Practice Patterns in Pediatric Critical Care Medicine: Results of a Workforce Survey.

Objective: To obtain current data on practice patterns of the U.S. pediatric critical care medicine workforce.

Treatment and triage recommendations for pediatric emergency mass critical care.

Introduction: This paper will outline the Task Force recommendations regarding treatment during pediatric emergency mass critical care, issues related to the allocation of scarce resources, and current challenges in the development of pediatric triage guidelines.

Methods: In May 2008, the Task Force for Mass Critical Care published guidance on provision of mass critical care to adults. Acknowledging that the critical care needs of children during disasters were unaddressed by this effort, a 17-member Steering Committee, assembled by the Oak Ridge Institute for Science and Education with guidance from members of the American Academy of Pediatrics, convened in April 2009 to determine priority topic areas for pediatric emergency mass critical care recommendations.

Organized interfacility transfer processes: an opportunity to improve pediatric emergency care.

Objective: The objective of the study was to determine the proportion of hospitals with established guidelines and agreements for the interfacility transfer of seriously ill and injured children.

Methods: Paper- and Web-based survey tools were utilized by states to survey all hospitals with an emergency department. In addition, a content analysis was done on existing state mandates and regulations addressing interfacility transfer guidelines/protocols and agreements.

Unintentional fatal phosphine gas poisoning of a family.

Objective: The objective of the study was to report the toxicity of phosphine gas after a residential fumigation that resulted in fatal poisoning of a 15-month-old toddler and her 4-year-old sibling.

Methods: This is a case report and a review of literature.

Results: A family of 6 members was exposed to phosphine gas after their yard was treated with aluminum phosphide for a rodent infestation.

Failure of nasogastric omeprazole suspension in pediatric intensive care patients.

Objectives: To determine the efficacy of nasogastric administration of omeprazole suspension in raising the gastric pH >4 in critically ill pediatric patients and to determine the most appropriate dosing regimen for this indication.

Design: Open-label pharmacodynamic study.

Setting: Twenty-six bed tertiary-care pediatric intensive care unit.

Alternative model for a pediatric trauma center: efficient use of physician manpower at a freestanding children's hospital.

Background: Freestanding children's hospitals may lack resources, especially surgical manpower, to meet American College of Surgeons trauma center criteria, and may organize trauma care in alternative ways.

Materials And Methods: At a tertiary care children's hospital, attending trauma surgeons and anesthesiologists took out-of-hospital call and directed initial care for only the most severely injured patients, whereas pediatric emergency physicians directed care for patients with less severe injuries. Survival data were analyzed using TRISS methodology.

Effect of repeal of the national maximum speed limit law on occurrence of crashes, injury crashes, and fatal crashes on Utah highways.

Speed limits were increased in Utah and other States after repeal of the national maximum speed limit law (NMSL) in 1995. This study analyzed effects of the increased speed limit on Utah highways on crash rates, fatality crash rates, and injury crash rates. Annual (1992-1999) rates of crashes, fatality crashes, and injury crashes for the following highway categories were calculated: urban Interstate segments (current speed limit 60-65 miles per hour (mph)); rural Interstate segments (current speed limit 70-75 mph); 55 mph rural non-Interstate highway segments; and high-speed non-Interstate highways (current speed limit 60-65 mph).

Evaluating the crash and citation rates of Utah drivers licensed with medical conditions, 1992-1996.

Background: Medical problems may affect the ability to drive motor vehicles, and programs that control the issuing of driver licenses to individuals with medical conditions exist in most states. The main activity of these programs is the imposition of restrictions upon the driving privileges of individuals with medical conditions that are deemed to pose some risk to public safety. However, little is known about the effectiveness of these licensing programs.