Methadone Initiation in the Emergency Department for Opioid Use Disorder.

Introduction: Overdose deaths from high-potency synthetic opioids, including fentanyl and its analogs, continue to rise along with emergency department (ED) visits for complications of opioid use disorder (OUD). Fentanyl accumulates in adipose tissue; although rare, this increases the risk of precipitated withdrawal in patients upon buprenorphine initiation. Many EDs have implemented medication for opioid use disorder (MOUD) programs using buprenorphine.

At-risk patient documentation and naloxone dispersal for a rural statewide EMS "Naloxone Leave Behind" program.

Objectives: For successful Naloxone Leave Behind (NLB) programs, Emergency Medical Services (EMS) must identify patients at-risk for opioid overdose. We describe the first year of Vermont's NLB program and report rates of EMS documentation of at-risk patients with subsequent distribution of NLB kits in the subgroup of those refusing transport to an emergency department (ED).

Methods: This retrospective cohort review of all EMS encounters over 1 year compared on-scene EMS documented to retrospective chart reviewidentified at-risk patients eligible for NLB kit dispersal.

Pediatric Emergency Medicine Physicians' Perspectives on Emergency Care of Children With Medical Complexity: A Multi-institution Mixed-Methods Assessment.

Objective: Children with medical complexity (CMC) compose 1% of the pediatric population but account for 20% of pediatric emergency department (ED) visits. Previous descriptions of challenges and interventions to ensure quality of care are limited. Our objective was to elicit pediatric emergency medicine (PEM) physicians' perspectives on challenges and opportunities for improvement of emergency care of CMC, with a focus on emergency information forms (EIFs).

Interhospital Transport of Children With Peripheral Venous Catheters by Private Vehicle: A Mixed Methods Assessment.

Background: Many children seeking emergency care at community hospitals require transport to tertiary centers for definitive management. Interhospital transport via ambulance versus patient's own vehicle (POV) are 2 possible modes of transport; however, presence of a peripheral venous catheter (PIV) can determine transport by ambulance. Caregiver satisfaction, patient comfort, and PIV complications related to POV transport have not been described.

Characteristics of opioid prescriptions for discharged pediatric emergency department patients with acute injuries.

This study describes the characteristics of opioid prescriptions for pediatric patients discharged from the emergency department (ED) with acute injuries, including type, formulation, quantity dispensed, and associations with patient age group and prescriber level of training. This retrospective cohort study enrolled all acutely injured patients receiving opioid prescriptions at discharge from an urban academic pediatric ED in a 1-year period. Electronic medical records were reviewed to abstract clinical and prescription data and prescriber level of training.

Cell Phone and Computer Use Among Parents Visiting an Urban Pediatric Emergency Department.

Objectives: The objectives of this study were to estimate the prevalence of cell phone and computer use among urban families bringing their children to an emergency department and to determine which technologies parents prefer to use to receive health information.

Methods: We visited 2 pediatric emergency departments in Baltimore, Md, and Little Rock, Ark. A convenience sample of parents of children 8 years old or younger completed a self-administered survey in the waiting area.

Improving Pediatric Preparedness in Critical Access Hospital Emergency Departments: Impact of a Longitudinal In Situ Simulation Program.

Objectives: Critical access hospitals (CAH) see few pediatric patients. Many of these hospitals do not have access to physicians with pediatric training. We sought to evaluate the impact of an in situ pediatric simulation program in the CAH emergency department setting on care team performance during resuscitation scenarios.

The Mortality of Ill Infants with False Tooth Extraction in a Rural Ugandan Emergency Department.

False tooth extraction (FTE), a cultural practice in East Africa used to treat fever and diarrhea in infants, has been thought to increase infant mortality. The mortality of clinically similar infants with and without false tooth extraction has not previously been examined. The objective of our retrospective cohort study was to examine the mortality, clinical presentation, and treatment of infants with and without false tooth extraction.

Developing a Sustainable Need-Based Pediatric Acute Care Training Curriculum in Solomon Islands.

Background: The Johns Hopkins Hospital Pediatric Emergency Department (PED) was invited to collaborate with the National Referral Hospital (NRH), Solomon Islands, to establish an acute care pediatric education program for the country's inaugural class of national medical graduate trainees.

Objective: To develop and evaluate a sustainable, need-based post-graduate training curriculum in pediatric acute care, resuscitation, and point-of-care ultrasound.

Methods: A need-based training curriculum was developed utilizing the ADDIE model and was implemented and revised over the course of 2 years and two site visits.

A systematic review of technology-based interventions for unintentional injury prevention education and behaviour change.

Objective: The aims of this literature review are to (1) summarise how computer and mobile technology-based health behaviour change applications have been evaluated in unintentional injury prevention, (2) describe how these successes can be applied to injury-prevention programmes in the future and (3) identify research gaps.

Methods: Studies included in this systematic review were education and behaviour change intervention trials and programme evaluations in which the intervention was delivered by either a computer or mobile technology and addressed an unintentional injury prevention topic. Articles were limited to those published in English and after 1990.

Unintentional injuries in child care centers in the United States: a systematic review.

The study systematically reviewed all types of unintentional injury and injury prevention research studies occurring within child care centers in the United States. A total of 2 reviewers searched 11 electronic databases to identify 53 articles meeting inclusion criteria. No studies used trauma registries or randomized control trials.

Self-Report of Child Care Directors Regarding Return-to-Care.

Background: The American Academy of Pediatrics (AAP) introduced revised return-to-care recommendations for mildly ill children in 2009 that were added to national standards in 2011. Child care directors' practices in a state without clear emphasis on return-to-care guidelines are unknown. We investigated director return-to-care practices just before the release of recently revised AAP guidelines.

Health-related quality of life in pediatric minor injury: reliability, validity, and responsiveness of the Pediatric Quality of Life Inventory in the emergency department.

Objective: To evaluate the feasibility, reliability, validity, and responsiveness of the Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL) in the first 2 weeks after pediatric emergency department care of minor injury.

Design: Prospective cohort study.

Pediatric minor injury outcomes: an initial report.

Objectives: The objectives were (1) to present a preliminary evaluation of outcomes after pediatric emergency department (PED) minor injury care (not previously described) and (2) to test the feasibility of study methods and of a HRQOL tool in this acute care setting.

Methods: A prospective observational study of clinical and functional short-term outcomes in PED patients with minor injury was performed.

Results: Thirty-five (80%) of 44 families completed telephone follow-up.

Unnecessary child care exclusions in a state that endorses national exclusion guidelines.

Objective: No study has evaluated the association between state endorsement of American Academy of Pediatrics (AAP) and American Public Health Association (APHA) national guidelines and unnecessary exclusion decisions. We sought to determine the rate of unnecessary exclusion decisions by child care directors in a state that endorses AAP/APHA guidelines and to identify factors that are associated with higher unnecessary exclusion decisions.

Methods: A telephone survey was administered to directors in metropolitan Milwaukee, Wisconsin.

Predicting need for hospitalization in acute pediatric asthma.

Objectives: To develop and validate predictive models to determine the need for hospitalization in children treated for acute asthma in the emergency department (ED).

Methods: Prospective cohort study of children aged 2 years and older treated at 2 pediatric EDs for acute asthma. The primary outcome was successful ED discharge, defined as actual discharge from the ED and no readmission for asthma within 7 days, versus need for extended care.