A5012053858- Sepsis Diagnosis and Treatment
- Emergency and Acute Care Studies
- Clinical Reasoning and Diagnostic Skills
- Nosocomial Infections in ICU
- Cardiac Arrest and Resuscitation
- Food Allergy and Anaphylaxis Research
- Hemodynamic Monitoring and Therapy
- Neonatal skin health care
- Intensive Care Unit Cognitive Disorders
- Airway Management and Intubation Techniques
- Respiratory Support and Mechanisms
- Respiratory and Cough-Related Research
- Asthma and respiratory diseases
- Escherichia coli research studies
- Neonatal Health and Biochemistry
- Streptococcal Infections and Treatments
- Anesthesia and Sedative Agents
- Pediatric Urology and Nephrology Studies
- Adolescent and Pediatric Healthcare
- Pharmaceutical studies and practices
- Therapeutic Uses of Natural Elements
- Pediatric Pain Management Techniques
- Intestinal Malrotation and Obstruction Disorders
- Renal function and acid-base balance
- Patient Safety and Medication Errors
Primary Children's Hospital
2007-2024
University of Utah
2007-2024
UC Davis Health System
2021
General Department of Preventive Medicine
2020
Children's Hospital of Philadelphia
2018
University of Pennsylvania
2018
Kennedy Krieger Institute
2018
Johns Hopkins University
2018
University of Michigan
2018
University of California, Riverside
1994
Septic shock impacts mortality, morbidity, and health care costs. A quality improvement (QI) initiative was launched to improve early recognition timely treatment of patients with septic in a pediatric emergency department (PED). Our primary aim describe the longitudinal effectiveness program, iterative changes clinical practice, associated outcomes.We implemented multiple interventions during our QI (February 2007 December 2014). Analysis compliance outcomes focused on bundle consisting of:...
Abstract The ovaries of endoparasitic species braconid and ichneumonid wasps contain large numbers polydnavirus (PDV) virions that replicate in specialized calyx cells the are injected into host larva during parasitization. In wasp Cotesia congregata parasitizes tobacco hornworm, Manduca sexta , total amount viral DNA present was determined to be 25–75 ng. Analysis on 0.4% agarose gels showed genome comprised 15–20 circles double‐stranded DNA. SDS‐PAGE analyses a number (>30) structural...
Procedural sedation is increasingly more common in pediatric emergency departments. We report our experience with intranasal midazolam (INM) using a unique atomization delivery device, specifically the efficacy and safety of this method sedation.We performed retrospective chart review children who received INM department from April 1, 2005, through June 30, 2005. All aged 1 to 60 months as initial means were eligible for study. Patients excluded if they older than months.There 205 patients...
Importance Pediatric consensus guidelines recommend antibiotic administration within 1 hour for septic shock and 3 hours sepsis without shock. Limited studies exist identifying a specific time past which delays in are associated with worse outcomes. Objective To determine point that is increased risk of mortality among pediatric patients sepsis. Design, Setting, Participants This retrospective cohort study used data from 51 US children’s hospitals the Improving Sepsis Outcomes collaborative....
OBJECTIVES The pediatric emergency department (ED)–based Pediatric Septic Shock Collaborative (PSSC) aimed to improve mortality and key care processes among children with presumed septic shock. METHODS This was a multicenter learning improvement collaborative of 19 EDs from November 2013 May 2016 shared screening patient identification recommendations, bundles care, educational materials. Process metrics included minutes initial vital sign assessment first third fluid bolus antibiotic...
Shiga toxin-producing Escherichia coli (STEC) infections are leading causes of pediatric acute renal failure. Identifying hemolytic uremic syndrome (HUS) risk factors is needed to guide care.We conducted a multicenter, historical cohort study identify features associated with development HUS (primary outcome) and need for replacement therapy (RRT) (secondary in STEC-infected children without at initial presentation. Children aged <18 years who submitted STEC-positive specimens between...
Objectives Current guidelines emphasize early recognition of pediatric septic shock using clinical examination findings. Elevated serum lactate has been associated with increased mortality in adult patients shock. Our objective was to determine the association between initial obtained emergency department (PED) from treated for and use vasoactive medication within 24 hours. Methods This a retrospective study 2008 through 2012 PED at tertiary care children’s hospital. Patients younger than 18...
BACKGROUND AND OBJECTIVES: National guidelines advocate for the administration of antibiotics within 1 hour to children with septic shock, although there is variance in pediatric evidence-based literature supporting this benchmark. Our objective study was describe association target time antibiotic (TTAA) outcomes treated suspected shock a emergency department. Septic when signs perfusion and/or hypotension are present. The primary outcome mortality. Secondary included PICU admission,...
Describe the clinical presentation, prevalence, and outcomes of concurrent serious bacterial infection (SBI) among infants with mastitis.Within Pediatric Emergency Medicine Collaborative Research Committee, 28 sites reviewed records aged ≤90 days mastitis who were seen in emergency department between January 1, 2008, December 31, 2017. Demographic, clinical, laboratory, treatment, outcome data summarized.Among 657 (median age 21 days), 641 (98%) well appearing, 138 (21%) had history fever at...
Objectives. To report the success rate of observation unit (OU) treatment pediatric skin and soft tissue infections (SSTIs) to see if we could identify variables at time initial evaluation that predicted successful OU treatment. Methods. A retrospective review children less than 18 years age admitted for SSTI our from emergency department between January 2003 June 2009. Results. On records review, 853 patients matched eligibility criteria; median was 5.2 (interquartile range = 2.5-9 years)....
OBJECTIVE Describe the clinical presentation, prevalence of concurrent serious bacterial infection (SBI), and outcomes among infants with omphalitis. METHODS Within Pediatric Emergency Medicine Collaborative Research Committee, 28 sites reviewed records ≤90 days age omphalitis seen in emergency department from January 1, 2008, to December 31, 2017. Demographic, clinical, laboratory, treatment, outcome data were summarized. RESULTS Among 566 (median 16 days), 537 (95%) well-appearing, 64...
This is a case of 3-year-old boy with sunflower-seed rectal bezoar who presented to our emergency department fever, abdominal pain, leukocytosis, vomiting, and an examination concerning for appendicitis. A failed diagnostic imaging attempt ultimately led the diagnosis. Children bezoars typically present diarrhea, tenesmus. Our patient atypically developed significant colitis secondary bezoar. We discuss uncommon seed illustrates atypical complication (colitis) unusual condition (rectal...
Guidelines exist for care of pediatric sepsis, but no study has assessed the benefit electronic learning (eLearning) in this topic area. The objective multicenter was to assess knowledge acquisition and retention sepsis across multiple health provider roles, using an adaptive interactive eLearning module.The used pretest, posttest, 90-day delayed test scores evaluate after module intervention. contained conditional logic-based assessments that allowed real-time adjustments displayed content...
Purpose: Severe sepsis is a significant source of morbidity and mortality in children. Lack adherence to evidence based treatment guidelines, including under-recognition delayed resuscitation, contribute increased morbidity. Single-site quality improvement (QI) initiatives focused on early recognition standardized care pathways have improved outcomes time interventions, as well decreased end-organ dysfunction mortality, but variation their utilization remains. Methods: The American Academy...
s: American Academy of Pediatrics, Section on Emergency Medicine, Abstract Presentations, 2006 AAP National Conference and Exhibition: POSTER PRESENTATIONS