A5052504307- Trauma and Emergency Care Studies
- Emergency and Acute Care Studies
- Injury Epidemiology and Prevention
- Cardiac Arrest and Resuscitation
- Healthcare Policy and Management
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Abdominal Trauma and Injuries
- Disaster Response and Management
- Child Abuse and Trauma
- Disaster Management and Resilience
- Traumatic Brain Injury and Neurovascular Disturbances
- Child and Adolescent Health
- Trauma Management and Diagnosis
- Child Abuse and Related Trauma
- Blood transfusion and management
- Ethics in Clinical Research
- Opioid Use Disorder Treatment
- Winter Sports Injuries and Performance
- Pediatric health and respiratory diseases
- Patient Satisfaction in Healthcare
- Neurosurgical Procedures and Complications
- Pelvic and Acetabular Injuries
- Hospital Admissions and Outcomes
- Homicide, Infanticide, and Child Abuse
- Nursing Roles and Practices
University of Utah
2015-2025
Primary Children's Hospital
2018-2024
American College of Surgeons
2024
ORCID
2024
Health Resources and Services Administration
2021
Case Western Reserve University
2021
University of California, Davis
2019
David Grant USAF Medical Center
2019
UC Davis Health System
2019
The Ohio State University
2019
Importance Emergency departments (EDs) with high pediatric readiness (coordination, personnel, quality improvement, safety, policies, and equipment) are associated lower mortality among children critical illness those admitted to trauma centers, but the benefit more diverse clinical conditions is unknown. Objective To evaluate association between ED readiness, in-hospital mortality, 1-year injured medically ill receiving emergency care in 11 states. Design, Setting, Participants This a...
Importance: Historically, pain management in the prehospital setting, specifically pediatric management, has been inadequate despite many EMS (emergency medical services) transports related to traumatic injury with noted as a symptom. The National Emergency Services Information System (NEMSIS) database offers largest national repository of data, and can be used assess current patterns across country. Objectives: To analyze using NEMSIS if variables such patient age and/or race/ethnicity are...
<h3>Importance</h3> The National Pediatric Readiness Project is a US initiative to improve emergency department (ED) readiness care for acutely ill and injured children. However, it unclear whether high ED pediatric associated with improved survival in trauma centers. <h3>Objective</h3> To evaluate the association between readiness, in-hospital mortality, complications among children presenting <h3>Design, Setting, Participants</h3> A retrospective cohort study of 832 EDs centers 50 states...
The purpose of our study was to describe children with life-threatening bleeding.We conducted a prospective observational bleeding events.Twenty-four childrens hospitals in the United States, Canada, and Italy participated.Children 0-17 years old who received greater than 40 mL/kg total blood products over 6 hours or were transfused under massive transfusion protocol included.Children compared according etiology: trauma, operative, medical.Patient characteristics, therapies administered,...
<h3>Importance</h3> There is substantial variability among emergency departments (EDs) in their readiness to care for acutely ill and injured children, including US trauma centers. While high ED pediatric associated with improved in-hospital survival children treated at centers, the association between long-term outcomes unknown. <h3>Objective</h3> To evaluate 1-year presenting 146 <h3>Design, Setting, Participants</h3> In this retrospective cohort study, younger than 18 years who were...
The National Pediatric Readiness Project assessment provides a comprehensive evaluation of the readiness US emergency departments (EDs) to care for children. Increased pediatric has been shown improve survival children with critical illness and injury.
Abstract Objective We estimate annual hospital expenditures to achieve high emergency department (ED) pediatric readiness (HPR), that is, weighted Pediatric Readiness Score (wPRS) ≥ 88 (0–100 scale) across EDs with different volumes of children, overall and after accounting for current levels readiness. Methods calculated the costs HPR based on two components: (1) ED equipment supplies (2) labor required a Emergency Care Coordinator (PECC) perform tasks. Data sources generate cost estimates...
Importance Children initially treated in a timely fashion at trauma centers with high levels of pediatric readiness have been shown to improved survival, but children historically had geographically disparate access center care. Considerable effort has invested improving nationally, including the implementation new standards improve emergency department all centers. Objective To assess current US pediatric-ready care and estimate potential improvement if high-level optimal readiness. Design,...
ABSTRACT Background Injured children initially treated at trauma centers with high emergency department (ED) pediatric readiness have improved survival. Centers limited resources may not be able to address all deficiencies and there currently is no evidence-based guidance for prioritizing different components of readiness. The objective this study was identify individual ED associated better-than-expected survival in US aid the allocation targeted improving Methods This cohort U.S. used...
