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.
- 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. Leveraging quality improvement (QI) language and methodology allows for alignment and engagement of hospital leaders and personnel unaccustomed to disaster planning. We aimed to create a family reunification...
- Tara F Corcoran •
- Sriram Ramgopal •
- Jennifer A Hoffmann •
- Kenneth A Michelson
CONCLUSIONS: 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)
CONCLUSIONS: 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
CONCLUSIONS: 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 not in the new PECARN CSI clinical prediction rule. Implementation of a risk-centered EMS decision aid for SMR in children after blunt trauma must address this discrepancy.
- 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 assess whether LLMs can analyze patient perspectives in EFIC interviews with performance comparable to human reviewers. We analyzed 102 EFIC community interviews from 9 sites, each with 46 questions, as part of the...
- Molly Greenshields •
- Michael C Monuteaux •
- Kate Dorney •
- Angelica Garcia •
- Lois K Lee •
- Caitlin A Farrell
CONCLUSIONS: 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 improve care for pediatric patients after drowning including pediatric resuscitation procedures by EMS personnel.
- 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
CONCLUSION: 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 large-scale studies are necessary to verify and validate these results.
- 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 protocol to align with the existing state protocol for adult CPR. While prehospital CPR for adults has moved toward continuous compressions, prehospital CPR for...
- 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
CONCLUSION: 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
CONCLUSION: 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 National Convention and Exhibition, the Section on Surgery and Council on Children and Disasters (COCD) partnered to present a joint symposium emphasizing importance of pediatric readiness and disaster preparedness and role...
- Sonia Y Jarrett •
- Andrew Redfern •
- Joyce Li •
- Camilo E Gutierrez •
- Priyanka Patel •
- Olurotimi Akinola •
- Michelle L Niescierenko
CONCLUSIONS: 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 the tool based on qualitative feedback.
- 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
CONCLUSIONS: 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
CONCLUSION: 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 the Emergency Department study investigated the pharmacology of intravenous magnesium sulfate (IVMg) in treating pediatric asthma exacerbations. Specifically, the objectives of the...
- 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 primary caregivers of pediatric patients in medical-surgical units in Jeddah, Saudi Arabia, and to identify factors influencing their preparedness. Methods: A quantitative cross-sectional study was conducted among 258 primary...
- 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 follow PECARN criteria exposes children to unnecessary radiation and contributes to increasing hospital costs, length of stay, and parental anxiety. We sought to evaluate the subsequent allocation of...
- 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 studies are needed to understand the role of PECCs in driving adherence to clinical care guidelines and improving quality and patient outcomes.
- Paul L Aronson •
- Nathan Kuppermann •
- Prashant Mahajan •
- Blake Nielsen •
- Cody S Olsen •
- Huong D Meeks •
- Robert W Grundmeier •
- PECARN Registry Working Group
CONCLUSIONS: 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 >2 days associated with intracranial lesions on CCT, neurosurgical intervention, intensive care admission, or death). Clinical algorithms have reduced CCT scans and hospitalisations by 10%. We aimed to established...
- 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 for pediatric care, including validated quality and safety programs that emphasize pediatric readiness, is an essential component to caring for rural children. Being prepared to care for children in routine situations is vital to being...
- A Kyle Cecil •
- Julianne M Cyr •
- Hussein Ahmad •
- Angela Strain •
- Alexander B Requarth •
- Jane H Brice
CONCLUSIONS: 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 of the more common pediatric patient characteristics associated with the type and reason for drug use, EMS agencies can improve pediatric readiness among prehospital...
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 readiness may save thousands of children's lives each year.
- 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
CONCLUSIONS: 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 research could provide insight into which specific factors influence successful implementation and sustained effects.
- 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 a decision-analytic simulation model. Previously published primary analyses of a nationally representative, population-based cohort of children receiving emergency services at 747 EDs in eleven states provided...
- Donna C Koo •
- Jennifer Xie •
- Mitchell R Price •
- Samuel Z Soffer •
- Lawrence Bodenstein
CONCLUSIONS: 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
CONCLUSION: 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
CONCLUSION: 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 the last 20 years and replaces the varied protocols previously used (eg, Rochester, Philadelphia, Boston). The guideline also incorporates lessons from newer studies, such as the work of the Febrile Infant Working Group of the Pediatric Emergency...
- 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
CONCLUSION: 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 cohort study of children aged under 24 months with minor head trauma who underwent repeated head imaging and initial CT scans according to the Pediatric Emergency Care Applied Research Network (PECARN) rules. We enrolled 741 children and...
- 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/RADAR through simulations and compared sample size considerations to non-inferiority designs in a hypothetical trial comparing antibiotics to no antibiotics (i.e., placebo) for children with...
- Ronine L Zamor •
- Danica B Liberman •
- Jeanine E Hall •
- Chris A Rees •
- Emily A Hartford •
- Pradip P Chaudhari •
- Elyse N Portillo •
- Michael D Johnson
Understanding and addressing health care disparities relies on collecting and reporting accurate data in clinical care and research. Data regarding a child's race, ethnicity, and language; sexual orientation and gender identity; and socioeconomic and geographic characteristics are important to ensure equity in research practices and reported outcomes. Disparities are known to exist across these sociodemographic categories. More consistent, accurate data collection could improve understanding of...
- 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 Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies/article-withdrawal.
