Understanding Disparities in the Pediatric ICU: A Scoping Review.

Background And Objectives: Health disparities are pervasive in pediatrics. We aimed to describe disparities among patients who are likely to be cared for in the PICU and delineate how sociodemographic data are collected and categorized.

Methods: Using MEDLINE as a data source, we identified studies which included an objective to assess sociodemographic disparities among PICU patients in the United States.

Child Opportunity Index and Pediatric Intensive Care Outcomes: A Multicenter Retrospective Study in the United States.

Objectives: To evaluate for associations between a child's neighborhood, as categorized by Child Opportunity Index (COI 2.0), and 1) PICU mortality, 2) severity of illness at PICU admission, and 3) PICU length of stay (LOS).

Design: Retrospective cohort study.

A Multicenter Retrospective Database Evaluation of Pediatric Patients Diagnosed With Tinea Capitis.

Purpose: Tinea capitis is a common pediatric superficial dermatophyte infection associated with lower socioeconomic status, overcrowded environments, and poor hygiene internationally. Nevertheless, to the authors' knowledge, no studies in the United States have reported an association between tinea capitis diagnoses and diagnostic codes for social determinants of health (SDOH). The objectives of the present study were to analyze the diagnostic and treatment approach and frequency of SDOH diagnostic codes in order to assess the presence of racial disparities in the treatment of pediatric patients aged 0 to 18 years diagnosed with tinea capitis.

Intensivists' Reported Management of Critical Bronchiolitis: More Data and New Guidelines Needed.

Objectives: Existing bronchiolitis guidelines do not reflect the needs of infants admitted to the PICU. This study aimed to identify PICU providers' reported practice variations and explore the need for critical bronchiolitis clinical guidelines.

Methods: Cross-sectional electronic survey available in English, Spanish, and Portuguese between November 2020 and March 2021, distributed via research networks from North and Latin America, Asia, and Australia/New Zealand.

Development of an Approach to Assessing Pediatric Fellows' Transport Medical Control Skills.

Background And Objective: Pediatric interfacility transport teams facilitate access to subspecialty care, and physicians often guide management remotely as transport medical control (TMC). Pediatric subspecialty fellows frequently perform TMC duties, but tools assessing competency are lacking. Our objective was to develop content validity for the items required to assess pediatric subspecialty fellows' TMC skills.

Gamification educational intervention improves pediatric nurses' comfort and speed drawing up code-dose epinephrine.

Purpose: Drawing up weight-based doses of epinephrine is a vital skill for pediatric nurses; however, non-intensive care unit (ICU) nurses may not routinely perform this skill and may not be as efficient or comfortable doing so during pediatric resuscitations. This study aimed to evaluate the impact of a gamification program on non-ICU pediatric nurses' knowledge and skills regarding epinephrine for pediatric cardiac arrest.

Design And Methods: Comfort and time to draw up three doses of epinephrine during out-of-ICU in-hospital pediatric cardiac arrest were measured pre- and post- a gamification-centered educational intervention.

Current utilization of interosseous access in pediatrics: a population-based analysis using an EHR database, TriNetX.

Background: When central or peripheral intravenous access cannot be achieved in a timely manner, intraosseous (IO) access is recommended as a safe and equally effective alternative for pediatric resuscitation. IO usage and its complications in the pediatric population have been primarily studied in the setting of cardiac arrest. However, population-based studies identifying noncardiac indications and complications associated with different age groups are sparse.

Benefits and Limitations of Virtual Recruitment: Perspectives From Subspeciality Directors.

Background And Objectives: Because of the coronavirus disease 2019 pandemic and recommendations from a range of leaders and organizations, the pediatrics subspecialty 2020 recruitment season was entirely virtual. Minimal data exist on the effect of this change to guide future strategies. The aim of this study was to understand the effects of virtual recruitment on pediatric subspecialty programs as perceived by program leaders.

Impact of Pediatric Intensive Care Unit Preadmission Huddle on Perceptions of Interprofessional Communication About Patient Safety.

Background: Preadmission discussions in the study institution's pediatric intensive care unit are not standardized and admission plans were thought to be disjointed, leading to a perceived lack of organization and preparation for the arrival of a critically ill child.

Objective: To evaluate the impact of a new, formalized preadmission pediatric intensive care unit interdisciplinary huddle on clinician perceptions of interprofessional communication. The hypothesis was that preadmission huddles would improve unit clinicians' perceptions of interprofessional communication.

Eye-Tracking Technology to Determine Procedural Proficiency in Ultrasound-Guided Regional Anesthesia.

Background: Eye-tracking measures attention patterns, which may offer insight into evaluating procedural expertise. The purpose of this study was to determine the feasibility of using eye tracking to assess visual fixation patterns when performing an ultrasound-guided regional anesthesia procedure and to assess for differences between experienced, intermediate, and novice practitioners.

Methods: Participants performed an ultrasound-guided sciatic nerve block 3 times on a fresh cadaver model while wearing eye-tracking glasses.

Evaluating Pediatric Families' Understanding of and Reactions to COVID-19 Visitor Restrictions.

