Hilary A. Hewes

ORCID: 0000-0002-4135-3422
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About
Contact & Profiles
Research Areas
  • Emergency and Acute Care Studies
  • Trauma and Emergency Care Studies
  • Injury Epidemiology and Prevention
  • Cardiac Arrest and Resuscitation
  • Healthcare Policy and Management
  • Trauma, Hemostasis, Coagulopathy, Resuscitation
  • Child and Adolescent Health
  • Abdominal Trauma and Injuries
  • Nursing Roles and Practices
  • Disaster Response and Management
  • Child Abuse and Trauma
  • Traumatic Brain Injury and Neurovascular Disturbances
  • Child Abuse and Related Trauma
  • Disaster Management and Resilience
  • Trauma Management and Diagnosis
  • Anesthesia and Pain Management
  • COVID-19 and healthcare impacts
  • Diabetes and associated disorders
  • Thermal Regulation in Medicine
  • Blood transfusion and management
  • Spinal Fractures and Fixation Techniques
  • Pediatric Pain Management Techniques
  • Global Health Care Issues
  • Genetic Syndromes and Imprinting
  • Patient Satisfaction in Healthcare

University of Utah
2015-2025

Primary Children's Hospital
2018-2025

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...

10.1001/jamanetworkopen.2022.50941 article EN cc-by-nc-nd JAMA Network Open 2023-01-13

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...

10.1080/10903127.2017.1367444 article EN Prehospital Emergency Care 2017-09-28

<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...

10.1001/jamapediatrics.2021.1319 article EN JAMA Pediatrics 2021-06-07

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,...

10.1097/ccm.0000000000005075 article EN Critical Care Medicine 2021-05-12

<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...

10.1001/jamasurg.2021.7419 article EN JAMA Surgery 2022-02-02

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.

10.1001/jamanetworkopen.2023.21707 article EN cc-by-nc-nd JAMA Network Open 2023-07-07

To use updated 2021 weighted Pediatric Readiness Score (wPRS) data to identify a threshold level of trauma center emergency department (ED) pediatric readiness.

10.1097/sla.0000000000006126 article EN Annals of Surgery 2023-10-13

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...

10.1002/emp2.13179 article EN cc-by-nc-nd Journal of the American College of Emergency Physicians Open 2024-06-01

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.

10.1001/jamanetworkopen.2024.42154 article EN cc-by-nc-nd JAMA Network Open 2024-11-01

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...

10.1097/ta.0000000000003779 article EN Journal of Trauma and Acute Care Surgery 2022-09-01

This cross-sectional study evaluates changes in pediatric inpatient capabilities among hospitals and examines the association with readiness.

10.1001/jamanetworkopen.2025.8277 article EN cc-by-nc-nd JAMA Network Open 2025-05-01

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...

10.1097/ta.0000000000001560 article EN Journal of Trauma and Acute Care Surgery 2017-05-23

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...

10.1097/ta.0000000000004387 article EN Journal of Trauma and Acute Care Surgery 2024-05-13

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,...

10.1001/jamanetworkopen.2024.22107 article EN cc-by-nc-nd JAMA Network Open 2024-07-22

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,...

10.1001/jamapediatrics.2024.6058 article EN JAMA Pediatrics 2025-02-03

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...

10.1186/s13063-018-2974-z article EN cc-by Trials 2018-10-30

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...

10.1093/haschl/qxad015 article EN cc-by-nc Health Affairs Scholar 2023-06-20

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...

10.1080/10903127.2018.1542472 article EN Prehospital Emergency Care 2018-11-01

The antifibrinolytic drug tranexamic acid (TXA) improves survival in adults with traumatic hemorrhage; however, the has not been evaluated a trial injured children. We assessed feasibility of large-scale evaluating effects TXA children severe hemorrhagic injuries.

10.1111/acem.14481 article EN Academic Emergency Medicine 2022-03-10

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.

10.1080/10903127.2022.2064020 article EN Prehospital Emergency Care 2022-04-08
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