Youth victim perspective: optimizing presentation of patient-reported outcomes in a violence intervention program.

Introduction: The health, well-being and psychological development of children in urban areas is threatened by exposure to interpersonal violence. Violence intervention programs, such as Project Ujima, provide children with comprehensive treatment following exposure to violence. Services focus on the interruption of the violence cycle, mental health, and developing resiliency.

Assessing improvements in emergency department referrals to a hospital-based violence intervention program.

Background: Youth violence is a major public health concern in the United States. Hospital-based Violence Intervention Programs (HVIPs) are integral in connecting youth sustaining interpersonal violence-related injuries to medical, mental health, and social services. At our pediatric emergency department, our baseline referral rate to the established HVIP was 32.

Participation of Children and Adolescents in Live Crisis Drills and Exercises.

Children and adolescents should be included in exercises and drills to the extent that their involvement advances readiness to meet their unique needs in the event of a crisis and/or furthers their own preparedness or resiliency. However, there is also a need to be cautious about the potential psychological risks and other unintended consequences of directly involving children in live exercises and drills. These risks and consequences are especially a concern when children are deceived and led to believe there is an actual attack and not a drill and/or for high-intensity active shooter drills.

Patient at Risk: Emergency medical service providers' opinions on improving an electronic emergency information form database for the medical care of children with special health care needs.

Background: Patient at Risk (PAR) is an online database using an emergency information form (EIF) that parents of children with special health care needs (CSHCN) complete to store their child's medical information. Emergency medical service (EMS) providers can then access PAR during medical emergencies or for pre-planning. PAR was active for over 10 years but use by patients and EMS was limited.

An educational intervention for medical students to improve self-efficacy in firearm injury prevention counseling.

Background: Most physicians support counseling patients about firearm injury prevention (FIP), but infrequently do so due to lack of training and low confidence. Interventions to increase counseling frequency should focus on improving physician self-efficacy. Firearm injuries affect many clinical specialties; therefore, trainees would benefit from early FIP education.

Trauma-Informed Care for Violently Injured Patients in the Emergency Department.

Violent traumatic injury remains a common condition treated by emergency physicians. The medical management of these patients is well described and remains an area of focus for providers. However, violently injured patients disproportionately carry a history of physical and psychological trauma that frequently affects clinical care in the emergency department.

Youth Victims of Violence Report Worse Quality of Life Than Youth With Chronic Diseases.

Objectives: Measuring health-related quality of life (HRQOL) provides the patient's perspective of his/her well-being and offers a unique outcome measure to demonstrate the impact of violence on the victim. To date, no study has described HRQOL in youth victims of violence in the United States. The purpose of this study was to describe HRQOL in youth victims of violence as compared with healthy youth and youth with chronic disease.

Association of Hospital Resources and Imaging Choice for Appendicitis in Pediatric Emergency Departments.

Objective: Abdominal pain and concern for appendicitis are common chief complaints in patients presenting to the pediatric emergency department (PED). Although many professional organizations recommend decreasing use of computed tomography (CT) and choosing ultrasound as first-line imaging for pediatric appendicitis, significant variability persists in imaging utilization. This study investigated practice variation across children's hospitals in the diagnostic imaging evaluation of appendicitis and determined hospital-level characteristics associated with the likelihood of ultrasound as the first imaging modality.

Physician Adherence to Centers for Disease Control and Prevention Guidelines for Sexually Active Adolescents in the Pediatric Emergency Setting.

Objectives: There is limited literature about physicians' adherence to 2010 Centers for Disease Control and Prevention (CDC) Sexually Transmitted Diseases Treatment Guidelines specific to specimen collection testing methods in adolescent females in the emergency setting is limited. The objectives are to (1) determine physician adherence to CDC guidelines for specimen collection/testing for chlamydia and gonorrhea, (2) determine physician characteristics associated with guideline adherence, and (3) describe physicians' knowledge of expedited partner therapy (EPT) laws.

