Emergency Department Initiative to Decrease High-flow Nasal Cannula Use for Admitted Patients with Bronchiolitis.

Background: Despite limited evidence, a high-flow nasal cannula (HFNC) is often used to treat mild to moderate (m/m) bronchiolitis. We aimed to decrease the rate of HFNC use in the pediatric emergency department (PED) for m/m bronchiolitis from a baseline of 37% to less than 18.5%.

Factors associated with US caregivers' uptake of pediatric COVID-19 vaccine by race and ethnicity.

Objectives: To assess differences in willingness to vaccinate children against COVID-19, and factors that may be associated with increased acceptance, among US caregivers of various racial and ethnic identities who presented with their child to the Emergency Department (ED) after emergency use authorization of vaccines for children ages 5-11.

Study Design: A multicenter, cross-sectional survey of caregivers presenting to 11 pediatric EDs in the United States in November-December 2021. Caregivers were asked about their identified race and ethnicity and if they planned to vaccinate their child.

Should COVID-19 vaccines be mandated in schools? - an international caregiver perspective.

Objectives: Caregiver attitudes toward mandating COVID-19 vaccines for their children are poorly understood. We aimed to determine caregiver acceptability of COVID-19 vaccine mandates for schools/daycares and assess if opposition to mandates would result in removal of children from the educational system.

Study Design: Perform a cross-sectional, anonymous survey of adult caregivers with children ≤ 18 years presenting to 21 pediatric emergency departments in the United States, Canada, Israel, and Switzerland, November 1st through December 31st, 2021.

Implementation of a Provider's Asthma-specific Note to Optimize Billing in the Pediatric Emergency Department.

Unlabelled: There is broad variability in provider documentation for asthma encounters within the pediatric emergency department. Inadequate provider documentation leads to discrepancies between the ideal current procedural terminology (CPT) code and the assigned CPT code based on the care provided. Multiple studies demonstrate improvement in medical provider documentation after implementing standardized documentation templates and educational programs.

Ultrasound features of purulent skin and soft tissue infection without abscess.

Purpose: Ultrasound (US) aids clinical management of skin and soft tissue infection (SSTI) by differentiating non-purulent cellulitis from abscess. However, purulent SSTI may be present without abscess. Guidelines recommend incision and drainage (I & D) for purulent SSTI, but US descriptions of purulent SSTI without abscess are lacking.

Management of Skin and Soft-Tissue Infections Before and After Clinical Pathway Implementation.

We evaluated if the introduction of a clinical pathway for skin and soft-tissue infections (SSTIs) would reduce methicillin-resistant Staphylococcus aureus (MRSA)-directed therapy for simple cellulitis and antibiotic use for simple abscess after drainage. We compared the treatment of SSTI during a 3-month prepathway and 11-month postpathway period. We included patients 57 days to 18 years old discharged from the emergency department (ED) with a diagnosis of cellulitis or abscess.

Utilization of Antipyretics for Nonurgent Fever in a Pediatric Emergency Department.

This retrospective cohort study aimed to describe antipyretic use among healthy patients in a pediatric emergency department (ED) with nonurgent fever defined as: triage level 4 or 5, chief complaint fever or temperature 38°C to 39°C, and otherwise normal vital signs, and determine if antipyretic administration is associated with increased ED length of stay (LOS). We compared continuous variables using Kruskal-Wallis and Wilcoxon rank sum testing. We adjusted confounding variables using logistic regression modeling.

A Teenager With Sickle Cell Disease and Scalp Swelling.

An intracranial bleed with a midline shift is a potentially life-threatening clinical condition. We present the unusual case of a 13-year-old boy with sickle cell disease who had numerous emergency department visits for a scalp hematoma and was subsequently determined to have subdural and epidural hematomas with midline shift, associated with a skull bone infarction. We review the pathophysiology of this unusual condition and emphasize the importance of including it in the differential diagnosis of any child with sickle cell anemia presenting with a nontraumatic scalp hematoma.

Sonographically Occult Abscesses of the Buttock and Perineum in Children.

Background: Ultrasound (US) is used to differentiate abscess from cellulitis. At our institution, we observed children who had purulent fluid obtained after a negative abscess US. We sought to determine the incidence of sonographically occult abscess (SOA) of the buttock and perineum, and identify associated clinical and demographic characteristics.

Fluid intake history and counseling in pediatric outpatients.

Objective: To determine if (a) during well visits physicians are discussing 6 common fluids and (b) if there is any association between fluid discussion and patient age, gender, or body mass index.

Methods: We performed a retrospective chart review of 500 pediatric well visits. We analyzed the relationships between history and/or counseling on fluid intake and patient age, gender, and body mass index percentile using logistic regression and likelihood ratio chi-square testing.