academy of Pediatrics (AAP) guidelines were published in 2021 for the evaluation and management of well-appearing febrile infants from age 8 to 60 days. This first guideline of its kind from the AAP brings together increasing evidence from...
- Franz E Babl •
- Silvia Bressan
No abstract...
- Ashley A Foster •
- Jennifer A Hoffmann •
- Rachel Crady •
- Hilary A Hewes •
- Joyce Li •
- Lawrence J Cook •
- Susan Duffy •
- Mark Johnson •
- Merritt Schreiber •
- Mohsen Saidinejad
Although pediatric readiness for BH conditions increased from 2013 to 2021, gaps remain, particularly among rural EDs and designated trauma centers. Having nurse and physician PECCs is a modifiable strategy to increase ED pediatric readiness pertaining to BH....
- Azusa Ono •
- Shingo Ishimori •
- Yuki Wada •
- Kazuhiro Yamamoto •
- Tadashi Shinomoto •
- Satoshi Onishi •
- Toshio Shimokawa •
- Yo Okizuka •
- Atsuko Harada
To assess the clinical significance of repeated head imaging in children with minor blunt force head trauma who underwent computed tomography (CT), limited to those who exclude with very low risk of important traumatic brain injury. We conducted a retrospective...
- John M VanBuren •
- Russell K Banks •
- Nathan Kuppermann •
- Jeffrey S Gerber •
- Richard M Ruddy •
- T Charles Casper •
- Todd A Florin •
- Pediatric Emergency Care Applied Research Network (PECARN)
Objective outcomes for pediatric community-acquired pneumonia (CAP) are lacking. The desirability of outcome ranking (DOOR) and response adjusted for duration of antibiotic risk (RADAR) outcome encompass clinical benefit and adverse effects, while also accounting for antibiotic exposure. We evaluated DOOR...
- Craig D Newgard •
- Shauna Rakshe •
- Apoorva Salvi •
- Amber Lin •
- Jennifer N B Cook •
- Marianne Gausche-Hill •
- Nathan Kuppermann •
- Jeremy D Goldhaber-Fiebert •
- Randall S Burd •
- Susan Malveau •
- Peter C Jenkins •
- Caroline Q Stephens •
- Nina E Glass •
- Hilary Hewes •
- N Clay Mann •
- Stefanie G Ames •
- Mary Fallat •
- Aaron R Jensen •
- Rachel L Ford •
- Angela Child •
- Brendan Carr •
- Kendrick Lang •
- Kyle Buchwalder •
- Katherine E Remick
CONCLUSIONS AND RELEVANCE: Although the findings of this study of injured children in US trauma centers were not statistically significant, they suggest that trauma centers should increase their level of ED pediatric readiness to reduce mortality and increase the number of pediatric lives saved after injury.
- Jordanna H Koppel •
- Sarina Levy-Mendelovich •
- Assaf A Barg •
- Tami Brutman Barazani •
- Shoham Baruch •
- Oren Feldman
No abstract...
- Katherine Remick •
- Marianne Gausche-Hill
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier...
- Hannah Canter •
- Jennifer Reed •
- Chella Palmer •
- T Charles Casper •
- Kristin Stukus •
- Sarah Schmidt •
- Michelle Pickett •
- Cynthia Mollen •
- Cara Elsholz •
- Andrea T Cruz •
- Erin Augustine •
- Monika K Goyal
CONCLUSIONS AND RELEVANCE: In this cross-sectional study of sexually active adolescents presenting to the ED, the majority of participants reported using at least 1 form of contraception; however, LARCs were the least used option, and 28.9% of participants reported no...
- Sriram Ramgopal •
- Christian Martin-Gill •
- Kenneth A Michelson
A low proportion of children have documentation of complete vital signs, highlighting areas in need of improvement to better align with pediatric readiness quality initiatives. A high proportion of children had abnormal vital signs using PALS criteria. Few abnormalities were...