- 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 contraceptive use. The unintended pregnancy risk was almost 8% in the study population. Few patients eligible for EC received it. These data suggest a high need and potential opportunity for provision of contraception services in...
- Sriram Ramgopal •
- Christian Martin-Gill •
- Kenneth A Michelson
CONCLUSIONS: 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 associated with hospitalization or transfer.
- Julie C Leonard •
- Monica Harding •
- Lawrence J Cook •
- Jeffrey R Leonard •
- Kathleen M Adelgais •
- Fahd A Ahmad •
- Lorin R Browne •
- Rebecca K Burger •
- Pradip P Chaudhari •
- Daniel J Corwin •
- Nicolaus W Glomb •
- Lois K Lee •
- Sylvia Owusu-Ansah •
- Lauren C Riney •
- Alexander J Rogers •
- Daniel M Rubalcava •
- Robert E Sapien •
- Matthew A Szadkowski •
- Leah Tzimenatos •
- Caleb E Ward •
- Kenneth Yen •
- Nathan Kuppermann
BACKGROUND: Cervical spine injuries in children are uncommon but potentially devastating; however, indiscriminate neck imaging after trauma unnecessarily exposes children to ionising radiation. The aim of this study was to derive and validate a paediatric clinical prediction rule that can be incorporated into an algorithm to guide radiographic screening for cervical spine injury among children in the emergency department.
- Katherine E Remick •
- Marianne Gausche-Hill •
- Amber Lin •
- Jeremy D Goldhaber-Fiebert •
- Benjamin Lang •
- Ashley Foster •
- Beech Burns •
- Peter C Jenkins •
- Hilary A Hewes •
- Nathan Kuppermann •
- K John McConnell •
- Jennifer Marin •
- Christopher Weyant •
- Rachel Ford •
- Sean R Babcock •
- Craig D Newgard •
- Pediatric Readiness Study Group
CONCLUSIONS: Annual hospital costs for HPR are modest, particularly when considered per child.
- Margaret Samuels-Kalow •
- Krislyn M Boggs •
- Stephanie S Loo •
- Maeve F Swanton •
- William A Manning •
- Rebecca E Cash •
- Courtney B Wolk •
- Elizabeth R Alpern •
- Kenneth A Michelson •
- Katherine E Remick •
- Carlos A Camargo
CONCLUSIONS: Implementation of the PECC role appears to be limited by heterogeneous interpretations of the PECC, de-prioritization of pediatrics, and limited system resources. However, many participants described motivation to improve pediatric care and implement the PECC role in context of increasing pediatric visits; they offered strategies for future implementation efforts.
- Craig D Newgard •
- McKenna Smith •
- Amber Lin •
- K John McConnell •
- Katherine E Remick •
- Randall S Burd •
- Jennifer R Marin •
- N Clay Mann •
- Marianne Gausche-Hill •
- Hilary A Hewes •
- Angela Child •
- Benjamin Lang •
- Ashley A Foster •
- Brandon Maughan •
- Jeremy D Goldhaber-Fiebert •
- Pediatric Readiness Study Group
High emergency department (ED) pediatric readiness is associated with improved survival in children, but the cost is unknown. We evaluated the costs of emergency care for children across quartiles of ED pediatric readiness. This was a retrospective cohort study of children aged 0-17 years receiving emergency services in 747 EDs in 9 states from January 1, 2012, through December 31, 2017. We measured ED pediatric readiness using the weighted Pediatric Readiness Score (range: 0-100). The primary...
- Joelle N Simpson •
- Joseph L Wright
This article summarizes how pediatricians may be uniquely positioned to mitigate the long-term trajectory of COVID-19 on the health and wellness of pediatric patients especially with regard to screening for social determinants of health that are recognized drivers of disparate health outcomes. Health inequities, that is, disproportionately deleterious health outcomes that affect marginalized populations, have been a major source of vulnerability in past public health emergencies and natural...
- Anna Lin •
- Sarita Chung
The concepts of pediatric surge in the United States continue to evolve from a theoretic framework to practical implementation. As disasters become more frequent, ranging from natural to human-caused, children remain a vulnerable population. The coronavirus disease 2019 pandemic and the 2022 to 2023 tripledemic respiratory surge revealed advances and continued challenges in our ability to care for a large influx of pediatric patients. Understanding pediatric surge through the framework of the 4...
- Sanyukta Desai •
- Katherine E Remick
Although children account for 20% of all emergency department (ED) visits, the majority of children seek emergency care in hospitals that see fewer than 10 children per day. The National Pediatric Readiness Project has defined key system-level standards for all EDs to safely care for ill and injured children. High pediatric readiness is associated with improvement in mortality for critically ill and injured children. However, to improve readiness and sustain system-level changes, hospitals must...
- Caroline G Melhado •
- Katherine Remick •
- Amy Miskovic •
- Bhavin Patel •
- Hilary A Hewes •
- Craig D Newgard •
- Avery B Nathens •
- Charles Macias •
- Lisa Gray •
- Brian K Yorkgitis •
- Michael W Dingeldein •
- Aaron R Jensen
CONCLUSION: Emergency department pediatric readiness in trauma centers remains variable and is predictably lower in centers that lack inpatient resources. There is, however, no aspect of ED pediatric readiness that is constrained to high-level pediatric facilities, and a highest quartile wPRS was achieved in all types of adult centers in our study. Ongoing efforts to improve pediatric readiness for initial stabilization at nonpediatric centers are needed, particularly in centers that routinely...
