SIPA Poorly Predicts Outcomes in Young Pediatric Trauma Patients.

Introduction: The shock index pediatric adjusted score (SIPA) predicts the need for blood transfusion (BT), hemorrhage control interventions (HCI), morbidity/mortality among older pediatric trauma patients but is less predictive in younger patients. We hypothesize that SIPA will be predictive among older pediatric patients for BT, HCI, mortality, and need for trauma intervention (NFTI), however we aim to further delineate the gap in utilizing SIPA in younger patients.

Methods: Using the ACS NTDB for 2017-2021 we evaluated patients 1-14 years old who were transported by EMS from the scene for definitive care.

Ethics of Pediatric Surgical Innovation: Considerations, Controversies, and Pitfalls.

AbstractThe field of surgery has relied on innovation and creativity to improve patient care and propel the field forward. Historically, regulatory oversight of innovative approaches to surgery has been largely inconsistent, rendering surgeons relatively unrestricted creative latitude in the operating room; whether this has proven to be more beneficial or harmful is subject to debate. While innovation plays a crucial role in the advancement of surgical techniques, the potential drawbacks of unregulated innovation must be seriously considered, especially when treating vulnerable populations such as infants and children.

Propofol administration for induction is associated with peri-intubation instability in trauma critical care unit patients.

Introduction: Peri-intubation hypotension is associated with increased hospital length of stay and morbidity. Propofol is associated with alterations in hemodynamics. We hypothesize that using propofol for induction leads to peri-intubation hypotension in trauma critical care patients.

Bridging the Gap: Comparison of Outpatient Clinic and Emergency Department Patients Undergoing Cholecystectomy.

Introduction: Literature shows failure of the outpatient clinic (OC) pathway after emergency department (ED) ultrasound diagnosis of symptomatic cholelithiasis (SC). We hypothesized SC to be more prevalent on final surgical pathology (FSP) in patients who successfully completed OC pathway.

Methods: This retrospective single-institution chart review compared OC and ED patients with right upper quadrant (RUQ) pain and cholelithiasis whom underwent cholecystectomy.

Perforated Appendicitis in Children: Management, Microbiology, and Antibiotic Stewardship.

Although appendicitis has been described for more than 300 years, its optimal management remains a topic of active investigation. Acute appendicitis is the most common cause of peritonitis in children, and rates of perforated appendicitis are much higher in children than in adults. Increased risk for perforated appendicitis in children is related to a delay in diagnosis due to age, size, access to care, and more.

Despite Recovery from Necrotizing Enterocolitis Infants Retain a Hyperinflammatory Response to Injury.

Background: Necrotizing enterocolitis (NEC) is the leading gastrointestinal cause of death of premature neonates. NEC is associated with prematurity, a hyperinflammatory response, and dysregulation of intestinal barrier function. We hypothesize that patients with NEC will have, and continue to have after recovery, an increased hyperinflammatory intestinal response compared to those patients without NEC.

Not all cholecystitis is created equal: Disparities contributing to ED presentation and failure of the outpatient algorithm.

Background: The majority of final surgical pathology (FSP) from both emergency department (ED) and outpatient clinic (OC) patients is chronic cholecystitis. We aimed to differentiate these presentations and identify disparities associated with ED utilization and OC failure.

Methods: Retrospective chart review of single institution ED and OC cholecystectomies for cholelithiasis.

Anecdotes Drive Attitudes, Data Drives Decisions: Optimizing the Emergency Department Workup Prior to Surgical Consultations.

Purpose: Emergency department (ED) wait times and ED length of stay (LOS) have a significant impact on patient morbidity and mortality and patient satisfaction. Consultation-to-decision time can contribute to increased wait times and LOS in the ED. Up to 40% of patients presenting to the ED require consultation from subspecialty services.

Dusk to Dawn: Evaluating the effect of a hospital-based youth violence prevention program on youths' perception of risk.

Background: Historically, youth violence prevention strategies used deterrence-based programming with limited success. We developed a youth violence prevention program, Dusk to Dawn (D2D), intended to improve youths' recognition of high-risk situations and teach new skills in conflict resolution. The aim of this study was to evaluate the effect of D2D on youths' perceptions of personal risk factors and high-risk situations.