Methods: This is a cross-sectional, anonymous, Internet-based survey of physician members of the American Academy of Pediatrics Section of Emergency Medicine.

Improvement in quality of life among violently injured youth after a brief intervention.

Background: Youth directly exposed to violence are at risk for experiencing elevated rates of emotional and behavioral problems, revictimization, and becoming future perpetrators of violence. Violence intervention and prevention programs throughout the country attempt to alleviate some of this burden. To date, outcomes have been positive but largely qualitative.

Medical providers' understanding of sex trafficking and their experience with at-risk patients.

Background And Objectives: Sex trafficking (ST) victims have unique medical and mental health needs and are often difficult to identify. Our objectives were to evaluate knowledge gaps and training needs of medical providers, to demonstrate the importance of provider training to meet the pediatric ST victim's specific needs, and to highlight barriers to the identification of and response to victims.

Methods: A survey was sent to providers in specialties that would be most likely to encounter victims of ST.

Child abuse pediatric consults in the pediatric emergency department improve adherence to hospital guidelines.

Background: Little data describes the role of child abuse pediatricians in consultation for physical abuse patients the pediatric emergency department.

Objectives: To compare adherence in the emergency department to hospital physical abuse guidelines and need to return for testing between 2 groups: those receiving a child abuse consultation in the pediatric emergency department vs those who received standard emergency department care with subsequent child abuse review.

Methods: We reviewed 471 records of visits to the pediatric emergency department for physical abuse.

Diagnostic findings in infants presenting to a pediatric emergency department for lethargy or feeding complaints.

Objectives: Lethargy is a common complaint among infants in the pediatric emergency department (ED), yet there is little data to guide appropriate evaluation. The objectives of the study were (1) to determine the frequency of diagnoses requiring intervention/monitoring and (2) to identify predictors of these diagnoses.

Methods: A retrospective chart review of patients aged 0 to 6 months with a chief complaint of lethargy or poor feeding from January 2004 to December 2009 was performed.

A comprehensive approach to pediatric injury prevention in the emergency department.

Injury is the leading cause of pediatric mortality and long-term disability. Although the primary care setting has traditionally been considered as the main venue to address injury anticipatory guidance, an emergency department (ED) visit may serve as a "teachable moment" because most injured children are cared for in this setting and the experience may elicit a greater chance of behavior change. However, EDs can also provide additional information and services beyond counseling to prevent injuries.

Injury prevention: opportunities in the emergency department.

Because injury is the leading cause of morbidity and mortality in young patients, emergency departments have a significant opportunity to provide injury-prevention interventions at a teachable moment. The emergency department has the ability to survey injuries in the community, use the hospital setting to screen patients, provide products, offer resources to assist families within this setting to change their risky behaviors, and connect families to community resources. With a thoughtful, collaborative approach, emergency departments are an excellent setting within which to promote injury prevention among patients and families.

H1N1 hemagglutinin-inhibition seroprevalence in Emergency Department Health Care workers after the first wave of the 2009 influenza pandemic.

Study Objective: The 2009 H1N1 pandemic (H1N1pdm) virus has been associated with high rates of asymptomatic infections. Existing influenza infection control policies do not address potential transmission through exposure to asymptomatic infected individuals in health care settings. We conducted a seroprevalence study of H1N1pdm infection to determine whether health care workers (HCWs) in the emergency department showed increased evidence of infection during the first wave of the pandemic than that previously reported in adults in the community.

Aggressive behavior in children and adolescents.

After completing this article, readers should be able to: 1. Describe the developmental stages of aggressive behavior in children.2.

Validation of two child passenger safety questionnaires.

Objective: To measure the validity of a booster seat questionnaire and a car seat questionnaire so that they can be reliably used in future trials.

Design: The two child passenger safety questionnaires were created. Each underwent expert review to ensure face and content validity.