- Andrew T Krack •
- Michelle Eckerle •
- Prashant Mahajan •
- Octavio Ramilo •
- John M VanBuren •
- Russell K Banks •
- T Charles Casper •
- David Schnadower •
- Nathan Kuppermann •
- Febrile Infant Working Group of the Pediatric Emergency Care Applied Research Network (PECARN)
CONCLUSIONS: Leukopenia ≤2500 cells/μL in febrile infants ≤60 days old is associated with IBIs. However, in the presence of normal PCT levels, no patients with leukopenia had IBIs. While this suggests leukopenia ≤2500 cells/μL is a risk factor for IBIs in non-critically ill young febrile infants only when PCT is unavailable or elevated, the overall low frequency of leukopenia in this cohort warrants caution in interpretation, with future validation required.
- Mohannad Abu-Sultanah •
- Riad Lutfi •
- Samer Abu-Sultaneh •
- Kellie J Pearson •
- Erin E Montgomery •
- Travis Whitfill •
- Marc A Auerbach •
- Kamal Abulebda
CONCLUSIONS: In this cohort, improving pediatric readiness scores in GEDs was associated with significant improvements in PICU and hospital length of stay. Future initiatives should focus on disseminating pediatric readiness efforts to improve outcomes of critically ill children nationally.
- Fiona A Pirrocco •
- Hamy Temkit •
- Cherisse Mechem •
- Karen Yeager
CONCLUSIONS: This study addresses important knowledge gaps regarding transfers from IHS and tribal EDs, highlights potential high-impact areas for pediatric readiness, and emphasizes the need for more granular data to inform resource allocation and educational interventions. Further studies are needed to delineate potentially avoidable transfers seen within this population.
- Stacy M Goins •
- Steven Thornton •
- Elizabeth Horne •
- Brooke Hoehn •
- Erin Brush •
- Julie Thamby •
- Angela Hemesath •
- Sarah Cantrell •
- Emily Greenwald •
- Elisabeth Tracy
CONCLUSIONS: This review suggests that diverse strategies exist to promote pediatric readiness. Most training programs are interdisciplinary and use a variety of educational techniques. However, studies infrequently report examining the impact of educational interventions on patient-centered outcomes and lack detail in describing their curriculum. Future educational efforts would benefit from heightened attention to such outcome measures and a rigorous description of their curricula to allow for...
- James F Holmes •
- Kenneth Yen •
- Irma T Ugalde •
- Paul Ishimine •
- Pradip P Chaudhari •
- Nisa Atigapramoj •
- Mohamed Badawy •
- Kevan A McCarten-Gibbs •
- Donovan Nielsen •
- Allyson C Sage •
- Grant Tatro •
- Jeffrey S Upperman •
- P David Adelson •
- Daniel J Tancredi •
- Nathan Kuppermann
BACKGROUND: The intra-abdominal injury and traumatic brain injury prediction rules derived by the Pediatric Emergency Care Applied Research Network (PECARN) were designed to reduce inappropriate use of CT in children with abdominal and head trauma, respectively. We aimed to validate these prediction rules for children presenting to emergency departments with blunt abdominal or minor head trauma.
- Jennifer A Hoffmann •
- Camille P Carter •
- Cody S Olsen •
- David Ashby •
- Kamali L Bouvay •
- Susan J Duffy •
- James M Chamberlain •
- Sofia S Chaudhary •
- Nicolaus W Glomb •
- Jacqueline Grupp-Phelan •
- Maya Haasz •
- Erin P O'Donnell •
- Mohsen Saidinejad •
- Bashar S Shihabuddin •
- Leah Tzimenatos •
- Neil G Uspal •
- Joseph J Zorc •
- Lawrence J Cook •
- Elizabeth R Alpern •
- PECARN Registry Study Group
CONCLUSIONS: During the late pandemic, pediatric MH ED visits decreased below expected rates; however, visits by females and for specific conditions remained elevated, indicating a need for increased attention to these groups. Prolonged ED visit lengths may reflect inadequate availability of MH services.
- Roberto Velasco •
- Borja Gomez •
- Ismael Labiano •
- Ana Mier •
- Alberto Ugedo •
- Javier Benito •
- Santiago Mintegi
CONCLUSIONS: The performance of blood biomarkers, except for procalcitonin, in febrile young infants is lower in fever of very short duration, decreasing the accuracy of the clinical decision rules.
- Cheryl A King •
- David Brent •
- Jacqueline Grupp-Phelan •
- Kent Page •
- Ewa Czyz •
- Taylor C McGuire •
- E Melinda Mahabee-Gittens •
- Lucy Block •
- T Charles Casper
CONCLUSIONS: Results from this large-scale prospective study suggest the importance of TB, PB, and PPE to our understanding of suicidal thoughts and suicide attempts among adolescents, pointing to promising prevention and intervention targets.
- Emma Tavender •
- Nitaa Eapen •
- Junfeng Wang •
- Vanessa C Rausa •
- Franz E Babl •
- Natalie Phillips
BACKGROUND: Paediatric cervical spine injury (CSI) after blunt trauma is rare but can have severe consequences. Clinical decision rules (CDRs) have been developed to guide clinical decision-making, minimise unnecessary tests and associated risks, whilst detecting all significant CSIs. Several validated CDRs are used to guide imaging decision-making in adults following blunt trauma and clinical criteria have been proposed as possible paediatric-specific CDRs. Little information is known about...
