Use of Outpatient Opioids Prescribed From a Pediatric Acute Care Setting.

Objectives: Deaths due to prescription opioid overdoses are at record high levels. Limiting the amount of opioid prescribed has been suggested as a prevention strategy, but little is known about how much is needed to adequately treat acutely painful conditions for outpatients. The purpose of this study was to quantify the usage of opioids prescribed from the pediatric emergency departments of a Midwestern tertiary care children's hospital system.

Addressing Parental Adverse Childhood Experiences in the Pediatric Setting.

Parents’ own adverse childhood experiences (ACEs) impact their children’s physical and emotional health. Causal mechanisms are not fully understood but are likely multifactorial, affecting parent resiliency and attachment behaviors, with possible intergenerational transmission. Although universal screening for parental ACEs is controversial, they may be identified during pediatric care.

Brief Motivational Intervention to Improve Adolescent Sexual Health Service Uptake: A Pilot Randomized Controlled Trial in the Emergency Department.

Objective: To test the hypothesis that our motivational sexual health intervention (SexHealth) would increase health service uptake when compared with control.

Study Design: In a randomized controlled trial at a pediatric emergency department, sexually active adolescents received either the SexHealth intervention or printed materials (control). SexHealth, delivered by a health educator, was a tablet-based, interactive intervention that included motivational techniques to promote sexual health, condom skills training, and tailored service recommendations.

Pediatric Emergency Department Challenges and Response to COVID-19.

Severe acute respiratory syndrome coronavirus 2, the virus causing the pandemic illness coronavirus disease 2019, was first detected in the United States in January 2020. As the illness spread across the country, all aspects and venues of health care were significantly impacted. This article explores the challenges and response of one children's emergency medicine division related to surge planning, personal protective equipment, screening, testing, staffing, and other operational challenges, and describes the impact and implications thus far.

The Relevance of Parental Adverse Childhood Experiences in Pediatric Practice.

Adverse childhood experiences affect a vast number of people, including the parents of the children we see as patients in our practices. Importantly, the trauma one experiences as a child affects not only health but also parenting style and ability, and thus is relevant in pediatric practice. Recent research has now established the significant relationship between adverse childhood experiences (ACEs) parents have before age 18 years and their children's health.

Choking in Children: What to Do and How to Prevent.

Choking happens when a child's airway is blocked by a foreign substance that impairs oxygenation and ventilation. It is one of the most frightening scenarios a parent can imagine. It happens suddenly and can have the direst of consequences.

Treatment and Prevention of Pediatric Sunburn.

Skin cancer is the most common cancer in the United States, and risk for melanoma is greatly increased with a serious sunburn in childhood or adolescence. Skin cancer also is one of the most preventable cancers, as sun exposure is an almost entirely modifiable risk factor. Proper skin protection should start early in life when infants begin to be exposed to the outdoors.

Shared Decisions in Pediatrics.

Shared decision-making (SDM) is a structured approach to engaging patients in discussion in medical therapy when there is more than one viable option for care. SDM may decrease decisional conflict between providers and patients, increase trust, and possibly even help decrease health care costs. Much more is known about this approach in adult health care environments, but research on SDM in child health care settings is growing.

Universal Intimate-Partner Violence Assessment in the Pediatric Emergency Department and Urgent Care Setting: A Retrospective Review.

Objective: The aim of this study was to examine universal intimate-partner violence (IPV) assessment in the pediatric acute care setting.

Methods: We reviewed universal IPV assessment over 1 year in 2 emergency departments and 3 urgent care centers within a children's hospital system. Written IPV assessment used 2 questions (ie, safety concerns at home, information desired); "yes" to either was considered positive.

Acute Marijuana Intoxication in Children.

As the number of states legalizing marijuana for medical and/or recreational use continues to grow, there are an increasing number of children exposed to marijuana-containing products in homes and communities. Increased exposure leads to a greater probability of accidental ingestion and toxicity. Because marijuana ingestion can cause a dangerous and potentially life-threatening toxicity for children, pediatric health care providers need an increased awareness of the danger.

