The Use of Telemedicine for Screening and Addressing Social Needs in a Primary Care Pediatric Population in Brooklyn, New York.

The objective of this study was to analyze temporal changes in social needs (SN), comparing those who received routine annual in-person care to those receiving SN screenings through a combination of tele-social care and in-person care biannually. Our prospective cohort study used a convenience sample of patients from primary care practices. Baseline data were collected from April 2019 to March 2020.

COVID-19 impacts on mobility and travel demand.

Since the beginning of the COVID-19 pandemic, many travel restriction policies were implemented to reduce further spread of the virus. These measures significantly affected travel demand to levels which could not have been anticipated by most planners in transportation agencies. As the pandemic has proven to have significant short-term impacts, it is anticipated that some of these impacts may translate to longer-term impacts on overall travel behavior and the movement of people and goods.

Social Determinants of Health and Pediatric Mental Health Before and During COVID-19 in New York City Primary Care Pediatrics.

In March 2020, at the start of the COVID-19 pandemic, New York City instituted a shelter-in-place order, dramatically affecting the area's social and economic landscape. Pediatric primary care practices universally screen for social determinants of health (SDOH) and mental health (MH) needs, providing an opportunity to assess changes in the population's needs during COVID-19. To assess changes in SDOH and MH needs of pediatric families before and during COVID-19, the authors conducted a prospective cohort study of patients seen in the hospital's pediatric primary care practices.

Bilateral Pneumothoraces in a 3-Month-Old Infant During an Apnea Test in the Diagnosis of Brain Death.

We present the case of a 3-month-old boy who suffered bilateral pneumothoraces secondary to insufflation of oxygen into the endotracheal tube during the apnea test as part of brain death testing. Although rare, awareness of this potential complication of the apnea test is of particular importance in pediatric patients who have narrow endotracheal tubes because resistance to expiratory flow increases exponentially as lumen diameter decreases.

Landlord Behavior After Receiving Pediatrician-Generated Letters to Address Poor Housing Conditions.

This cohort study examines whether providing a pediatrician-generated letter regarding patients’ poor housing conditions can encourage landlords to improve those conditions.

Severe Acute Respiratory Syndrome Coronavirus 2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth.

Objective: To characterize the demographic and clinical features of pediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) syndromes and identify admission variables predictive of disease severity.

Study Design: We conducted a multicenter, retrospective, and prospective study of pediatric patients hospitalized with acute SARS-CoV-2 infections and multisystem inflammatory syndrome in children (MIS-C) at 8 sites in New York, New Jersey, and Connecticut.

Results: We identified 281 hospitalized patients with SARS-CoV-2 infections and divided them into 3 groups based on clinical features.

Initial Observations of COVID-19 in US Children.

Coronavirus disease (COVID-19) has affected children differently from adults worldwide. Data on the clinical presentation of the infection in children are limited. We present a detailed account of pediatric inpatients infected with severe acute respiratory syndrome coronavirus 2 virus at our institution during widespread local transmission, aiming to understand disease presentation and outcomes.

Validation of Risk Stratification Criteria to Identify Febrile Neonates at Low Risk of Serious Bacterial Infection.

Our objective was to evaluate the accuracy of risk stratification criteria for febrile neonates in the emergency department. This was a retrospective study of febrile neonates ≤56 days of age. Patients were low risk for serious bacterial infection (SBI) if all test results were within normal ranges.

Rising Clinical Burden of Psychiatric Visits on the Pediatric Emergency Department.

Objective: The mental health epidemic in pediatrics has resulted in a growing clinical burden on the health care system, including pediatric emergency departments (PED). Our objective was to describe the changing characteristics of visits to an urban PED, in particular length of stay, for emergency psychiatric evaluations (EPEs) over a 10-year period.

Methods: A retrospective study of children with an EPE in the PED at a large urban quaternary care children's hospital was performed during two discrete periods a decade apart: July 1, 2003-June 30, 2004 (period 1) and July 1, 2013-June 30, 2014 (period 2).

Intranasal fentanyl for initial treatment of vaso-occlusive crisis in sickle cell disease.

