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https://www.readbyqxmd.com/read/29150972/patient-level-factors-and-the-quality-of-care-delivered-in-pediatric-emergency-departments
#1
James P Marcin, Patrick S Romano, Parul Dayal, Madan Dharmar, James M Chamberlain, Nanette Dudley, Charles G Macias, Lise E Nigrovic, Elizabeth C Powell, Alexander J Rogers, Meridith Sonnett, Leah Tzimenatos, Elizabeth R Alpern, Rebecca Andrews-Dickert, Dominic A Borgialli, Erika Sidney, T Charles Casper, J Michael Dean, Nathan Kuppermann
OBJECTIVE: Quality of care delivered to adult patients in the emergency department (ED) is often associated with demographic and clinical factors such as a patient's race/ethnicity and insurance status. We sought to determine whether the quality of care delivered to children in the ED was associated with a variety of patient-level factors. METHODS: This was a retrospective, observational cohort study. Pediatric patients (<18 years) who received care between January 2011 and December 2011 at one of twelve EDs participating in the Pediatric Emergency Care Applied Research Network (PECARN) were included...
November 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29143331/implicit-review-instrument-to-evaluate-quality-of-care-delivered-by-physicians-to-children-in-emergency-departments
#2
James P Marcin, Patrick S Romano, Madan Dharmar, James M Chamberlain, Nanette Dudley, Charles G Macias, Lise E Nigrovic, Elizabeth C Powell, Alexander J Rogers, Meridith Sonnett, Leah Tzimenatos, Elizabeth R Alpern, Rebecca Andrews-Dickert, Dominic A Borgialli, Erika Sidney, Charlie Casper, Jonathan Michael Dean, Nathan Kuppermann
OBJECTIVE: To evaluate the consistency, reliability, and validity of an implicit review instrument that measures the quality of care provided to children in the emergency department (ED). DATA SOURCES/STUDY SETTING: Medical records of randomly selected children from 12 EDs in the Pediatric Emergency Care Applied Research Network (PECARN). STUDY DESIGN: Eight pediatric emergency medicine physicians applied the instrument to 620 medical records...
November 16, 2017: Health Services Research
https://www.readbyqxmd.com/read/29071378/comparison-of-pecarn-and-catch-clinical-decision-rules-in-children-with-minor-blunt-head-trauma
#3
Ö Bozan, G Aksel, H A Kahraman, Ö Giritli, S E Eroğlu
INTRODUCTION AND PURPOSE: Computerized brain tomography (CBT) imaging plays a key role in the management of patients with head trauma, and there is an indication for CBT in moderate and severe injuries. However, it is difficult to determine an indication for CBT in patients with minor head trauma. The primary aim of this study is to compare the efficiency of the most commonly used clinical decision rules: the guidelines of the Pediatric Emergency Care Applied Research Network (PECARN), and those of the Canadian Assessment of Tomography for Childhood Head Injury (CATCH)...
October 25, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29068636/calculated-decisions-pecarn-pediatric-head-injury-trauma-algorithm
#4
Daniel Runde, Joshua Beiner
No abstract text is available yet for this article.
October 25, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28988964/epidemiology-of-bacteremia-in-febrile-infants-aged-60-days-and-younger
#5
Elizabeth C Powell, Prashant V Mahajan, Genie Roosevelt, John D Hoyle, Rajender Gattu, Andrea T Cruz, Alexander J Rogers, Shireen M Atabaki, David M Jaffe, T Charles Casper, Octavio Ramilo, Nathan Kuppermann
STUDY OBJECTIVE: To describe the current epidemiology of bacteremia in febrile infants 60 days of age and younger in the Pediatric Emergency Care Applied Research Network (PECARN). METHODS: We conducted a planned secondary analysis of a prospective observational study of febrile infants 60 days of age and younger presenting to any of 26 PECARN emergency departments (2008 to 2013) who had blood cultures obtained. We excluded infants with significant comorbidities or critically ill appearance...