- Stefanie G Ames •
- Apoorva Salvi •
- Amber Lin •
- Susan Malveau •
- N Clay Mann •
- Peter C Jenkins •
- Matthew Hansen •
- Linda Papa •
- Sabrina Schmitz •
- Cesar Sabogal •
- Craig D Newgard •
- Pediatric Readiness Study Group
CONCLUSIONS: The 1-year mortality of children presenting to an ED is 2.2% for injured children and 1.4% for medically ill children with most deaths occurring in the ED. Future interventional trials, quality improvement efforts, and health policy focused in the ED could have the potential to improve outcomes of pediatric patients.
- Jennifer K Saper •
- Michelle L Macy •
- Christian Martin-Gill •
- Sriram Ramgopal
CONCLUSIONS: EMS encounters from outpatient settings most commonly originate from outpatient offices, relative to urgent care settings, where pediatric emergency readiness may be limited. It is important that outpatient settings and providers are ready for varied emergencies, including those occurring for a behavioral health concern, and that readiness guidelines are updated to address these needs.
- Jacqueline Grupp-Phelan •
- Adam Horwitz •
- David Brent •
- Lauren Chernick •
- Rohit Shenoi •
- Charlie Casper •
- Michael Webb •
- Cheryl King •
- Pediatric Emergency Care Applied Research Network (PECARN)
CONCLUSIONS: The CASSY can be a valuable tool in providing patient-specific risk probabilities for a suicide attempt at 3 months and tailor the threshold cutoffs based on the availability of local mental health resources. We give an example of a clinical risk pathway, which should include segmentation of the ED population by medical versus psychiatric chief complaint.
- Monica Christine Ciorba •
- Marc Maegele
CONCLUSION: 4% of polytrauma patients are children. Because children differ from adults both anatomically and physiologically, the diagnostic evaluation and management of polytrauma in children presents a special challenge. The evidence base for pediatric polytrauma management is still inadequate; current recommendations are based on consensus, in consideration of the special features of children compared to adults.
- Caleb E Ward •
- Kathleen M Adelgais •
- Maija Holsti •
- Kammy K Jacobsen •
- Harold K Simon •
- Claudia R Morris •
- Victor M Gonzalez •
- Gonzalo Lerner •
- Kimia Ghaffari •
- John M VanBuren •
- E Brooke Lerner •
- Manish I Shah •
- Pediatric Emergency Care Applied Research Network (PECARN) PediDOSE Study Group
CONCLUSIONS: In communities where this study will occur, most respondents supported PediDOSE being conducted with EFIC and most approved of children being enrolled without prior consent. Support was lowest among non-Hispanic Black respondents and highest among health care providers. Further research is needed to determine optimal ways to address the concerns of specific racial and ethnic groups when conducting EFIC trials.
- Michelle Pintea •
- Deanna Dahl Grove
CONCLUSIONS: Health care coalitions and localities can use this tool to evaluate pediatric preparedness, identify needed improvements, and improve outcomes for children, families, and communities.
- Kathryn Westphal •
- Hania Adib •
- Vignesh Doraiswamy •
- Kevin Basiago •
- Jennifer Lee •
- Sumeet L Banker •
- John Morrison •
- Saylor McCartor •
- Stephanie Berger •
- Erinn O Schmit •
- Annalise Van Meurs •
- Meredith Mitchell •
- Clifton Lee •
- Julie K Wood •
- Lauren G Tapp •
- Deborah Kunkel •
- Elizabeth E Halvorson •
- Nicholas M Potisek •
- Hypothermic Young Infant Research Collaborative
CONCLUSIONS: Several febrile infant decision tools were highly sensitive, minimizing missed SBIs and IBIs in hypothermic infants. However, the low specificity of these decision tools may lead to unnecessary testing, antimicrobial exposure, and hospitalization.
- Krislyn M Boggs •
- Emma Voligny •
- Marc Auerbach •
- Janice A Espinola •
- Margaret E Samuels-Kalow •
- Ashley F Sullivan •
- Carlos A Camargo
CONCLUSIONS: There is variation in state PFRPs, although all prioritize the presence of a PECC. We encourage further research on the effect of different aspects of PFRPs on patient outcomes.
- Carl O Eriksson •
- Nathan Bahr •
- Garth Meckler •
- Matthew Hansen •
- Grace Walker-Stevenson •
- Ahamed Idris •
- Tom P Aufderheide •
- Mohamud R Daya •
- Ericka L Fink •
- Jonathan Jui •
- Maureen Luetje •
- Christian Martin-Gill •
- Steven Mcgaughey •
- Jon Pelletier •
- Danny Thomas •
- Jeanne-Marie Guise •
- Child Safety Initiative–Emergency Medical Services for Children
CONCLUSIONS AND RELEVANCE: In this large geographically diverse cohort of children with EMS-treated OHCA, 60% of all patients experienced at least 1 severe ASE. The odds of a severe ASE were higher for neonates than adolescents and even higher when the cardiac arrest was birth related. Given the national increase in out-of-hospital births and ongoing poor outcomes of OHCA in young children, these findings represent an urgent call to action to improve care delivery and training for this...
