Diagnostic testing for evaluation of brief resolved unexplained events.

Background: Since the publication of the American Academy of Pediatrics (AAP) clinical practice guideline for brief resolved unexplained events (BRUEs), a few small, single-center studies have suggested low yield of diagnostic testing in infants presenting with such an event. We conducted this large retrospective multicenter study to determine the role of diagnostic testing in leading to a confirmatory diagnosis in BRUE patients.

Methods: Secondary analysis from a large multicenter cohort derived from 15 hospitals participating in the BRUE Quality Improvement and Research Collaborative.

Diagnostic testing for and detection of physical abuse in infants with brief resolved unexplained events.

Background: A Brief Resolved Unexplained Event (BRUE) can be a sign of occult physical abuse.

Objectives: To identify rates of diagnostic testing able to detect physical abuse (head imaging, skeletal survey, and liver transaminases) at BRUE presentation. The secondary objective was to estimate the rate of physical abuse diagnosed at initial BRUE presentation through 1 year of age.

Risk Prediction After a Brief Resolved Unexplained Event.

Objectives: Only 4% of brief resolved unexplained events (BRUE) are caused by a serious underlying illness. The American Academy of Pediatrics (AAP) guidelines do not distinguish patients who would benefit from further investigation and hospitalization. We aimed to derive and validate a clinical decision rule for predicting the risk of a serious underlying diagnosis or event recurrence.

Improving Emergency Department Use of Safety-Net Antibiotic Prescriptions for Acute Otitis Media.

Objectives: Acute otitis media (AOM) is the most common reason for pediatric antibiotic prescriptions. The 2013 American Academy of Pediatrics' AOM guidelines recommend observation for nonsevere AOM. Our aim was to increase the percentage safety-net antibiotic prescription (SNAP) offered to patients 6 months of age or older diagnosed with AOM in 2 pediatric emergency departments (EDs) from a baseline of 0.

Explanatory Diagnoses Following Hospitalization for a Brief Resolved Unexplained Event.

Background And Objectives: Most young infants presenting to the emergency department (ED) with a brief resolved unexplained event (BRUE) are hospitalized. We sought to determine the rate of explanatory diagnosis after hospitalization for a BRUE.

Methods: This was a multicenter retrospective cohort study of infants hospitalized with a BRUE after an ED visit between October 1, 2015, and September 30, 2018.

Accuracy of Diagnostic Codes for Identifying Brief Resolved Unexplained Events.

Objectives: To evaluate (ICD-10) coding strategies for the identification of patients with a brief resolved unexplained event (BRUE).

Methods: Multicenter retrospective cohort study, including patients aged <1 year with an emergency department (ED) visit between October 1, 2015, and September 30, 2018, and an ICD-10 code for the following: (1) BRUE; (2) characteristics of BRUE; (3) serious underlying diagnoses presenting as a BRUE; and (4) nonserious diagnoses presenting as a BRUE. Sixteen algorithms were developed by using various combinations of these 4 groups of ICD-10 codes.

Risk Factors and Outcomes After a Brief Resolved Unexplained Event: A Multicenter Study.

Background: The accuracy of the risk criteria for brief resolved unexplained events (BRUEs) from the American Academy of Pediatrics (AAP) is unknown. We sought to evaluate if AAP risk criteria and event characteristics predict BRUE outcomes.

Methods: This retrospective cohort included infants <1 year of age evaluated in the emergency departments (EDs) of 15 pediatric and community hospitals for a BRUE between October 1, 2015, and September 30, 2018.

Optimizing Critical Care Documentation in a Pediatric Emergency Department.

Objective: Emergency department (ED) physicians frequently provide critical care (CC) but document inconsistently. Variability in documentation can result in underbilling and is inconsistent with financial stewardship. We used admissions to the intensive care unit (ICU) as a proxy for CC provision.

Intravenous acetaminophen use in pediatrics.

Acetaminophen is a commonly used pediatric medication that has recently been approved for intravenous use in the United States. The purpose of this article was to review the pharmacodynamics, indications, contraindications, and precautions for the use of intravenous acetaminophen in pediatrics.

Kohler's Disease.

We present a pediatric case report of foot pain due to Kohler's disease.

Pediatric button battery and small magnet coingestion: two cases with different outcomes.

Ingestion of button batteries and ingestion of 2 or more small magnets have both been increasingly recognized as having high potential for injury. Coingestion of a button battery and a small magnet has only rarely been described but has the potential for both ischemic injury due to the tight magnetic adherence and the electric current injury from the button battery. We report 2 cases of button battery and small magnet coingestion; one required surgical repair of an important bowel injury, while the other had a benign course.