Emergency care

Trends in Pediatric Emergency and Inpatient Healthcare Use for Mental and Behavioral Health Among North Carolinians During the Early COVID-19 Pandemic

Posted on by Kayla Korzekwinski

Journal of the Pediatric Infectious Diseases Society • December 2023

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Sielaty R, Boutzoukas AE, Zimmerman KO, Caison B, Charles CO, CoyneSmith T, Darden T, Overman RA, Benjamin, Jr DK, Brookhart MA

Widespread school closures and health care avoidance during the COVID-19 pandemic led to disruptions in access to pediatric mental health care. This study conducted a retrospective analysis of emergency and inpatient administrative claims from privately insured children aged 6-20 years in North Carolina between January 2019 and December 2020.

Impact of Personal Protective Equipment on the Performance of Emergency Pediatric Tasks

Posted on by Kayla Korzekwinski

Pediatric Emergency Care • December 2021

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Adler MD, Krug S, Eiger C, Good GL, Kou M, Nash M, Henretig FM, Hornik CP, Gosnell L, Chen JY, Debski J, Sharma G, Siegel D, Donoghue A
This study evaluated the impacts of personal protective equipment (PPE) on timeliness or success of emergency procedures performed by pediatric health care providers (HCPs). For session 1, HCPs wore normal attire; for session 2, they wore full-shroud PPE garb with 2 glove types: Ebola level or chemical. During each session, they performed clinical tasks on a patient simulator: intubation, bag-valve mask ventilation, venous catheter (IV) placement, push-pull fluid bolus, and defibrillation. Personal protective equipment did not affect procedure timeliness or success on a simulated child, with the exception of IV placement. Further study is needed to investigate PPE’s impact on procedures performed in a clinical care context.

Impact of Personal Protective Equipment on Pediatric Cardiopulmonary Resuscitation Performance: A Controlled Trial

Posted on by Kayla Korzekwinski

Pediatric Emergency Care • June 2020

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Donoghue A, Kou M, Good G, Eiger C, Nash M, Henretig F, Stacks H, Kochman A, Debski J, Chen JY, Sharma G, Hornik C, Gosnell L, Siegel D, Krug S, Adler M, on behalf of the Best Pharmaceuticals for Children Act – Pediatric Trials Network

This study aimed to determine whether personal protective equipment (PPE) results in deterioration in chest compression (CC) quality and greater fatigue for administering health care providers (HCPs). HCPs completed 2 sessions. In session 1 (baseline), HCPs wore normal attire; in session 2, HCPs donned full PPE. We enrolled 108 HCPs. During a clinically appropriate 2-minute period, neither CC quality nor self-reported fatigue worsened to a significant degree in providers wearing PPE. Our data suggest that Pediatric Basic Life Support recommendations for CC providers to switch every 2 minutes need not be altered with PPE use.

Impact of Personal Protective Equipment on the Performance of Emergency Pediatric Procedures by Prehospital Providers

Posted on by Kayla Korzekwinski

Disaster Medicine and Public Health Preparedness • May 2020

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Kou M, Donoghue AJ, Stacks H, Kochman A, Semiao M, Nash M, Siegel D, Ku L, Debski J, Chen J-Y, Sharma G, Gosnell L, Krug S, Adler MD

This study examined the effects of personal protective equipment (PPE) on the ability of prehospital providers (PHPs) to perform resuscitation procedures on pediatric patients. This prospective study was conducted at a US simulation center. Paramedics wore normal attire at the baseline session and donned full Level B PPE for the second session. PPE did not have a significant impact on PHPs performing critical tasks while caring for a pediatric patient with a highly infectious or chemical exposure. This information may guide PHPs faced with the situation of resuscitating children while wearing Level B PPE.

Medication Use in the Neonatal Intensive Care Unit and Changes from 2010 to 2018

Posted on by Kayla Korzekwinski

The Journal of Pediatrics • January 2022

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Stark A, Smith PB, Hornik CP, Zimmerman KO, Hornik CD, Pradeep S, Clark RH, Benjamin DK, Laughon M, Greenberg RG.

The goal of this study was to provide up-to-date medication prescribing patterns in US neonatal intensive care units (NICUs) and to examine trends in prescribing patterns over time. The most frequently prescribed medications included ampicillin, gentamicin, caffeine citrate, poractant alfa, morphine, vancomycin, furosemide, fentanyl, midazolam, and acetaminophen. Of the top 50 medications used in infants with extremely low birth weight, only 20 (40%) are FDA-labeled for use in infants. Trends of medication use in the NICU change substantially over time. It is imperative to identify changes in medication use in the NICU to better inform further prospective studies.

Adverse Events After Routine Immunization of Extremely Low Birth Weight Infants

Posted on by Kayla Korzekwinski

JAMA Pediatrics • August 2016

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DeMeo SD, Raman SR, Hornik CP, Wilson CC, Clark R, Smith PB
Immunization of extremely low birth weight (ELBW) infants in the neonatal intensive care unit (NICU) is associated with adverse events including fever and apnea/bradycardia in the immediate post-immunization period. This presents a diagnostic dilemma for clinicians, leading to the potential for immunization delay and sepsis evaluations. The goal of this study is to compare the incidence of sepsis evaluations, need for increased respiratory support, intubation, seizures, and death among immunized ELBW infants in the 3 days pre- and post-immunization.

Gaps in Drug Dosing for Obese Children: A Systematic Review of Commonly Prescribed Emergency Care Medications

Posted on by Kayla Korzekwinski

Clinical Therapy • September 2015

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Rowe S, Siegel D, Benjamin DK Jr; Best Pharmaceuticals for Children Act – Pediatric Trials Network Administrative Core Committee.

Approximately 1 of 6 children in the United States is obese. This has important implications for drug dosing and safety because pharmacokinetic (PK) changes are known to occur in obesity due to altered body composition and physiologic mechanisms. Inappropriate drug dosing in an emergency setting can limit therapeutic efficacy and increase drug-related toxic effects for obese children.