- Maryam Saran •
- Morteza Arab-Zozani •
- Meysam Behzadifar •
- Mehrdad Gholami •
- Samad Azari •
- Nicola Luigi Bragazzi •
- Masoud Behzadifar
CONCLUSION: Limitations of evidence: The restricted number of included studies may impact generalizability. High heterogeneity was observed, leading to subgroup analyses based on age, assessment criteria, and study region. Absent data on overuse causes hinders drawing conclusions on contributing factors. Furthermore, this study solely addressed overuse rates, not associated harm or benefits. Interpretation: The overuse of CT scans in mild head injury patients is concerning, as it can result in...
- Amy Tucker •
- Teresa Bailey •
- Courtney Edwards •
- Amy Stewart
CONCLUSION: We found that participation in the quality improvement initiative was associated with emergency department pediatric readiness improvements.
- Nina E Glass •
- Craig D Newgard
No abstract
- Wen-Kai Cai •
- Yin-Chun Tien •
- Chia-Hao Hsu
No abstract
- Alexander T Janke •
- Courtney W Mangus •
- Christopher M Fung •
- Neil Kamdar •
- Michelle L Macy •
- Michele M Nypaver •
- Keith E Kocher
CONCLUSIONS AND RELEVANCE: In this cohort study of more than 2.7 million ED visits, a pediatric viral illness surge was associated with different pediatric acute care across EDs in the state. Clinical management pathways and quality improvement efforts may more effectively mitigate dangerous clinical conditions with strong collaborative relationships across EDs and setting of care.
- Mariann Nocera Kelley •
- Willliam Lynders •
- Emily Pelletier •
- Megan Petrucelli •
- Beth Emerson •
- Gunjan K Tiyyagura •
- Michael Paul Goldman
Prior reports describe the care children receive in community EDs (CEDs) compared with paediatric EDs (PEDs) as uneven. The Emergency Medical Services for Children (EMSC) initiative works to close these gaps using quality improvement (QI) methodology. Project champion from a community hospital network identified the use of safe pharmacological and non-pharmacological anxiolysis and analgesia (A&A) as one such gap and partnered with EMSC to address it. Our primary Specific, Measurable,...
- Monika Goyal •
- Elizabeth R Alpern •
- Michael Webb •
- David C Brousseau •
- James M Chamberlain •
- Joseph J Zorc •
- Theresa Frey •
- Alexandria Wiersma •
- Bradley J Barney •
- Amy L Drendel •
- PECARN IMPROVE and PECARN Registry Study Groups •
- PECARN IMPROVE and PECARN Registry Study Groups
No abstract
- Snimarjot Kaur •
- William Lynders •
- Michael Goldman •
- Christie Bruno •
- Juliana Morin •
- Scott Maruschock •
- Marc Auerbach
CONCLUSIONS: A locally facilitated CED in situ simulation curriculum was successfully developed and implemented under local leadership, with remote collaboration by AMC. The curriculum was well received and effective.
- Daniel S Tsze •
- Nathan Kuppermann •
- T Charles Casper •
- Bradley J Barney •
- Lawrence P Richer •
- Danica B Liberman •
- Pamela J Okada •
- Claudia R Morris •
- Sage R Myers •
- Jane K Soung •
- Rakesh D Mistry •
- Lynn Babcock •
- Sandra P Spencer •
- Michael D Johnson •
- Eileen J Klein •
- Kimberly S Quayle •
- Dale W Steele •
- Andrea T Cruz •
- Alexander J Rogers •
- Danny G Thomas •
- Jacqueline M Grupp-Phelan •
- Tiffani J Johnson •
- Peter S Dayan •
- Pediatric Emergency Care Applied Research Network (PECARN)
INTRODUCTION: Headache is a common chief complaint of children presenting to emergency departments (EDs). Approximately 0.5%-1% will have emergent intracranial abnormalities (EIAs) such as brain tumours or strokes. However, more than one-third undergo emergent neuroimaging in the ED, resulting in a large number of children unnecessarily exposed to radiation. The overuse of neuroimaging in children with headaches in the ED is driven by clinician concern for life-threatening EIAs and lack of...
- Chrystal Rutledge •
- Kristen Waddell •
- Stacy Gaither •
- Travis Whitfill •
- Marc Auerbach •
- Nancy Tofil
CONCLUSIONS: This study shows a significant disparity in the performance and readiness of GEDs versus a PED in a medically underserved area. More education and better access to resources is needed in these areas to adequately care for critically ill pediatric patients.
- Caroline Q Stephens •
- Mary E Fallat
Pediatric trauma system development is essential to public health infrastructure and pediatric health systems. Currently, trauma systems are managed at the state level, with significant variation in consideration of pediatric needs. A recently developed Pediatric Trauma System Assessment Score (PTSAS) demonstrated that states with lower PTSAS have increased pediatric mortality from trauma. Critical gaps are identified within six PTSAS domains: Legislation and Funding, Access to Care, Injury...