October 6, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28947466/randomised-controlled-trial-of-lactobacillus-rhamnosus-lgg-versus-placebo-in-children-presenting-to-the-emergency-department-with-acute-gastroenteritis-the-pecarn-probiotic-study-protocol
#6
David Schnadower, Phillip I Tarr, Casper T Charles, Marc H Gorelick, Michael J Dean, Karen J O'Connell, Prashant Mahajan, Thomas H Chun, Seema R Bhatt, Cindy G Roskind, Elizabeth C Powell, Alexander J Rogers, Cheryl Vance, Robert E Sapien, Feng Gao, Stephen B Freedman
INTRODUCTION: Acute gastroenteritis (AGE) is a common and burdensome condition that affects millions of children worldwide each year. Currently available strategies are limited to symptomatic management, treatment and prevention of dehydration and infection control; no disease-modifying interventions exist. Probiotics, defined as live microorganisms beneficial to the host, have shown promise in improving AGE outcomes, but existing studies have sufficient limitations such that the use of probiotics cannot currently be recommended with confidence...
September 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28923560/computed-tomography-findings-in-young-children-with-minor-head-injury-presenting-to-the-emergency-department-greater-than-24h-post-injury
#7
Renana Gelernter, Giora Weiser, Eran Kozer
BACKGROUND: Large studies which developed decision rules for the use of Computed tomography (CT) in children with minor head trauma excluded children with late presentation (more than 24h). OBJECTIVE: To assess the prevalence of significant traumatic brain injury (TBI) on CT in infants with head trauma presenting to the emergency department (ED) more than 24h from the injury. METHODS: A retrospective chart review of infants less than 24 months old referred for head CT because of traumatic brain injury from January 2004 to December 2014 in Assaf-Harofeh medical center was conducted...
September 11, 2017: Injury
https://www.readbyqxmd.com/read/28872046/racial-and-ethnic-differences-in-antibiotic-use-for-viral-illness-in-emergency-departments
#8
Monika K Goyal, Tiffani J Johnson, James M Chamberlain, T Charles Casper, Timothy Simmons, Evaline A Alessandrini, Lalit Bajaj, Robert W Grundmeier, Jeffrey S Gerber, Scott A Lorch, Elizabeth R Alpern
BACKGROUND AND OBJECTIVES: In the primary care setting, there are racial and ethnic differences in antibiotic prescribing for acute respiratory tract infections (ARTIs). Viral ARTIs are commonly diagnosed in the pediatric emergency department (PED), in which racial and ethnic differences in antibiotic prescribing have not been previously reported. We sought to investigate whether patient race and ethnicity was associated with differences in antibiotic prescribing for viral ARTIs in the PED...
October 2017: Pediatrics
https://www.readbyqxmd.com/read/28856440/the-impact-of-the-introduction-of-pecarn-head-ct-rules-on-the-utilisation-of-head-ct-scans-in-a-private-tertiary-hospital-in-sub-saharan-africa
#9
Isaac O Kobe, Mahmoud M Qureshi, Saidi Hassan, David L Oluoch-Olunya
BACKGROUND: The decision to order head CT scans to rule out clinically significant traumatic brain injury in mild head injury in children is made on the basis of clinical decision rules of which the Paediatric Emergency Care Applied Research Network (PECARN) CT head rules have been found to be most sensitive. PURPOSES: The purpose of this study is to determine the proportion of head CT scans done for children with mild head injury and to determine disposition of patients from casualty after the introduction of PECARN head CT rules compared to the period before...
December 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28814616/the-yale-observation-scale-score-and-the-risk-of-serious-bacterial-infections-in-febrile-infants
#10
Lise E Nigrovic, Prashant V Mahajan, Stephen M Blumberg, Lorin R Browne, James G Linakis, Richard M Ruddy, Jonathan E Bennett, Alexander J Rogers, Leah Tzimenatos, Elizabeth C Powell, Elizabeth R Alpern, T Charles Casper, Octavio Ramilo, Nathan Kuppermann
OBJECTIVES: To assess the performance of the Yale Observation Scale (YOS) score and unstructured clinician suspicion to identify febrile infants ≤60 days of age with and without serious bacterial infections (SBIs). METHODS: We performed a planned secondary analysis of a prospective cohort of non-critically ill, febrile, full-term infants ≤60 days of age presenting to 1 of 26 participating emergency departments in the Pediatric Emergency Care Applied Research Network...
