A5081543125- Emergency and Acute Care Studies
- Trauma and Emergency Care Studies
- Cardiac Arrest and Resuscitation
- Child and Adolescent Health
- Airway Management and Intubation Techniques
- Neonatal Respiratory Health Research
- Spinal Fractures and Fixation Techniques
- Global Health Workforce Issues
- Asthma and respiratory diseases
- Radiation Dose and Imaging
- Medical Education and Admissions
- Diversity and Career in Medicine
- Trauma Management and Diagnosis
- Disaster Response and Management
- Preterm Birth and Chorioamnionitis
- Spine and Intervertebral Disc Pathology
- Restraint-Related Deaths
- Injury Epidemiology and Prevention
- Ultrasound in Clinical Applications
- Appendicitis Diagnosis and Management
- Epilepsy research and treatment
- Healthcare cost, quality, practices
- Organizational Learning and Leadership
- Medical Imaging and Analysis
- Food Allergy and Anaphylaxis Research
Children's Hospital of Pittsburgh
2017-2025
University of Pittsburgh
2017-2025
University of Pittsburgh Medical Center
2019-2024
George Washington University
2008
Ill and injured children have unique needs that can be magnified when the child's ailment is serious or life-threatening. This especially true in out-of-hospital environment. Providing high-quality care to requires an emergency medical services (EMS) system infrastructure designed support of pediatric patients. As department setting, it important all EMS agencies appropriate resources, including physician oversight, trained competent staff, education, policies, medications, equipment,...
In the United States, race-based disparities in cardiovascular disease care have proven to be pervasive, deadly, and expensive. African American/Black, Hispanic/Latinx, Native/Indigenous American individuals are at an increased risk of less likely receive high-quality, evidence-based medical as compared with their White counterparts. Although States population is diverse, workforce that provides its much-needed lacks diversity. The available data show provided by physicians from racially...
Spinal motion restriction (SMR) is commonly applied to injured children with potential cervical spine injuries (CSI). There are, however, risks indiscriminate SMR application. We recently derived the Pediatric Emergency Care Applied Research Network (PECARN) CSI clinical prediction rule. Effective implementation of this rule requires an accurate understanding current emergency medical services (EMS) practices. Little known about prevalence prehospital application in children. Our primary...
Abstract Objective National guidelines in the United States recommend intramuscular and intranasal routes for midazolam management of seizures prehospital setting. We evaluated association route administration with use additional benzodiazepine doses children cared by emergency medical services (EMS). Methods conducted a retrospective cohort study from US multiagency EMS dataset years 2018–2022, including transported to hospital clinician impression seizures, convulsions, or status...
Improving health and safety in our communities requires deliberate focus commitment to equity. Inequities are differences access, treatment, outcomes between individuals across populations that systemic, avoidable, unjust. Within care general, Emergency Medical Services (EMS) particular, there demonstrated inequities the quality of provided patients based on a number characteristics linked discrimination, exclusion, or bias. Given critical role EMS plays within system, it is imperative...
Background: Fluctuations in emergency medical services (EMS) responses can have a substantial impact on the ability of agencies to meet resource needs within an EMS system. We aimed identify weather characteristics as potentially predictable factors associated with responses. Methods: reviewed hourly counts scene documented by 24 Western Pennsylvania from January 1, 2014 December 31, 2017 and compared rates characteristics. Responses counties nonadjacent studied reporting station...
POSITION STATEMENTEmergency medical services (EMS), similar to all aspects of health care systems, can play a vital role in examining and reducing disparities through educational, operational, quality improvement interventions. Public statistics existing research highlight that patients certain socioeconomic status, gender identity, sexual orientation, race/ethnicity are disproportionately affected with respect morbidity mortality for acute conditions multiple disease processes, leading...
Abstract Background Pediatric patients attended to by emergency medical services ( EMS ) but not transported the hospital are an at‐risk population. We aimed evaluate risk factors associated with nontransport in pediatric patients. Methods reviewed records of 24 agencies a regional system Southwestern Pennsylvania between January 1, 2014, and December 31, 2017. abstracted demographics (age, sex, complaint, median household income zip code, race, ethnicity), clinical characteristics (abnormal...
