A5041530916- Airway Management and Intubation Techniques
- Respiratory Support and Mechanisms
- Cardiac Arrest and Resuscitation
- Tracheal and airway disorders
- Emergency and Acute Care Studies
- Sepsis Diagnosis and Treatment
- Family and Patient Care in Intensive Care Units
- Cardiac, Anesthesia and Surgical Outcomes
- Congenital Diaphragmatic Hernia Studies
- Intensive Care Unit Cognitive Disorders
- Anesthesia and Sedative Agents
- Neonatal Respiratory Health Research
- Infant Development and Preterm Care
- Pediatric Pain Management Techniques
- Ultrasound in Clinical Applications
- Streptococcal Infections and Treatments
- Clinical Reasoning and Diagnostic Skills
- Pneumonia and Respiratory Infections
- Inhalation and Respiratory Drug Delivery
- Patient Safety and Medication Errors
- Hospital Admissions and Outcomes
- Respiratory viral infections research
- Simulation-Based Education in Healthcare
- Actinomycetales infections and treatment
- Viral gastroenteritis research and epidemiology
Women & Children's Hospital of Buffalo
2015-2025
University at Buffalo, State University of New York
2017-2024
Jacobs Institute
2023
Action Network
2023
Park Terrace Care Center
2023
Duke University
2020
Impact
2020
Weatherford College
2018
Creative Commons
2018
Duke University Hospital
2015
To improve handover communication and patient outcomes for postoperative admissions to a multidisciplinary PICU.Prospective cohort study.Multidisciplinary PICU in university hospital.The team responsible care, including attending, fellow, house staff physicians, nurses from pediatric critical care medicine, surgery, anesthesia.An online survey distributed PICU, anesthesia providers identified existing barriers challenges effective handovers guided the formation of standard protocol....
Tracheal intubation in PICUs is a common procedure often associated with adverse events. The aim of this study to evaluate the association between immediate events such as tracheal or desaturation and ICU outcomes: length stay, duration mechanical ventilation, mortality. Prospective cohort 35 using multicenter quality improvement database (National Emergency Airway Registry for Children: NEAR4KIDS) from January 2013 June 2015. Desaturation defined Spo2 less than 80%. participating NEAR4KIDS....
Determine if apneic oxygenation (AO) delivered via nasal cannula during the phase of tracheal intubation (TI), reduces adverse TI-associated events (TIAEs) in children. AO was implemented across 14 pediatric intensive care units as a quality improvement intervention 2016-2020. Implementation consisted an safety checklist, leadership endorsement, local champion, and data feedback to frontline clinicians. Standardized oxygen flow for follows: 5 L/min infants (< 1 year), 10 young children (1-7...
Video (indirect) laryngoscopy is used as a primary tracheal intubation device for difficult airways in emergency departments and adult ICUs. The use outcomes of video compared with direct has not been quantified PICUs or cardiac
Objectives: Tracheal intubation in critically ill children with shock poses a risk of hemodynamic compromise. Ketamine has been considered the drug choice for induction these patients, but limited data exist. We investigated whether administration ketamine tracheal or without was associated fewer adverse events compared other agents. also if there dose dependence any association between use and events. Design: performed retrospective analysis using prospectively collected observational from...
Abstract Background Tracheal intubation (TI) practice across pediatric emergency departments (EDs) has not been comprehensively reported. We aim to describe TI and outcomes in EDs contrast those intensive care units (ICUs) use the data identify quality improvement targets. [Correction added on 30 April 2022, after first online publication: The sentence modified.] Methods Consecutive encounters from ICUs National Emergency Airway Registry for Children (NEAR4KIDS) database 2015 2018 were...
Observational data suggest pediatric intensive care unit-related sleep and circadian disruption (PICU-SCD) affects many critically ill children. Multicenter trials exploring PICU-SCD have been impractical because measuring in this setting is challenging. This study validates a questionnaire for caregivers to describe children's the PICU.
Objectives: Sleep promotion bundles being tested in PICUs use elements adapted from adult bundles. As children may react differently than adults ICU environments, this study investigated what parents report disrupted the sleep of their child a PICU. Design: Secondary analysis multicenter validation Survey quality Setting: Four Northeastern U.S. PICUs, one hospital-based pediatric laboratory. Patients: Parents sleeping at bedside PICU or Interventions: Anonymous one-time survey eliciting...
Objectives: Tracheal intubation (TI) is a critical skill for PICU attending physicians to maintain. We hypothesize that attendings perform fewer TIs and have lower success rate in programs with Pediatric Critical Care Medicine (PCCM) fellowship. Design: Retrospective study using the National Emergency Airway Registry Children (NEAR4KIDS) from July 2016 June 2020. Exposures were presence of PCCM fellowship TI maintenance program (SMP). The primary outcome was attending’s first attempt...