June 6, 2017: Pediatrics
https://www.readbyqxmd.com/read/28759413/the-yale-observation-scale-score-and-the-risk-of-serious-bacterial-infections-in-febrile-infants
#11
Lise E Nigrovic, Prashant V Mahajan, Stephen M Blumberg, Lorin R Browne, James G Linakis, Richard M Ruddy, Jonathan E Bennett, Alexander J Rogers, Leah Tzimenatos, Elizabeth C Powell, Elizabeth R Alpern, T Charles Casper, Octavio Ramilo, Nathan Kuppermann
OBJECTIVES: To assess the performance of the Yale Observation Scale (YOS) score and unstructured clinician suspicion to identify febrile infants ≤60 days of age with and without serious bacterial infections (SBIs). METHODS: We performed a planned secondary analysis of a prospective cohort of non-critically ill, febrile, full-term infants ≤60 days of age presenting to 1 of 26 participating emergency departments in the Pediatric Emergency Care Applied Research Network...
July 2017: Pediatrics
https://www.readbyqxmd.com/read/28643031/pediatric-emergency-care-applied-research-network-pecarn-prediction-rules-in-identifying-high-risk-children-with-mild-traumatic-brain-injury
#12
B Nakhjavan-Shahraki, M Yousefifard, M J Hajighanbari, A Oraii, S Safari, M Hosseini
PURPOSE: Pediatric Emergency Care Applied Research Network (PECARN) traumatic brain injury (TBI) prognostic rules is a scoring system for prediction of the need for computed tomography (CT) scanning in children with mild TBI. However, its validation has not been assessed in developing countries. Therefore, the present study was designed to assess the value of PECARN rule in identification of children with clinically important TBI (ciTBI). METHOD: In this prospective cross-sectional study, 594 children (mean age: 7...
June 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28606098/determining-the-longitudinal-validity-and-meaningful-differences-in-hrql-of-the-pedsql%C3%A2-sickle-cell-disease-module
#13
MULTICENTER STUDY
Julie A Panepinto, J Paul Scott, Oluwakemi Badaki-Makun, Deepika S Darbari, Corrie E Chumpitazi, Gladstone E Airewele, Angela M Ellison, Kim Smith-Whitley, Prashant Mahajan, Sharada A Sarnaik, T Charles Casper, Larry J Cook, Julie Leonard, Monica L Hulbert, Elizabeth C Powell, Robert I Liem, Robert Hickey, Lakshmanan Krishnamurti, Cheryl A Hillery, David C Brousseau
BACKGROUND: Detecting change in health status over time and ascertaining meaningful changes are critical elements when using health-related quality of life (HRQL) instruments to measure patient-centered outcomes. The PedsQL™ Sickle Cell Disease module, a disease specific HRQL instrument, has previously been shown to be valid and reliable. Our objectives were to determine the longitudinal validity of the PedsQL™ Sickle Cell Disease module and the change in HRQL that is meaningful to patients...
June 12, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28423460/individual-and-neighborhood-characteristics-of-children-seeking-emergency-department-care-for-firearm-injuries-within-the-pecarn-network
#14
Patrick M Carter, Lawrence J Cook, Michelle L Macy, Mark R Zonfrillo, Rachel M Stanley, James M Chamberlain, Joel A Fein, Elizabeth R Alpern, Rebecca M Cunningham
OBJECTIVE: The objective was to describe the characteristics of children seeking emergency care for firearm injuries within the PECARN network and assess the influence of both individual and neighborhood factors on firearm-related injury risk. METHODS: This was a retrospective, multicenter cross-sectional analysis of children (<19 years old) presenting to 16 pediatric EDs (2004-2008). ICD-9-CM E-codes were used to identify and categorize firearm injuries by mechanism/intent...
July 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28410792/accuracy-of-pecarn-catch-and-chalice-head-injury-decision-rules-in-children-a-prospective-cohort-study
#15
Franz E Babl, Meredith L Borland, Natalie Phillips, Amit Kochar, Sarah Dalton, Mary McCaskill, John A Cheek, Yuri Gilhotra, Jeremy Furyk, Jocelyn Neutze, Mark D Lyttle, Silvia Bressan, Susan Donath, Charlotte Molesworth, Kim Jachno, Brenton Ward, Amanda Williams, Amy Baylis, Louise Crowe, Ed Oakley, Stuart R Dalziel
BACKGROUND: Clinical decision rules can help to determine the need for CT imaging in children with head injuries. We aimed to validate three clinical decision rules (PECARN, CATCH, and CHALICE) in a large sample of children. METHODS: In this prospective observational study, we included children and adolescents (aged <18 years) with head injuries of any severity who presented to the emergency departments of ten Australian and New Zealand hospitals. We assessed the diagnostic accuracy of PECARN (stratified into children aged <2 years and ≥2 years), CATCH, and CHALICE in predicting each rule-specific outcome measure (clinically important traumatic brain injury [TBI], need for neurological intervention, and clinically significant intracranial injury, respectively)...
