Using Two Statewide Medical Operations Coordination Centers to Load Balance in Pediatric Hospitals During a Severe Respiratory Surge in the United States.

Objectives: Report on the use of two statewide Medical Operations Coordination Centers (MOCCs) to manage a rapid surge in pediatric acute and critical care patient needs.

Design: Brief report.

Setting: The states of Washington and Oregon during the pediatric respiratory surge in November 2022/December 2022 which overwhelmed existing pediatric acute and critical care hospital capacity.

A chart review tool to systematically assess the safety of prehospital care for children with out-of-hospital cardiac arrest.

Objective: Create an easy-to-use pediatric out-of-hospital cardiac arrest (OHCA)-specific chart review tool to reliably detect severe adverse safety events (ASEs) in the prehospital care of children with OHCA.

Methods: We revised our previously validated pediatric prehospital adverse event detection system (PEDS) tool, used to evaluate ASEs in the prehospital care of children during emergent calls, to create an OHCA-specific chart review tool. We developed decision support for reviewers, reviewer training, and a dedicated section for chart data abstraction.

Universal Level Designations for Hospitalized Pediatric Patients in Evacuation.

Children comprise approximately 22% of the population in the United States.1 In a widespread disaster such as a hurricane, pandemic, wildfire or major earthquake, children are at least proportionately affected to their share of the population, if not more so. They also have unique vulnerabilities including physical, mental, and developmental differences from adults, which make them more prone to adverse health effects of disasters.

Hospital Mortality and Functional Outcomes in Pediatric Neurocritical Care.

Objectives: Pediatric neurocritical care (PNCC) outcomes research is scarce. We aimed to expand knowledge about outcomes in PNCC by evaluating death and changes in Functional Status Scale (FSS) from baseline among PNCC diagnoses.

Methods: We conducted a 2-year observational study of children aged 0 to 18 years admitted to the ICU with a primary neurologic diagnosis ( = 325).

The Burden of Pediatric Neurocritical Care in the United States.

Background: Disorders requiring pediatric neurocritical care (PNCC) affect thousands of children annually. We aimed to quantify the burden of PNCC through generation of national estimates of disease incidence, utilization of critical care interventions (CCI), and hospital outcomes.

Methods: We performed a retrospective cohort analysis of the Kids Inpatient Database over three years to evaluate pediatric traumatic brain injury, neuro-infection or inflammatory diseases, status epilepticus, stroke, hypoxic ischemic injury after cardiac arrest, and spinal cord injury.

Reliability and Usability of a 7-Minute Chart Review Tool to Identify Pediatric Prehospital Adverse Safety Events.

Background And Objectives: Although medical errors in the hospital are a recognized source of morbidity and mortality, less is known about safety events in the prehospital care of children. As part of a multiphase study, we developed and evaluated the reliability and usability of the pediatric prehospital safety event detection system (PEDS), a tool used to identify safety events in prehospital care.

Methods: The tool was based on hospital chart review tools, literature review, and results from focus groups and a national Delphi survey.

Endovascular Therapy in Pediatric Stroke: Utilization, Patient Characteristics, and Outcomes.

Background And Purpose: Despite strong evidence for endovascular therapy in adults with acute arterial ischemic stroke, limited data exist in children. We aimed to describe endovascular therapy utilization and explore outcomes in a national sample of pediatric arterial ischemic stroke.

Methods: We queried the 2012 Kids' Inpatient Database for children aged greater than 28 days to 20 years with the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for arterial ischemic stroke and evaluated groups based on the procedure code for endovascular therapy.

The Association Between Hospital Capacity Strain and Inpatient Outcomes in Highly Developed Countries: A Systematic Review.

Background: Increases in patient needs can strain hospital resources, which may worsen care quality and outcomes. This systematic literature review sought to understand whether hospital capacity strain is associated with worse health outcomes for hospitalized patients and to evaluate benefits and harms of health system interventions to improve care quality during times of hospital capacity strain.

Methods: Parallel searches were conducted in MEDLINE, CINAHL, the Cochrane Library, and reference lists from 1999-2015.

Perspectives and Uses of the Electronic Health Record Among US Pediatricians: A National Survey.

Little is known about how existing electronic health records (EHRs) influence the practice of pediatric medicine. A total of 808 pediatricians participated in a survey about workflows using the EHR. The EHR was the most commonly used source of initial patient information.

Care of the child with Ebola virus disease.

Objectives: To provide clinicians with practical considerations for care of children with Ebola virus disease in resource-rich settings.

Data Sources: Review of the published medical literature, World Health Organization and government documents, and expert opinion.

Data Synthesis: There are limited data regarding Ebola virus disease in children; however, reported case-fatality proportions in children are high.

Variability in Electronic Health Record Usage and Perceptions among Specialty vs. Primary Care Physicians.

Despite federal incentives for adoption of electronic health records (EHRs), surveys have shown that EHR use is less common among specialty physicians than generalists. Concerns have been raised that current-generation EHR systems are inadequate to meet the unique information gathering needs of specialists. This study sought to identify whether information gathering needs and EHR usage patterns are different between specialists and generalists, and if so, to characterize their precise nature.

Risk factors for mechanical ventilation in U.S. children hospitalized with seasonal influenza and 2009 pandemic influenza A*.

Objective: We tested the hypothesis that the use of mechanical ventilator support in children hospitalized with influenza during the 2009 H1N1 influenza A (H1N1) pandemic was higher than would be expected in children hospitalized for seasonal influenza after adjusting for patient risk.

Design: Retrospective cohort study.

Setting: Forty-three U.