To use updated 2021 weighted Pediatric Readiness Score (wPRS) data to identify a threshold level of trauma center emergency department (ED) pediatric readiness.
BACKGROUND With increasing attention to the quality of health care delivery, evaluating trauma triage decisions in a large system emergency can help decision makers reduce mortality, morbidity, unnecessary transfers, and costs. OBJECTIVES To quantify magnitude pediatric traumatic injury undertriage (hospital mortality risk) overtriage (early center discharge after transfer) statewide system. METHODS A population-based evaluation outcomes secondary (interfacility transfers) patterns from 2001...
High emergency department (ED) pediatric readiness is associated with improved survival among children receiving care, but state and national costs to reach high ED the resulting number of lives that may be saved are unknown.
Trauma is the leading cause of morbidity and mortality in children United States. The antifibrinolytic drug tranexamic acid (TXA) improves survival adults with traumatic hemorrhage, however, has not been evaluated a clinical trial severely injured children. We designed Traumatic Injury Clinical Trial Evaluating Tranexamic Acid Children (TIC-TOC) to evaluate feasibility conducting confirmatory that evaluates effects TXA severe trauma hemorrhagic injuries. evidence torso or brain injuries will...
Abstract Background and Objective High ED pediatric readiness is associated with improved survival in children, but the cost unknown. We evaluated costs of emergency care for children across quartiles readiness. Methods This was a retrospective cohort study 0 to 17 years receiving services 747 EDs 9 states from 1/1/2012 through 12/31/2017. measured using weighted Pediatric Readiness Score (wPRS, range 0-100). The primary outcome total acute (ED inpatient) 2022 dollars, adjusted case mix...
ABSTRACT BACKGROUND Emergency department (ED) pediatric readiness has been associated with lower mortality for injured children but historically suboptimal in non-pediatric trauma centers. Over the past decade, National Pediatric Readiness Project (NPRP) invested resources improving ED readiness. This study aimed to quantify current center and identify associations center-level characteristics target further efforts guide improvement. METHODS The cohort included all centers that responded...
Importance High emergency department (ED) pediatric readiness is associated with improved survival, but the impact of changes to ED unknown. Objective To evaluate association in at US trauma centers between 2013 and 2021 mortality. Design, Setting, Participants This retrospective cohort study was performed from January 1, 2012, through December 31, 2021, EDs 48 states District Columbia. included injured children younger than 18 years admission or injury-related death a participating center,...
Objectives In the United States, pediatric emergency department (ED) visits for behavioral health (BH) are increasing. We sought to determine ED-level characteristics associated with having recommended BH-related policies. Methods conducted a retrospective serial cross-sectional study of National Pediatric Readiness Project assessments administered US EDs in 2013 and 2021. Changes responses related BH items over time were examined. Multivariable logistic regression models examined ED...
The quality of emergency department (ED) care for children in the US is highly variable. National Pediatric Readiness Project aims to improve survival receiving services. We conducted a cost-effectiveness analysis increasing ED pediatric readiness, using decision-analytic simulation model. Previously published primary analyses nationally representative, population-based cohort services at 747 EDs eleven states provided clinical and cost parameters. From health sector perspective, we used 3...
Objective: Pediatric patients represent low frequency but potentially high-risk encounters for emergency medical services (EMS) providers. Scant information is available from EMS agencies on the of pediatric skill evaluation and presence care coordination, both which may help systems optimize children. The objective our study was to assess type methods used psychomotor skills competency using pediatric-specific equipment coordination in ground transport agencies. Methods: A web-based...
Whether ambulance transport patterns are optimized to match children high-readiness emergency departments (EDs) and the resulting effect on survival unknown. We quantified number of transported by 9-1-1 medical services (EMS) EDs, additional within 30 minutes a ED, estimated survival.
To determine whether convictions and sentencing differ between child abuse homicide cases adult to identify characteristics of the victim, suspect, or crime that influence conviction results.Retrospective case review.Homicide data abstracted from National Violent Death Reporting System in Utah.All deaths classified as Utah January 1, 2002, December 31, 2007.Judicial processing for results.Conviction rate, level felony conviction, severity suspects vs homicide.Utah had 373 victims during...
BACKGROUND There is wide variability of transfusion practices for children with hemorrhagic injuries across trauma centers. We are planning a multicenter, randomized clinical trial evaluating tranexamic acid in hemorrhage. Standardization sites important to minimize confounding. Therefore, we sought generate consensus-based guidelines the trial. METHODS used modified Delphi process utilizing multi-site, multi-disciplinary panel experts develop our guidelines. A survey 23 categories on...