- Jennifer A Hoffmann •
- Camille P Carter •
- Cody S Olsen •
- Pradip P Chaudhari •
- Sofia Chaudhary •
- Susan Duffy •
- Nicolaus Glomb •
- Monika K Goyal •
- Jacqueline Grupp-Phelan •
- Maya Haasz •
- Bijan Ketabchi •
- Nicole Kravitz-Wirtz •
- E Brooke Lerner •
- Bashar Shihabuddin •
- Wendi Wendt •
- Lawrence J Cook •
- Elizabeth R Alpern •
- PECARN Registry Study Group
CONCLUSIONS: Firearm injury ED visits for children increased beyond expected prepandemic trends, with greater increases among certain population subgroups. These findings may inform firearm injury prevention efforts.
- Alejandra Arango •
- David Brent •
- Jacqueline Grupp-Phelan •
- Bradley J Barney •
- Anthony Spirito •
- Megan M Mroczkowski •
- Rohit Shenoi •
- Melinda Mahabee-Gittens •
- T Charles Casper •
- Cheryl King •
- Pediatric Emergency Care Applied Research Network (PECARN)
CONCLUSIONS: In this large and geographically diverse sample, overall and school connectedness were related prospectively to lower likelihood of suicide attempts, and connectedness was more protective for youth not in certain high-risk subgroups. Results inform preventive efforts aimed at improving youth connectedness and reducing suicide risk.
- Kathleen M Brown •
- Nicole S Glaser •
- Julie K McManemy •
- Andrew DePiero •
- Lise E Nigrovic •
- Kimberly S Quayle •
- Michael J Stoner •
- Jeff E Schunk •
- Jennifer L Trainor •
- Leah Tzimenatos •
- Arleta Rewers •
- Sage R Myers •
- Maria Y Kwok •
- Simona Ghetti •
- T Charles Casper •
- Cody S Olsen •
- Nathan Kuppermann •
- Pediatric Emergency Care Applied Research Network Diabetic Ketoacidosis FLUID Study Group
CONCLUSIONS: Protocol adherence data in the FLUID Trial suggest that physicians are uncomfortable using weight-based fluid calculations for overweight or obese children. However, higher rates of fluid infusion were not associated with increased risk of mental status changes or cerebral injury, suggesting that physicians should not limit fluid resuscitation in obese children and youth with DKA.
- Jessica A Harper •
- Amanda C Coyle •
- Clara Tam •
- Megan Skakum •
- Mirna Ragheb •
- Lucy Wilson •
- Mê-Linh Lê •
- Terry P Klassen •
- Alex Aregbesola
BACKGROUND: Most children who need emergency care visit general emergency departments and urgent care centres; the weighted pediatric readiness score (WPRS) is currently used to evaluate emergency departments' readiness for pediatric patients. The aim of this study was to determine whether a higher WPRS was associated with decreased mortality and improved health care outcomes and utilization.
- Caroline Melhado •
- Katherine Remick •
- Amy Miskovic •
- Bhavin Patel •
- Hilary A Hewes •
- Craig D Newgard •
- Avery B Nathens •
- Charles Macias •
- Lisa Gray •
- Brian K Yorkgitis •
- Michael W Dingeldein •
- Aaron R Jensen
CONCLUSION: Trauma centers should address gaps in pediatric readiness to include a pediatric-specific quality improvement plan and aim to achieve wPRS ≥93.
Computed Tomography Overuse in Pediatric Minor Head Trauma: Insights from a Single-Center Experience
- Derya Bako •
- Utku Özer •
- Engin Beydoğan
BACKGROUND: Minor head trauma is a common reason for emergency department visits in children, but many of these cases are not clinically significant. Despite established criteria for selecting patients who require computed tomography (CT), concerns about overuse of CT persist. This study aimed to determine the frequency of clinically important traumatic brain injury by retrospectively evaluating cranial CT scans in children categorized as very low risk for such injuries based on PECARN...
- Todd A Florin •
- Octavio Ramilo •
- Russell K Banks •
- David Schnadower •
- Kimberly S Quayle •
- Elizabeth C Powell •
- Michelle L Pickett •
- Lise E Nigrovic •
- Rakesh Mistry •
- Aaron N Leetch •
- Robert W Hickey •
- Eric W Glissmeyer •
- Peter S Dayan •
- Andrea T Cruz •
- Daniel M Cohen •
- Amanda Bogie •
- Fran Balamuth •
- Shireen M Atabaki •
- John M VanBuren •
- Prashant Mahajan •
- Nathan Kuppermann •
- Febrile Infant Working Group of the Pediatric Emergency Care Applied Research Network (PECARN)
CONCLUSIONS: Radiographic pneumonias were uncommon in febrile infants. Viral detection was common. Pneumonia was associated with respiratory distress, but few other factors. Although ANC and PCT levels were elevated in infants with definite pneumonias, further work is necessary to evaluate the role of blood biomarkers in infant pneumonias.
- Colleen K Gutman •
- Jeanine E Hall •
- K Casey Lion
No abstract
- Peter C Jenkins •
- Amber Lin •
- Stefanie G Ames •
- Craig D Newgard •
- Benjamin Lang •
- James E Winslow •
- Jennifer R Marin •
- Jennifer N B Cook •
- Jeremy D Goldhaber-Fiebert •
- Linda Papa •
- Mark R Zonfrillo •
- Matthew Hansen •
- Stephen P Wall •
- Susan Malveau •
- Nathan Kuppermann •
- Pediatric Readiness Study Group
CONCLUSIONS AND RELEVANCE: In this study, racial and ethnic disparities in mortality existed among children treated for acute medical emergencies but not traumatic injuries. Increased ED pediatric readiness was associated with reduced disparities; it was estimated that increasing the ED pediatric readiness levels of hospitals in the 3 lowest quartiles would result in an estimated 3-fold reduction in disparity for pediatric mortality. However, increased pediatric readiness did not eliminate...
