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Full-Text Articles in Medicine and Health Sciences
Call Me Telephone Triage Skills For Pediatricians Across Multiple Settings, Cody Clary, Jonathan Ermer, Rebecca Callahan, Kayla Heller, Luke Stephens, Margaret Kirkpatrick, Nehal Parikh, Cody Tigges, Madhuradhar Chegondi
Call Me Telephone Triage Skills For Pediatricians Across Multiple Settings, Cody Clary, Jonathan Ermer, Rebecca Callahan, Kayla Heller, Luke Stephens, Margaret Kirkpatrick, Nehal Parikh, Cody Tigges, Madhuradhar Chegondi
Presentations
Come explore current evidence surrounding telephone triage skills across a variety of settings and learn ways to teach these valuable skills while promoting best practices. Outpatient pediatricians, hospitalists, ICU physicians and ED providers all have telephone calls incorporated into their work. Often physicians are operating with very little training in this area, and methodology about teaching these skills to pediatric trainees is limited. We will highlight educational innovations at a variety of programs designed to improve resident and fellow education, sharing our results and providing opportunities for others to design their own content relevant to their own practice. Participants will …
Variation In Systemic Corticosteroid Prescribing During Asthma-Related Hospitalizations Across Children's Hospitals, Sian Best, Matt Hall, Jessica L. Bettenhausen, Shelby Chesbro, Nicholas Clark, Megan Collins, Adrienne G. Deporre, Jonathan Ermer, Bridgette Jones, Leah Jones, Jessica Markham, Elisha Mccoy, Maria Newmaster, Laura Plencner, Henry T. Puls, Smit Shah, Kathryn Kyler
Variation In Systemic Corticosteroid Prescribing During Asthma-Related Hospitalizations Across Children's Hospitals, Sian Best, Matt Hall, Jessica L. Bettenhausen, Shelby Chesbro, Nicholas Clark, Megan Collins, Adrienne G. Deporre, Jonathan Ermer, Bridgette Jones, Leah Jones, Jessica Markham, Elisha Mccoy, Maria Newmaster, Laura Plencner, Henry T. Puls, Smit Shah, Kathryn Kyler
Presentations
Asthma exacerbations are a leading cause of pediatric hospitalizations, and systemic corticosteroids remain a key component of inpatient treatment. Emergency department-focused studies have shown dexamethasone to be equivalent to prednisone/prednisolone in terms of outcomes such as readmission rates, but less is known about the trends in dexamethasone use versus other systemic corticosteroids, and associated outcomes in the inpatient setting. Objective (216) To describe variability and trends in inpatient systemic corticosteroid prescribing practices for acute asthma exacerbations, and to determine associations between the prescribed steroid and hospitalization outcomes. Design/Methods (949) This retrospective cross-sectional study utilized the PHIS database to examine patients …
Improving Frequency Of Peer Review Of Abnormal Genital Exam Findings In Patients Undergoing Sexual Abuse Evaluation, Lyndsey Hultman, Terra N. Frazier, Jennifer Hansen
Improving Frequency Of Peer Review Of Abnormal Genital Exam Findings In Patients Undergoing Sexual Abuse Evaluation, Lyndsey Hultman, Terra N. Frazier, Jennifer Hansen
Presentations
Background/Objectives: 2023 Child Advocacy Center (CAC) accreditation standards require that “all medical professionals providing services to CAC clients must demonstrate that 100% of all findings deemed abnormal or “diagnostic” of trauma from sexual abuse have undergone expert review by an advanced medical consultant”. Prior to program implementation, scheduled Case Review occurred among the authors’ institution child abuse pediatricians (CAPs), but typical practice was to review cases upon CAP request. The authors’ institution faced practice standard implementation barriers of high case volumes and collaboration with multiple different CACs. Our primary aim was to increase peer review of abnormal exams from a …
Antimicrobial Duration Stewardship Project: A Qi Approach, Joshua Saucedo, Rana El Feghaly, Amanda Nedved, Leslie Hueschen, Marsha Dannenburg, Tanis Stewart, Patty Philips, Jennifer Floyd
Antimicrobial Duration Stewardship Project: A Qi Approach, Joshua Saucedo, Rana El Feghaly, Amanda Nedved, Leslie Hueschen, Marsha Dannenburg, Tanis Stewart, Patty Philips, Jennifer Floyd
Presentations
A QI project aimed at increasing the percentage of children discharged home from the emergency department with a diagnosis of community acquired pneumonia (CAP) or acute bacterial rhinosinusitis (ABRS) treated with an optimal antibiotic duration (5 days or less for CAP, 7 days or less for ABRS) from 22% to 70% by July 2025. Additionally, assess for differences in care based on demographic and socioeconomic factors such as the area deprivation index. National guidelines and CMH clinical pathways recommend short antibiotic durations (5-7 days) for most infections (5 days for community acquired pneumonia, 5-7 days for acute bacterial rhinosinusitis). At …
Testing For Bleeding Disorders In Child Abuse: Adherence To Aap Recommendations And Results Of Testing, Lyndsey Hultman, Angela Doswell, Henry T. Puls, Shannon L. Carpenter, Angela Bachim, Kristine Campbell, Daniel Lindberg, Joanne Wood, James Anderst
Testing For Bleeding Disorders In Child Abuse: Adherence To Aap Recommendations And Results Of Testing, Lyndsey Hultman, Angela Doswell, Henry T. Puls, Shannon L. Carpenter, Angela Bachim, Kristine Campbell, Daniel Lindberg, Joanne Wood, James Anderst
Presentations