The COVID-19 pandemic led to changes in hospital visitor policies and little is known about the impact on patients and their families. This study evaluated families' understanding of and reactions to COVID-19-related visitor restriction policy at an academic children's hospital. We conducted a cross-sectional study with families of patients admitted to the pediatric ICU and general pediatric wards from September 2020 to November 2020.

An Antiracism Approach to Conducting, Reporting, and Evaluating Pediatric Critical Care Research.

Reporting race and ethnicity without consideration for the complexity of these variables is unfortunately common in research. This practice exacerbates the systemic racism present in healthcare and research, of which pediatric critical care is not immune. Scientifically, this approach lacks rigor, as people are grouped into socially derived categories that are often not scientifically justified, and the field is denied the opportunity to examine closely the true associations between race/ethnicity and clinical outcomes.

Defining Priority Areas for Critical Care Simulation: A Modified Delphi Consensus Project.

Background Simulation is used in critical care for skill development, formative assessment, and interprofessional team performance. Healthcare educators need to balance the relatively high cost to deliver simulation education with the potential impact on healthcare quality. It is unclear how to prioritize simulation in critical care education, especially considering interprofessional needs across adult and pediatric populations.

Transport Medical Control Education for Pediatric Critical Care Fellows: A National Needs Assessment Study.

Objectives: Characterize transport medical control education in Pediatric Critical Care Medicine fellowship.

Design: Cross-sectional survey study.

Setting: Pediatric Critical Care Medicine fellowship programs in the United States.

PICU Passport: Pilot study of a handheld resident curriculum.

Background: To explore the impact of an educational tool designed to streamline resident learning during their pediatric intensive care (PICU) rotations.

Methods: Topics and procedures were chosen for inclusion based on national requirements for pediatric residents. Residents received a PICU Passport at the beginning of their rotations.

Blindfolding Improves Communication in Inexperienced Residents Undergoing ACLS Training.

Background: Closed-loop communication (CLC) is associated with decreased medical errors and improved time-to-task completion during resuscitations. Depriving team leaders of sight during training may accelerate the acquisition of favorable communication skills; however, its effect on the frequency of CLC is unclear, especially with trainees.

Objective: We assessed the effect of depriving interns of sight during advanced cardiovascular life support (ACLS) on verbal communication patterns and resuscitation confidence.

Practice Patterns of Central Venous Catheter Placement and Confirmation in Pediatric Critical Care.

Optimal practices for the placement of central venous catheters (CVCs) in critically ill children are unclear. This study describes the clinical practice of pediatric critical care medicine (PCCM) providers regarding CVC placement, including site selection, confirmation practices and assessment of complications. Two-hundred fourteen PCCM providers responded to an electronic survey, including 170 (79%) attending physicians, 30 (14%) fellow physicians, and 14 (7%) advanced practice providers.

Development of an Innovative Nonanimal Training Model for Infant Pleural Effusion Drainage via Pigtail Catheter Placement.

Background: Chest tube placement is an important skill for providers and bedside nurses caring for critically ill infants, allowing for the evacuation of pleural fluid and pneumothoraces. No realistic simulation models are commercially available for trainees to practice and learn this skill on infants.

Purpose: Our objective was to develop an inexpensive and reproducible model for percutaneous pleural pigtail placement for pleural fluid removal via the Seldinger technique.

Racial Minority Families' Preferences for Communication in Pediatric Intensive Care Often Overlooked.

Objective: To compare the communication experiences and preferences of racial/ethnic minority and non-Hispanic white (NHW) families in the pediatric intensive care unit (PICU), including their interactions with bedside nurses.

Methods: Retrospective cohort study performed at a quaternary university-affiliated children's hospital with 70 pediatric intensive care beds. From October 2013 to December 2014, English-speaking family members of children admitted to the PICU were asked about their experiences communicating with PICU caregivers using a survey tool.

Development and Validation of the Pediatric Resuscitation and Escalation of Care Self-Efficacy Scale.

Objectives: To validate a scale to assess pediatric providers' resuscitation and escalation of care self-efficacy and assess which provider characteristics and experiences may contribute to self-efficacy.

Methods: Cross-sectional cohort study performed at an academic children's hospital. Pediatric nurses, respiratory therapists, and residents completed the Generalized Self-Efficacy Scale (GSES) and Pediatric Resuscitation Self-Efficacy Scale (PRSES) as well as a survey assessing their experiences with pediatric escalation of care.

Assessing Competence in Central Venous Catheter Placement by Pediatric Critical Care Fellows: A National Survey Study.

Objectives: To describe the current approach to initial training, ongoing skill maintenance, and assessment of competence in central venous catheter placement by pediatric critical care medicine fellows, a subset of trainees in whom this skill is required.

Design: Cross-sectional internet-based survey with deliberate sampling.

Setting: United States pediatric critical care medicine fellowship programs.

Communication With Limited English-Proficient Families in the PICU.

Objective: Health care disparities have been described for children of limited English-proficient (LEP) families compared with children of English-proficient (EP) families. Poor communication with the medical team may contribute to these worse health outcomes. Previous studies exploring communication in the PICU have excluded LEP families.