- JoAnna K Leyenaar •
- Seneca D Freyleue •
- Mary Arakelyan •
- David C Goodman •
- A James O'Malley
CONCLUSIONS AND RELEVANCE: Between 2009 and 2019, the largest decreases in pediatric hospitalizations occurred at rural and urban nonteaching hospitals. Clinical and policy initiatives to support hospitals with low pediatric volumes may be needed to maintain hospital access and pediatric readiness, particularly in rural communities.
- Kendall J Burdick •
- Aixa Perez Coulter •
- Michael Tirabassi
CONCLUSIONS: We did not find evidence that prehospital transport within the "Golden Hour" had a substantial association with survival, though it may be associated with length of stay. There are many factors contributing to trauma outcomes, so efforts should continue to expand access and pediatric readiness.
- Mohsen Saidinejad •
- Susan Duffy •
- Dina Wallin •
- Jennifer A Hoffmann •
- Madeline Joseph •
- Jennifer Schieferle Uhlenbrock •
- Kathleen Brown •
- Muhammad Waseem •
- Sally K Snow •
- Madeline Andrew •
- Alice A Kuo •
- Carmen Sulton •
- Thomas Chun •
- Lois K Lee •
- AMERICAN ACADEMY OF PEDIATRICS •
- Committee on Pediatric Emergency Medicine •
- Gregory P Conners •
- James Callahan •
- Toni Gross •
- Madeline Joseph •
- Lois Lee •
- Elizabeth Mack •
- Jennifer Marin •
- Suzan Mazor •
- Ronald Paul •
- Nathan Timm •
- AMERICAN COLLEGE OF EMERGENCY PHYSICIANS •
- Pediatric Emergency Medicine Committee •
- Ann M Dietrich •
- Kiyetta H Alade •
- Christopher S Amato •
- Zaza Atanelov •
- Marc Auerbach •
- Isabel A Barata •
- Lee S Benjamin •
- Kathleen T Berg •
- Kathleen Brown •
- Cindy Chang •
- Jessica Chow •
- Corrie E Chumpitazi •
- Ilene A Claudius •
- Joshua Easter •
- Ashley Foster •
- Sean M Fox •
- Marianne Gausche-Hill •
- Michael J Gerardi •
- Jeffrey M Goodloe •
- Melanie Heniff •
- James Jim L Homme •
- Paul T Ishimine •
- Susan D John •
- Madeline M Joseph •
- Samuel Hiu-Fung Lam •
- Simone L Lawson •
- Moon O Lee •
- Joyce Li •
- Sophia D Lin •
- Dyllon Ivy Martini •
- Larry Bruce Mellick •
- Donna Mendez •
- Emory M Petrack •
- Lauren Rice •
- Emily A Rose •
- Timothy Ruttan •
- Mohsen Saidinejad •
- Genevieve Santillanes •
- Joelle N Simpson •
- Shyam M Sivasankar •
- Daniel Slubowski •
- Annalise Sorrentino •
- Michael J Stoner •
- Carmen D Sulton •
- Jonathan H Valente •
- Samreen Vora •
- Jessica J Wall •
- Dina Wallin •
- Theresa A Walls •
- Muhammad Waseem •
- Dale P Woolridge •
- EMERGENCY NURSES ASSOCIATION •
- Pediatric Committee •
- Cam Brandt •
- Krisi M Kult •
- Justin J Milici •
- Nicholas A Nelson •
- Michele A Redlo •
- Maureen R Curtis Cooper •
- Michele Redlo •
- Krisi Kult •
- Katherine Logee •
- Dixie Elizabeth Bryant •
- Maureen Curtis Cooper •
- Kristen Cline •
- POLICY STATEMENT •
- Organizational Principles to Guide and Define the Child Health Care System and/or Improve the Health of All Children •
- This article is being jointly published in Pediatrics, Annals of Emergency Medicine, and Journal of Emergency Nursing.
Mental and behavioral health (MBH) emergencies in children and youth continue to increasingly affect not only the emergency department (ED), but the entire spectrum of emergency medical services for children, from prehospital services to the community. Inadequate community and institutional infrastructure to care for children and youth with MBH conditions makes the ED an essential part of the health care safety net for these patients. As a result, an increasing number of children and youth are...
- Chris A Rees •
- David C Brousseau •
- Daniel M Cohen •
- Anthony Villella •
- Carlton Dampier •
- Kathleen Brown •
- Andrew Campbell •
- Corrie E Chumpitazi •
- Gladstone Airewele •
- Todd Chang •
- Christopher Denton •
- Angela Ellison •
- Alexis Thompson •
- Fahd Ahmad •
- Nitya Bakshi •
- Keli D Coleman •
- Sara Leibovich •
- Deborah Leake •
- Dunia Hatabah •
- Hagar Wilkinson •
- Michelle Robinson •
- T Charles Casper •
- Elliott Vichinsky •
- Claudia R Morris •
- SCD Arginine Study Group and PECARN
BACKGROUND: Despite substantial illness burden and healthcare utilization conferred by pain from vaso-occlusive episodes (VOE) in children with sickle cell disease (SCD), disease-modifying therapies to effectively treat SCD-VOE are lacking. The aim of the Sickle Cell Disease Treatment with Arginine Therapy (STArT) Trial is to provide definitive evidence regarding the efficacy of intravenous arginine as a treatment for acute SCD-VOE among children, adolescents, and young adults.