As of July 2013, pediatric resident trainee guidelines in the United States no longer require proficiency nonneonatal tracheal intubation. We hypothesized that laryngoscopy by residents has decreased over time, with a more pronounced decrease after this guideline change.Prospective cohort study.Twenty-five PICUs at various children's hospitals across States.Tracheal intubations performed from 2010 to June 2016 multicenter intubation database (National Emergency Airway Registry for...
<h3>BACKGROUND:</h3> The objective of this work was to describe the use negative-pressure ventilation (NPV) in a heterogeneous critically ill, pediatric population. <h3>METHODS:</h3> A retrospective chart review conducted all patients admitted ICU with acute respiratory failure supported NPV from January 1, 2012 May 15, 2015. <h3>RESULTS:</h3> Two hundred thirty-three subjects at median age 15.5 months were for various etiologies, most commonly bronchiolitis (70%). Median (interquartile...
Abstract Introduction Children with CHD and acquired heart disease have unique, high-risk physiology. They may a higher risk of adverse tracheal-intubation-associated events, as compared children non-cardiac disease. Materials methods We sought to evaluate the occurrence events in cardiac A retrospective analysis tracheal intubations from 38 international paediatric ICUs was performed using National Emergency Airway Registry for (NEAR4KIDS) quality improvement registry. The primary outcome...
Pediatric antibiotic prescriptions originate from an increasingly broad range of ambulatory settings. In this retrospective study, pharyngitis, otitis media, sinusitis, pneumonia, and upper respiratory infection cases, at 11 primary care offices, 2 independent urgent centers (UCCs), a pediatric emergency department in Western New York, were analyzed relative to medical society practice guidelines utilization. Of 2358 eligible visits across all sites, 25% for study diagnoses, with 38% UCC (P...
Tracheal intubation carries a high risk of adverse events. The current literature is unclear regarding the "New Trainee Effect" on tracheal safety in PICU. We evaluated effect timing PICU fellow academic cycle associated hypothesize 1) PICUs with pediatric critical care medicine fellowship programs have more events during first quarter (July-September) year compared rest and 2) event rates attempt success performed by fellows improve through 3-year clinical fellowship. Retrospective cohort...
External laryngeal manipulation is a commonly used maneuver to improve visualization of the glottis during tracheal intubation in children. However, effectiveness attempt success rate nonanesthesia setting not clear. The study objective was evaluate association between external use and initial PICUs. A retrospective observational using multicenter emergency airway quality improvement registry. Thirty-five PICUs within general children's hospitals (29 United States, three Canada, one Japan,...
Objectives: Cricoid pressure is often used to prevent regurgitation during induction and mask ventilation prior high-risk tracheal intubation in critically ill children. Clinical data children showing benefit are limited. Our objective was evaluate the association between cricoid use occurrence of for PICU. Design: A retrospective cohort study a multicenter pediatric airway quality improvement registry. Settings: Thirty-five PICUs within general children’s hospitals (29 United States, three...
Evaluate differences in tracheal intubation-associated events and process variances (i.e., multiple intubation attempts oxygen desaturation) between pediatric cardiac ICUs noncardiac PICUs children with underlying disease. Retrospective cohort study using a multicenter quality improvement database (National Emergency Airway Registry for Children). Thirty-six (five ICUs, 31 ICUs) from July 2012 to March 2016. Children medical or surgical disease who underwent an ICU. None. Our primary outcome...
OBJECTIVES: Extracorporeal membrane oxygenation (ECMO) and/or inhaled anesthetics (IAs) are considered in the management of asthma when refractory to conventional therapy. We aimed compare outcomes these two modalities PICU care and determine associated survival hospital discharge among patients a United States database. DESIGN: Retrospective analysis using Virtual Pediatric Systems (VPS, LLC) SETTING: PICUs participating VPS PATIENTS: Patients less than 18 years old with diagnosis treated...
OBJECTIVES: To describe tracheal intubation (TI) practice by Advanced Practice Registered Nurses (APRNs) in North American PICUs, including rates of TI-associated events (TIAEs) from 2015 to 2019. DESIGN/SETTING: Retrospective study using the National Emergency Airway Registry for Children with all TIs performed PICU and pediatric cardiac ICU between January December The primary outcome was first attempt TI success rate. Secondary outcomes were TIAEs, severe hypoxemia. SUBJECTS: Critically...
This retrospective study aims to analyze the baseline characteristics and factors associated with poor outcomes in patients necrotizing enterocolitis (NEC) complicating respiratory syncytial virus (RSV) infection. Using Virtual Pediatric Systems data registry, under 2 years admitted pediatric intensive care unit (PICU) were screened. Patients documented RSV infection NEC, intestinal perforation, noninfectious gastroenteritis/colitis, or pneumatosis intestinalis occurring around timing of...