June 17, 2017: Lancet
https://www.readbyqxmd.com/read/28393708/minor-head-trauma-in-the-pediatric-emergency-department-decision-making-nodes
#16
Mario Mastrangelo, Fabio Midulla
BACKGROUND: Minor head trauma is one of the leading cause of access to pediatric emergency departments with only a limited quote of patients resulting in clinically relevant brain injuries. OBJECTIVES: The aim of this review is to guide physicians involved in the management of pediatric head trauma towards a correct clinical approach. METHODS: A Pubmed/Medline search was realized through different entries including "minor head trauma" or "mild head trauma", "minor head injury" or "mild head injury", "acute head trauma"...
April 4, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28341799/use-of-traumatic-brain-injury-prediction-rules-with-clinical-decision-support
#17
MULTICENTER STUDY
Peter S Dayan, Dustin W Ballard, Eric Tham, Jeff M Hoffman, Marguerite Swietlik, Sara J Deakyne, Evaline A Alessandrini, Leah Tzimenatos, Lalit Bajaj, David R Vinson, Dustin G Mark, Steve R Offerman, Uli K Chettipally, Marilyn D Paterno, Molly H Schaeffer, Jun Wang, T Charles Casper, Howard S Goldberg, Robert W Grundmeier, Nathan Kuppermann
OBJECTIVES: We determined whether implementing the Pediatric Emergency Care Applied Research Network (PECARN) traumatic brain injury (TBI) prediction rules and providing risks of clinically important TBIs (ciTBIs) with computerized clinical decision support (CDS) reduces computed tomography (CT) use for children with minor head trauma. METHODS: Nonrandomized trial with concurrent controls at 5 pediatric emergency departments (PEDs) and 8 general EDs (GEDs) between November 2011 and June 2014...
April 2017: Pediatrics
https://www.readbyqxmd.com/read/28192567/development-and-internal-validation-of-a-clinical-risk-score-for-treating-children-with-mild-head-trauma-and-intracranial-injury
#18
MULTICENTER STUDY
Jacob K Greenberg, Yan Yan, Christopher R Carpenter, Angela Lumba-Brown, Martin S Keller, Jose A Pineda, Ross C Brownson, David D Limbrick
Importance: The appropriate treatment of children with mild traumatic brain injury (mTBI) and intracranial injury (ICI) on computed tomographic imaging remains unclear. Evidence-based risk assessments may improve patient safety and reduce resource use. Objective: To derive a risk score predicting the need for intensive care unit observation in children with mTBI and ICI. Design, Setting, and Participants: This retrospective analysis of the prospective Pediatric Emergency Care Applied Research Network (PECARN) head injury cohort study included patients enrolled in 25 North American emergency departments from 2004 to 2006...
April 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28170143/prevalence-of-brain-injuries-and-recurrence-of-seizures-in-children-with-posttraumatic-seizures
#19
Mohamed K Badawy, Peter S Dayan, Michael G Tunik, Frances M Nadel, Kathleen A Lillis, Michelle Miskin, Dominic A Borgialli, Michael C Bachman, Shireen M Atabaki, John D Hoyle, James F Holmes, Nathan Kuppermann
OBJECTIVES: Computed tomography (CT) is often used in the emergency department (ED) evaluation of children with posttraumatic seizures (PTS); however, the frequency of traumatic brain injuries (TBIs) and short-term seizure recurrence is lacking. Our main objective was to evaluate the frequency of TBIs on CT and short-term seizure recurrence in children with PTS. We also aimed to determine the associations between the likelihood of TBI on CT with the timing of onset of PTS after the traumatic event and duration of PTS...
May 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28039943/the-pecarn-tbi-rules-do-not-apply-to-abusive-head-trauma
#20
Julia N Magana, Nathan Kuppermann
No abstract text is available yet for this article.
March 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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