Outpatient follow-up and future care-seeking for pediatric ambulatory care-sensitive conditions.

Objectives: Outpatient follow-up visits are often recommended for children with ambulatory care-sensitive conditions (ACSCs) who are discharged from emergency departments or urgent care centers (acute care settings). We sought to assess whether attending a follow-up visit within 7 days is associated with seeking initial office-based care rather than acute care during a subsequent ACSC illness. Understanding this association is crucial to guide recommendations for routine short-term follow-up visits in children who seek acute care for these common conditions.

Parental Perceptions of Early Childhood In-Home Research with Monitoring: A Qualitative Study.

Objective: To explore perceptions, concerns, and enthusiasm from a diverse group of parents regarding early childhood research that involves home monitoring technologies for collecting environmental exposure data.

Study Design: A diverse group of new and expecting parents participated in semi-structured interviews. A single interviewer conducted all sessions and introduced a hypothetical longitudinal early childhood research study, which included novel home monitoring approaches: 1) wearable devices, 2) audio monitoring, and 3) environmental sampling.

Comparison of Neighborhood Disadvantage Indices on Emergency Medical Services Interventions and Outcomes for Pediatric Out-of-Hospital Emergencies.

Objective: Measures of neighborhood disadvantage demonstrate correlations to health outcomes in children. We compared differing indices of neighborhood disadvantage with emergency medical services (EMS) interventions in children.

Methods: We performed a retrospective study of EMS encounters for children (<18 years) from approximately 2000 US EMS agencies between 2021 and 2022.

Clinician Perspectives on Decision Support and AI-based Decision Support in a Pediatric ED.

Background: Clinical decision support (CDS) systems offer the potential to improve pediatric care through enhanced test ordering, prescribing, and standardization of care. Its augmentation with artificial intelligence (AI-CDS) may help address current limitations with CDS implementation regarding alarm fatigue and accuracy of recommendations. We sought to evaluate strengths and perceptions of CDS, with a focus on AI-CDS, through semistructured interviews of clinician partners.

Establishing thresholds for shock index in children to identify major trauma.

Background: An abnormal shock index (SI) is associated with greater injury severity among children with trauma. We sought to empirically-derive age-adjusted SI cutpoints associated with major trauma in children, and to compare the accuracy of these cutpoints to existing criteria for pediatric SI.

Methods: We performed a retrospective cohort study using the 2021 National Trauma Data Bank (NTDB) Participant Use File.

Comparing AVPU and Glasgow Coma Scales Among Children Seen by Emergency Medical Services.

Objectives: Consciousness assessment is an important component in the prehospital care of ill or injured children. Both the Glasgow Coma Scale (GCS) and the Alert, Verbal, Pain, Unresponsive (AVPU) scale are used for this purpose. We sought to identify cut points for the GCS to correspond to the AVPU scale for pediatric emergency medical services (EMS) encounters.

Children's Hospital Resource Utilization During the 2022 Viral Respiratory Surge.

Objectives: Multiple viral respiratory epidemics occurred concurrently in 2022 but their true extent is unclear. To aid future surge planning efforts, we compared epidemiology and resource utilization with prepandemic viral respiratory seasons in 38 US children's hospitals.

Methods: We performed a serial cross-sectional study from October 2017 to March 2023.

RSV Vaccination Intention Among People Who Are or Plan to Become Pregnant.

Objectives: Respiratory syncytial virus (RSV) is a common pediatric infection, with young infants being at the highest risk of hospitalization and long-term sequela. New preventive agents have been recommended to prevent severe RSV illness in infants, including a vaccine administered during pregnancy. The current rates of recommended vaccination in pregnancy are suboptimal.

Centiles for the shock index among injured children in the prehospital setting.

Objective: The shock index (SI), the ratio of heart rate to systolic blood pressure, is a clinical tool for assessing injury severity. Age-adjusted SI models may improve predictive value for injured children in the out-of-hospital setting. We sought to characterize the proportion of children in the prehospital setting with an abnormal SI using established criteria, describe the age-based distribution of SI among injured children, and determine prehospital interventions by SI.

Measures of Patient Acuity Among Children Encountered by Emergency Medical Services by the Child Opportunity Index.

Children have differing utilization of emergency medical services (EMS) by socioeconomic status. We evaluated differences in prehospital care among children by the Child Opportunity Index (COI), the agreement between a child's COI at the scene and at home, and in-hospital outcomes for children by COI. We performed a retrospective study of pediatric (<18 years) scene encounters from approximately 2,000 United States EMS agencies from the 2021-2022 ESO Data Collaborative.

Pediatric Utilization of Emergency Medical Services from Outpatient Offices and Urgent Care Centers.