Risk of Intimate Partner Homicide Among Caregivers in an Urban Children's Hospital.

This study examines the risk of intimate partner homicide among adults in pediatric health care settings.

Trampolines: What's the Harm?

Trampolines hold the promise of fun and enjoyment for many children, but they are associated with a significant number of orthopedic and other injuries. Injuries vary from minor to severe, and the most common are extremity injuries. Although most injuries are associated with residential (ie, backyard) trampolines, a growing number of injuries now occur in trampoline parks.

Development of a Novel Computerized Clinical Decision Support System to Improve Adolescent Sexual Health Care Provision.

Objective: The objective was to develop an acceptable clinical decision support (CDS) system to facilitate evidence-based sexual health care for adolescents in the emergency department (ED).

Methods: In this multiphased iterative process, we engaged an expert group to synthesize evidence on a wide range of sexual health services (e.g.

Fireworks-Related Injury in Children.

Many children are attracted to the color, noise, light, and excitement generated by fireworks. Both home and public displays of fireworks are a festive part of American culture, enjoyed on holidays, during sporting events, and on a variety of other occasions. However, fireworks pose a risk of serious injury to children and youth.

Intimate Partner Violence Educational Materials in the Acute Care Setting: Acceptability and Impact on Female Caregiver Attitudes Toward Screening.

Objectives: This study aimed to determine acceptability of intimate partner violence (IPV) materials and effect of the materials on caregiver attitudes toward IPV screening.

Methods: We used an anonymous computerized survey to assess approval of IPV materials and screening, and willingness to disclose IPV in response to screening among mothers bringing a child to an urban pediatric emergency department or 2 suburban pediatric urgent care centers affiliated with a free-standing academic children's hospital. We compared responses between participants recruited before and after display of the IPV materials, as well as between subgroups, using χ2 tests.

Vehicular Hyperthermia-A Highly Preventable and Potentially Fatal Problem.

A child dying of heat injury due to being left unattended in a motor vehicle is a needless tragedy. Each year in the United States an average of 38 children mostly younger than age 2 years die of vehicular hyperthermia, frequently the result of a parental lapse of attention and not intentional neglect. Serious illness results quickly from exposure to rising heat within the passenger compartment, even on days when the temperature is fairly moderate.

Intimate Partner Violence and Pediatric Practice.

Millions of parents, most of them mothers, are abused by an intimate partner each year in the United States. Intimate partner violence is all too common in homes with children; it's estimated that 15 million children are exposed each year. The short- and long-term impacts to child health and well-being are profound.

Dry Drowning: Myths and Misconceptions.

Drowning is a leading cause of death in children and is highly preventable. More than 10 people die of drowning in the United States each day, most of them adults. Rates of drowning are highest in children given their developmental vulnerabilities.

Building a Collaboration Between a Children's Hospital and an Early Childhood Education and Social Services Center.

To address toxic stress among children growing up in poverty, an innovative collaboration was developed between a community center, Operation Breakthrough (OB), and a tertiary care children's hospital, Children's Mercy Hospital (CMH). OB started as a day care center but has expanded and developed ways to provide shelter, safety, food, employment, education and health care. CMH is a traditional academic children's hospital that, in recent years, has been looking for ways to better address the social determinants of health.

A Novel Partnership Disrupts the Norm in Early Childhood Education and Pediatric Health Care.

Children living in poverty in the United States in 2016 face a devastating combination of psychological problems. Their neighborhoods are often violent. They have no place to get healthy food.

Comparative Performance of Pediatric Weight Estimation Techniques: A Human Factor Errors Analysis.

Objective: We compared performance characteristics of 7 weight estimation methods examining predictive performance and human factors errors.

Methods: This was a prospective study of 80 emergency care providers (raters) and 80 children aged 2 months to 16 years. Raters estimated weights in 5 children with the following 7 strategies: visual estimation, Advanced Pediatric Life Support, Luscombe and Owens, Broselow tape, devised weight estimation method, 2D Mercy TAPE (2DT), and 3D Mercy TAPE (3DT).