Background: Analgesia administration for children with vaso-occlusive crises is often delayed in the emergency department. Intranasal fentanyl (INF) has been shown to be safe and effective in providing rapid analgesia for other painful conditions. Our objective was to determine if children with a vaso-occlusive crisis (VOC) who received initial treatment with INF compared to placebo achieved a greater decrease in pain score after 20 min.

Accuracy of Point-of-care Lung Ultrasonography for Diagnosis of Acute Chest Syndrome in Pediatric Patients with Sickle Cell Disease and Fever.

Objectives: The objective was to determine the test performance characteristics for point-of-care lung ultrasonography (LUS) performed by pediatric emergency medicine (PEM) physicians compared with radiographic diagnosis of acute chest syndrome (ACS) in patients with sickle cell disease (SCD) and fever.

Methods: This was a prospective study of patients up to 21 years with SCD and fever requiring chest X-ray (CXR) evaluation for ACS. Before obtaining CXR, a blinded PEM physician performed LUS using a standardized scanning protocol.

Appendicitis and Analgesia in the Pediatric Emergency Department: Are We Adequately Controlling Pain?

Objectives: The primary objective of the study was to compare analgesia-prescribing practices and timing of analgesia administration between pediatric emergency medicine (PEM) and general emergency medicine (GEM) practitioners for children with appendicitis. The secondary objective was to compare analgesia administration versus triage pain score, pediatric appendicitis score (PAS), and body mass index (BMI).

Methods: This was a retrospective chart review of patients younger than 21 years who presented to either an urban pediatric emergency department (ED) or 2 general EDs and were diagnosed with appendicitis.

Ultrasound findings of the elbow posterior fat pad in children with radial head subluxation.

Objective: The aim of this study was to determine whether elbow ultrasound findings of the posterior fat pad (PFP) are present in patients with diagnosis of radial head subluxation (RHS).

Methods: This was a prospective study of children presenting to an urban pediatric emergency department diagnosed clinically with RHS. Physicians received a 1-hour training session on musculoskeletal ultrasound including the elbow.

Management of Fever in postpneumococcal vaccine era: comparison of management practices by pediatric emergency medicine and general emergency medicine physicians.

Background. The primary objective of this study was to compare management practices of general emergency physicians (GEMPs) and pediatric emergency medicine physicians (PEMPs) for well-appearing young febrile children. Methods.

Comparison of GlideScope Videolaryngoscopy to Direct Laryngoscopy for Intubation of a Pediatric Simulator by Novice Physicians.

Objective. To compare novice clinicians' performance using GlideScope videolaryngoscopy (GVL) to direct laryngoscopy (DL). Methods.

Accuracy of point-of-care ultrasound for diagnosis of skull fractures in children.

Objective: To determine the test performance characteristics for point-of-care ultrasound performed by clinicians compared with computed tomography (CT) diagnosis of skull fractures.

Methods: We conducted a prospective study in a convenience sample of patients ≤21 years of age who presented to the emergency department with head injuries or suspected skull fractures that required CT scan evaluation. After a 1-hour, focused ultrasound training session, clinicians performed ultrasound examinations to evaluate patients for skull fractures.

Accuracy of point-of-care ultrasonography for diagnosis of elbow fractures in children.

Study Objective: We determine the test performance characteristics for point-of-care ultrasonography performed by pediatric emergency physicians compared with radiographic diagnosis of elbow fractures and compare interobserver agreement between enrolling physicians and an experienced pediatric emergency medicine sonologist.

Methods: This was a prospective study of children aged up to 21 years and presenting to the emergency department (ED) with elbow injuries requiring radiographs. Before obtaining radiographs, pediatric emergency physicians performed focused elbow ultrasonography.

Adolescents' use of the emergency department: does source of primary care make a difference?

Background: Many of the 18 million emergency department visits by adolescents annually in the United States are for nonurgent problems that might be addressed in a primary care setting.

Methods: As part of a larger randomized controlled intervention, 1023 adolescents aged 12 to 21 years registering in an urban pediatric emergency department (PED) were tracked over the subsequent 365 days to record all visits to the PED. Adolescents identifying an adolescent medicine service (AMS) as the primary care source were compared with adolescents receiving primary care elsewhere in an integrated urban medical system (non-AMS) to determine how often after the index PED visit they revisited the PED, returned to primary care (PC), visited a subspecialist (SS), or were hospitalized.