Objective: National efforts have highlighted the need for pediatric emergency readiness across all settings where children receive care. Outpatient offices and urgent care centers are frequent starting points for acutely injured and ill children, emphasizing the need to maintain pediatric readiness in these settings. We aimed to characterize emergency medical services (EMS) utilization from outpatient offices and urgent care centers to better understand pediatric readiness needs.

Acute care utilization for ambulatory care-sensitive conditions among publicly insured children.

Background: Although characteristics of preventable hospitalizations for ambulatory care-sensitive conditions (ACSCs) have been described, less is known about patterns of emergency and other acute care utilization for ACSCs among children who are not hospitalized. We sought to describe patterns of utilization for ACSCs according to the initial site of care and to determine characteristics associated with seeking initial care in an acute care setting rather than in an office. A better understanding of the sequence of health care utilization for ACSCs may inform efforts to shift care for these common conditions to the medical home.

A pilot recruitment strategy to enhance ethical and equitable access to Covid-19 pediatric vaccine trials.

Background/aims: The SARS-CoV-2 pandemic disproportionately impacted communities with lower access to health care in the United States, particularly before vaccines were widely available. These same communities are often underrepresented in clinical trials. Efforts to ensure equitable enrollment of participants in trials related to treatment and prevention of Covid-19 can raise concerns about exploitation if communities with lower access to health care are targeted for recruitment.

Parent Awareness of and Attitudes Toward Gender-Affirming Pediatric Health Care: A Cross-Sectional Survey.

Purpose: We aimed to characterize parent attitudes toward gender-affirming healthcare for transgender youth, from a general parent sample in a diverse urban setting.

Methods: We surveyed Chicago parents through the Voices of Child Health in Chicago Parent Panel Survey via web and phone in English and Spanish from May-July 2022. We used both probability-based and nonprobability-based sampling, with calibration weights for the nonprobability sample.

Childhood Exposure to Firearm Violence in Chicago and Its Impact on Mental Health.

Objective: To describe how often Chicago children are exposed to firearm violence, the types of exposure, and the parent-reported impact of these exposures on child mental health symptoms.

Methods: Data were collected in May-July 2022 using the Voices of Child Health in Chicago Parent Panel Survey, administered to parents with children aged 2-17 years from all 77 Chicago neighborhoods. Firearm violence exposure was characterized as indirect (hearing gunshots or knowing someone who was shot) or direct (witnessing a shooting, being threatened with a firearm, being shot at but not injured, or being shot and injured).

Emergency Department Care for Children During the 2022 Viral Respiratory Illness Surge.

Importance: Pediatric readiness is essential for all emergency departments (EDs). Children's experience of care may differ according to operational challenges in children's hospitals, community hospitals, and rural EDs caused by recurring and sometimes unpredictable viral illness surges.

Objective: To describe wait times, lengths of stay (LOS), and ED revisits across diverse EDs participating in a statewide quality collaborative during a surge in visits in 2022.

Establishing outcome-driven vital signs ranges for children in the prehospital setting.

Background: Vital signs are frequently used in pediatric prehospital assessments and guide protocol utilization. Common pediatric vital sign classification criteria identify >80% of children in the prehospital setting as having abnormal vital signs, though few receive lifesaving interventions (LSIs). We sought to identify data-driven thresholds for abnormal vital signs by evaluating their association with prehospital LSIs.

Traumatic Injuries and Radiographic Study Utilization Among Children With Drowning Presenting to U.S. Pediatric Hospitals.

Objective: The role of traumatic injuries in fatal and nonfatal drownings is poorly described. We sought to characterize the incidence of traumatic injuries and diagnostic imaging performed among children who received pediatric hospital care for drowning.

Methods: We conducted a retrospective study of children (≤18 years) with drowning encounters at 45 pediatric hospitals, October 2015 through December 2020.

Perceptions of Artificial Intelligence-Assisted Care for Children With a Respiratory Complaint.

Objectives: To evaluate caregiver opinions on the use of artificial intelligence (AI)-assisted medical decision-making for children with a respiratory complaint in the emergency department (ED).

Methods: We surveyed a sample of caregivers of children presenting to a pediatric ED with a respiratory complaint. We assessed caregiver opinions with respect to AI, defined as "specialized computer programs" that "help make decisions about the best way to care for children.

Ease of Use ratings and real-world child restraint system errors from Safe Kids Illinois seat checks, 2015-2019.

Background: Child restraint systems (CRSs) significantly reduce risk of crash-related injury, however installation and use errors undermine their benefits. The National Highway Traffic Safety Administration (NHTSA) created the Ease of Use (EOU) rating system to help guide consumers and incentivize manufacturers to improve their products. The EOU rating system assigns one to five stars to four CRS features and overall.