Background: The American Academy of Pediatrics (AAP) recommends evaluations for bleeding disorders in children who have bruising and/or intracranial hemorrhage (ICH) concerning for abuse. Adherence to these recommendations is not known nor are the frequencies of identification of bleeding disorders or laboratory findings suggestive of a bleeding disorder. Objective: Using a multicenter research network (CAPNET), the objectives of this study were to characterize (1) the adherence to AAP recommendations for bleeding disorder testing in total and across CAPNET sites and (2) the frequency of identification of specific bleeding disorders and laboratory values concerning for bleeding disorders. Methods: We performed a …
Single-Step Collagen-Elastin Dermal Matrix With Split-Thickness Skin Grafting For Keloid Burn Scars: A Case Series, Meredith Elman, Pablo Aguayo
Single-Step Collagen-Elastin Dermal Matrix With Split-Thickness Skin Grafting For Keloid Burn Scars: A Case Series, Meredith Elman, Pablo Aguayo
Presentations
Introduction Keloids may pose significant difficulty to affected patients: they can be painful, itchy, impact mobility if they cross joints, and most disruptively, can be physically disfiguring and cause emotional distress. While multiple treatments exist, none reliably provide scar resolution, and up to 100% of keloids return after surgical excision. MatriDerm is a dermal replacement scaffold that has shown previous efficacy in management of a variety of acute and chronic wounds in adults, including burns. In this two patient case series, we aim to demonstrate the efficacy of single-step application of MatriDerm dermal substitute with split-thickness skin grafting in the …
Large Single Center Experience With Extubation During Neonatal And Pediatric Extracorporeal Membrane Oxygenation, Cara Holton, Johanna I. Orrick, Debra E. Newton, Jenna Miller
Large Single Center Experience With Extubation During Neonatal And Pediatric Extracorporeal Membrane Oxygenation, Cara Holton, Johanna I. Orrick, Debra E. Newton, Jenna Miller
Presentations
Introduction: Extubation of neonatal and pediatric patients supported with extracorporeal membrane oxygenation (ECMO) may avoid ventilator induced lung injury, decrease neurosedative exposure, and improve rehabilitation and mobility. Few studies have evaluated incidence and outcomes of pediatric patients extubated during ECMO. Methods: A single-center retrospective cohort study was performed to describe our experience with extubation on ECMO. All patients extubated on ECMO from 2013-2022 were included. Patients who had a tracheostomy prior to ECMO cannulation were excluded. Patients who had a tracheostomy placed during their ECMO run were included if extubation took place prior to tracheostomy placement. Results: Forty patients were …
Successful Hepatectomy, Anhepatic State, And Liver Transplant On Ecmo, Jenna Miller, Kari L. Davidson, Bhargava Mullapudi, Richard J. Hendrickson, Ryan T. Fischer, Lisa Conley, Wes Ware, Michelle Mckain, Tara Benton
Successful Hepatectomy, Anhepatic State, And Liver Transplant On Ecmo, Jenna Miller, Kari L. Davidson, Bhargava Mullapudi, Richard J. Hendrickson, Ryan T. Fischer, Lisa Conley, Wes Ware, Michelle Mckain, Tara Benton
Presentations
We discuss the case of a 13-month-old previously healthy male who presented with acute liver failure (ALF) of unknown etiology. He progressed to fulminant cardiopulmonary failure requiring mechanical ventilation and high dose inotropes with persistent lactate >20. He was cannulated to VA ECMO and tandem continuous renal replacement therapy (CRRT) with single pass albumin dialysis (SPAD) and plasma exchange (PLEX) therapies. He required high dose inotropes on ECMO and had persistently elevated lactate despite maximal medical therapy. Limited imaging studies suggested cirrhotic liver and possible intestinal pneumatosis. Due to evidence of fulminant ALF and potential for a reversible process, he …
Position Specific Injury Patterns In Male Developmental Academy Soccer Players, Andrew Donaldson, Catharine Kral, Shannon Margherio, Mckeenna Noe, Brian S. Harvey
Position Specific Injury Patterns In Male Developmental Academy Soccer Players, Andrew Donaldson, Catharine Kral, Shannon Margherio, Mckeenna Noe, Brian S. Harvey
Presentations
Background: Despite the availability of high-quality evidence describing injury patterns in European professional soccer players, there is a paucity of data regarding American athletes. This disparity is accentuated for elite youth athletes. Our study identifies position-specific injury patterns occurring in elite youth male soccer players. Hypothesis: We hypothesize that there are injury types, locations, and specific injuries that occur most frequently in elite youth soccer players and that certain positions have a higher frequency of these injuries than others. Methods: Data from a retrospective review of the IRB-approved Male Academy Soccer Registry from August 1, 2019 through June 30, 2022 …
Improving Nutritional Delivery To Pediatric Patients On Continuous Renal Replacement Therapy, Jennifer Ruiz-Boada, Sarah Brunner, Tara Benton, Vimal Chadha
Improving Nutritional Delivery To Pediatric Patients On Continuous Renal Replacement Therapy, Jennifer Ruiz-Boada, Sarah Brunner, Tara Benton, Vimal Chadha
Presentations
INTRODUCTION: Continuous renal replacement therapy (CRRT) is used in critically ill children with acute renal failure. CRRT can lead to malnutrition by removing essential proteins and micronutrients. Malnutrition is associated with worse outcomes, including increased length of stay and mortality. CRRT guidelines suggest the importance of early nutrition and ensuring high protein intake. After evaluating our CRRT patients, we found sub-optimal adherence to the guidelines. This Quality Improvement project aimed to increase the percentage of patients achieving 75% of their goal protein and caloric intake by day 5 of CRRT initiation by 15% by August 2023. METHODS: A multidisciplinary group …