Background: Prehospital pediatric endotracheal intubation (ETI) is rarely performed. Previous research has suggested that prehospital ETI, when performed by ground advanced life support crews, associated with poor outcomes. In this study, we aim to evaluate the first-attempt success rate, overall rate and complications of ETI critical care transport (CCT) personnel.Methods: We conducted a retrospective observational study in multi-state CCT service performing rotor wing, ground, fixed wing...
Asthma represents one of the most common medical conditions among children encountered by emergency services (EMS). While care disparities for with asthma have been observed in other healthcare settings, limited data exist characterizing prehospital care. We sought to characterize differences treatment and transport suspected exacerbations race ethnicity, within context community socioeconomic status.We conducted a multi-agency retrospective study EMS encounters 2019 (2-17 years) wheezing...
Advanced diagnostic imaging modalities, including ultrasonography, computed tomography, and magnetic resonance imaging, are key components in the evaluation management of pediatric patients presenting to emergency department. Advances technology have led availability faster more accurate tools improve patient care. Notwithstanding these advances, it is important for physicians, physician assistants, nurse practitioners understand risks limitations associated with advanced children limit...
During the COVID-19 pandemic, many emergency medical services (EMS) agencies modified treatment guidelines for clinical care and standard operating procedures. For prehospital of pediatric asthma exacerbations, modifications included changes to bronchodilator administration, systemic corticosteroid introduction alternative medications. Since timely administration bronchodilators corticosteroids has been shown improve outcomes, we investigated association protocol in management on hospital...
Objective. To describe pediatric Medicaid patients with emergency department (PED) visits for anaphylaxis who received epinephrine auto-injector (EAI) prescriptions in the ED versus those did not; and to compare filled their not. Methods. We conducted a cross-sectional study of aged 0 21 years presenting 2 PEDs, symptoms meeting National Institute Allergy Infectious Diseases criteria anaphylaxis, between July 2012 2014. Results. identified 86 across hospitals confirmed diagnosis PED. Of...
This is a joint policy statement from the American Academy of Pediatrics, College Emergency Physicians, Nurses Association, National Association Medical Services and Technicians on pediatric readiness in emergency medical services systems.
Abstract Objectives The COVID‐19 pandemic has had an impact on emergency medical services (EMS) and its guidelines, which aid in patient care. This study characterizes state territory EMS office recommendations to statewide operational clinical guidelines describes the mechanisms of distribution implementation during pandemic. Methods A mixed‐methods was conducted 2 phases. In phase 1, changes development guidance protocols for management operations were identified among 50 states, District...
Asthma is a common pediatric diagnosis for emergency medical services (EMS) transports, however there paucity of data on prehospital asthma management. The purpose this study was to describe management patients with suspected exacerbation.We conducted retrospective review electronic records from 24 ground EMS agencies in Southwestern Pennsylvania between 1 January 2014 31 December 2017. We identified 2 17 years documented wheezing, excluding those anaphylaxis. Patients respiratory distress...
This is a joint policy statement from the American Academy of Pediatrics, College Emergency Physicians, Nurses Association, National Association Medical Services and Technicians on pediatric readiness in emergency medical services systems.
This study aimed to compare statewide emergency medical services protocols for the management of pediatric respiratory distress.We performed a descriptive distress in United States, excluding those without model or mandatory protocols. We compared medication recommendations specific disease processes, including asthma, croup, epiglottitis, anaphylaxis, generalized distress, intubation, and drug assisted intubation.Thirty-four state were included. All had address distress. There was high...
Abstract Background Timely administration of systemic corticosteroids is a cornerstone asthma exacerbation treatment, yet little known regarding potential benefits prehospital by emergency medical services (EMS) clinicians. We examined factors associated with corticosteroid hospitalization and hospital length stay (LOS). Methods performed retrospective study EMS encounters for patients 2–50 years age suspected from national data set. evaluated using generalized estimating equations....