Addition of a biomarker panel to a clinical score to identify patients at low risk for appendicitis.

Background: The diagnosis of pediatric acute appendicitis can be difficult. Although scoring systems such as the Pediatric Appendicitis Score (PAS) are helpful, they lack adequate sensitivity and specificity as standalone diagnostics. When used for risk stratification, they often result in large percentages of moderate-risk patients requiring further diagnostic evaluation.

Variation in specialists' reported hospitalization practices of children sustaining blunt abdominal trauma.

Introduction: Children with blunt abdominal trauma (BAT) are often hospitalized despite no intervention. We identified factors associated with emergency department (ED) disposition of children with BAT and differing computed tomography (CT) findings.

Methods: We surveyed pediatric and general emergency physicians (EPs), pediatric and trauma surgeons regarding care of 2 hypothetical asymptomatic patients: a 9-year-old struck by a slow-moving car (Case 1) and an 11-month-old who fell 10 feet (Case 2).

Variation in specialists' reported hospitalization practices of children sustaining blunt head trauma.

Introduction: Questions surround the appropriate emergency department (ED) disposition of children who have sustained blunt head trauma (BHT). Our objective was to identify physician disposition preferences of children with blunt head trauma (BHT) and varying computed tomography (CT) findings.

Methods: WE SURVEYED PEDIATRIC AND GENERAL EMERGENCY PHYSICIANS (EP), PEDIATRIC NEUROSURGEONS (PNSURG), GENERAL NEUROSURGEONS (GNSURG), PEDIATRIC SURGEONS (PSURG) AND TRAUMA SURGEONS REGARDING CARE OF TWO HYPOTHETICAL PATIENTS: Case 1: a 9-year-old who fell 10 feet and Case 2: an 11-month-old who fell 5 feet.

Pharmacokinetics of intravenous lorazepam in pediatric patients with and without status epilepticus.

Objective: To evaluate the single dose pharmacokinetics of an intravenous dose of lorazepam in pediatric patients treated for status epilepticus (SE) or with a history of SE.

Study Design: Ten hospitals in the Pediatric Emergency Care Applied Research Network enlisted patients 3 months to 17 years with convulsive SE (status cohort) or for a traditional pharmacokinetics study (elective cohort). Sparse sampling was used for the status cohort, and intensive sampling was used for the elective cohort.

Ultrasound-assisted peripheral venous access in young children: a randomized controlled trial and pilot feasibility study.

Objectives: Intravenous (IV) access in children treated in the emergency department (ED) is frequently required and often difficult to obtain. While it has been shown that ultrasound can be useful in adults for both central and peripheral venous access, research regarding children has been limited. We sought to determine if the use of a static ultrasound technique could, a) allow clinicians to visualize peripheral veins and b) improve success rates of peripheral venous cannulation in young children in the ED.

Does an isolated history of loss of consciousness or amnesia predict brain injuries in children after blunt head trauma?

Background: A history of loss of consciousness (LOC) is frequently used as an indication for cranial computed tomography (CT) in the emergency department (ED) evaluation of children with blunt head trauma.

Objective: We sought to determine whether an isolated LOC and/or amnesia is predictive of traumatic brain injury (TBI) in children with blunt head trauma.

Methods: We prospectively enrolled children <18 years old presenting to a level I trauma center ED between July 1998 and September 2001 with blunt head trauma.

A decision rule for identifying children at low risk for brain injuries after blunt head trauma.

Study Objective: Computed tomography (CT) is frequently used in evaluating children with blunt head trauma. Routine use of CT, however, has disadvantages. Therefore, we sought to derive a decision rule for identifying children at low risk for traumatic brain injuries.

Identification of children with intra-abdominal injuries after blunt trauma.

Study Objective: We sought to determine the utility of laboratory testing after adjusting for physical examination findings in the identification of children with intra-abdominal injuries after blunt trauma.

Methods: The study was a prospective observational series of children younger than 16 years old who sustained blunt trauma and were at risk for intra-abdominal injuries during a 2(1/2)-year period at an urban Level I trauma center. Patients were examined by faculty emergency physicians and underwent standardized laboratory testing.