- Mohsen Saidinejad •
- Susan Duffy •
- Dina Wallin •
- Jennifer A Hoffmann •
- Madeline M Joseph •
- Jennifer Schieferle Uhlenbrock •
- Kathleen Brown •
- Muhammad Waseem •
- Sally Snow •
- Madeline Andrew •
- Alice A Kuo •
- Carmen Sulton •
- Thomas Chun •
- Lois K Lee •
- AMERICAN ACADEMY OF PEDIATRICS Committee on Pediatric Emergency Medicine •
- AMERICAN COLLEGE OF EMERGENCY PHYSICIANS Pediatric Emergency Medicine Committee •
- EMERGENCY NURSES ASSOCIATION Pediatric Committee
Mental and behavioral health (MBH) emergencies in children and youth continue to increasingly affect not only the emergency department (ED), but the entire spectrum of emergency medical services for children, from prehospital services to the community. Inadequate community and institutional infrastructure to care for children and youth with MBH conditions makes the ED an essential part of the health care safety net for these patients. As a result, an increasing number of children and youth are...
- Mohsen Saidinejad •
- Susan Duffy •
- Dina Wallin •
- Jennifer A Hoffmann •
- Madeline Joseph •
- Jennifer Schieferle Uhlenbrock •
- Kathleen Brown •
- Muhammad Waseem •
- Sally K Snow •
- Madeline Andrew •
- Alice A Kuo •
- Carmen Sulton •
- Thomas Chun •
- Lois K Lee
Mental and behavioral health (MBH) emergencies in children and youth continue to increasingly affect not only the emergency department (ED), but the entire spectrum of emergency medical services for children, from prehospital services to the community. Inadequate community and institutional infrastructure to care for children and youth with MBH conditions makes the ED an essential part of the health care safety net for these patients. As a result, an increasing number of children and youth are...
- Molly M Diaz Kane
Head injuries, and specifically blunt head trauma, are common among pediatric patients of all ages. Patients may present to their primary care provider, to urgent care, or to the emergency department after head trauma. Such injuries may occur as a result of a variety of mechanisms, including falls, motor vehicle collisions, or sports injuries. Clinical decision rules exist to help guide the clinician in the initial evaluation of head injury and in determining when head imaging may be indicated....
- Nina E Glass •
- Apoorva Salvi •
- Ran Wei •
- Amber Lin •
- Susan Malveau •
- Jennifer N B Cook •
- N Clay Mann •
- Randall S Burd •
- Peter C Jenkins •
- Matthew Hansen •
- Nicholas M Mohr •
- Caroline Stephens •
- Mary E Fallat •
- E Brooke Lerner •
- Brendan G Carr •
- Stephen P Wall •
- Craig D Newgard
CONCLUSIONS AND RELEVANCE: These findings suggest that trauma centers with high ED pediatric readiness had lower mortality after considering transport time and proximity. Improving ED pediatric readiness among all trauma centers, rather than selective transport to trauma centers with high ED readiness, had the largest association with pediatric survival. Thus, increased pediatric readiness at all US trauma centers may substantially improve patient outcomes after trauma.
- James P Byrne •
- Marie L Crandall
No abstract
- Alfred Sacchetti •
- Eric Hicken •
- W Richard Bukata •
- Dana Durso
CONCLUSIONS: Pediatric patients seeking ED care overwhelmingly arrive through a private mode regardless of the severity of their problem or type of ED in which treated. Emergency Medical Services programs and state hospital regulatory agencies need to recognize this practice and assure the pediatric competence of every ED within their system.
- Steven W Thornton •
- Harold J Leraas •
- Elizabeth Horne •
- Marcelo Cerullo •
- Doreen Chang •
- Emily Greenwald •
- Suresh Agarwal •
- Krista L Haines •
- Elisabeth T Tracy
CONCLUSIONS: There is relatively limited exposure to high-acuity pediatric trauma at US centers. Investigation into pediatric trauma resuscitation education and simulation may promote pediatric readiness and lead to improved outcomes.
- Ernest Leva •
- Minh-Tu Do •
- Rachael Grieco •
- Anna Petrova
This study demonstrates the trend of computed tomography (CT) usage for children with mild traumatic brain injury (mTBI) in the context of the initiation of the Safe CT Imaging Collaborative Initiative to promote the Pediatric Emergency Care Applied Research Network (PECARN) rules at the acute care hospitals in New Jersey. We used administrative databases of 10 children's and 59 general hospitals to compare CT rates before 2014-2015, during 2016, and after the initiation of the program...
- Ashley A Foster •
- Joyce Li •
- Matthew H Wilkinson •
- Michael Ely •
- Marianne Gausche-Hill •
- Craig Newgard •
- Katherine Remick
CONCLUSION: Characteristics of PECC workforce vary but PECC activities of education and QI work are common among all. There is a reported need for additional training and support. Further studies will determine the impact of PECC characteristics on pediatric readiness.