Pediatric emergency care最新文献

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The Use of POCUS to Identify Subgaleal Fluid Collections and Intracranial Infections. POCUS在鉴别galal下积液和颅内感染中的应用。
IF 1.2 4区 医学
Pediatric emergency care Pub Date : 2025-06-01 Epub Date: 2025-05-30 DOI: 10.1097/PEC.0000000000003311
Shaheen Andreas, Henry Chicaiza, Rahul Shah
{"title":"The Use of POCUS to Identify Subgaleal Fluid Collections and Intracranial Infections.","authors":"Shaheen Andreas, Henry Chicaiza, Rahul Shah","doi":"10.1097/PEC.0000000000003311","DOIUrl":"10.1097/PEC.0000000000003311","url":null,"abstract":"<p><strong>Abstract: </strong>Point-of-care ultrasound (POCUS) has been useful in describing soft tissue infections, such as cellulitis and abscesses. There has been limited use of ultrasound to describe findings of intracranial infections, such as Pott's puffy tumor, in cases of forehead prominence and signs of infection. In this case series we present POCUS findings in 2 cases of intracranial infections and one case of soft tissue edema without intracranial involvement from a single pediatric tertiary care center. Ultrasound findings revealed subgaleal fluid collections with associated periosteal lifting of the frontal bone in cases of Pott's Puffy tumor and intracranial infection, but no bony disruption or periosteal lifting in the patient with traumatic soft tissue edema. As pediatric intracranial infections may continue to have uncharacteristic seasonal peaks, POCUS may be considered as a first-line imaging technique for patients presenting with forehead swelling for differentiating infectious and traumatic etiologies as well as judging the need for further imaging techniques such as computed tomography and magnetic resonance imaging.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"486-488"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Changes in Seasonal Patterns for Common Pediatric Respiratory Viruses During the COVID Pandemic. COVID大流行期间常见儿科呼吸道病毒的季节性变化
IF 1.2 4区 医学
Pediatric emergency care Pub Date : 2025-06-01 Epub Date: 2025-02-04 DOI: 10.1097/PEC.0000000000003340
Tara Lozy, Rimma Perotte, Austin Eigen, Karen Eigen, Ashley Kourgialis, Timothy Scheinert, Sondra Maureen Nemetski
{"title":"Changes in Seasonal Patterns for Common Pediatric Respiratory Viruses During the COVID Pandemic.","authors":"Tara Lozy, Rimma Perotte, Austin Eigen, Karen Eigen, Ashley Kourgialis, Timothy Scheinert, Sondra Maureen Nemetski","doi":"10.1097/PEC.0000000000003340","DOIUrl":"10.1097/PEC.0000000000003340","url":null,"abstract":"<p><strong>Objectives: </strong>Observed alterations in seasonal patterns of common pediatric respiratory viruses during and immediately after the COVID-19 pandemic had far-reaching implications for the care of ill children. Here, we quantify the effects of the pandemic and related nonpharmaceutical interventions on the prevalence and seasonality of common pediatric respiratory illnesses.</p><p><strong>Methods: </strong>We performed a retrospective chart review within a large health network to identify incidence rates of common respiratory viruses and compared them to historical trends. Time series analyses using seasonal autoregressive integrated moving average models were utilized to identify seasonal patterns for the different virus types and quantify deviations from expected incidence rates.</p><p><strong>Results: </strong>Overall, we noted a steep decline in non-COVID viral infection rates at the onset of the COVID pandemic in March 2020, largely coincident with the institution of mask mandates and lockdown measures. This trend continued until the Spring of 2021, at which time non-COVID infections resurged to rates higher than pre-COVID levels. In addition, the historically observed seasonality of these viruses was significantly disrupted by the pandemic. In particular, the historical peaks for influenza A and human metapneumovirus shifted from February and March, respectively, to bimodal peaks in December 2021 and May 2022; respiratory syncytial virus demonstrated an unprecedented Spring/Summer season in 2021; parainfluenza type 1 was unusually active in 2022, an even-numbered year; and influenza B virtually disappeared during and immediately after the pandemic.</p><p><strong>Conclusions: </strong>Our observations add to the growing body of literature supporting the hypothesis that human interactions are one of the key drivers of pediatric respiratory viral seasonality in addition to climate. Understanding the effect of human interactions on disease spread is crucial for the development of effective mitigation measures for future pandemics while avoiding dangerous spikes of other illnesses once those interventions are lifted.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"415-422"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dieulafoy Lesion in a Pediatric Patient. 一名儿科患者的双侧静脉病变。
IF 1.2 4区 医学
Pediatric emergency care Pub Date : 2025-06-01 Epub Date: 2025-02-21 DOI: 10.1097/PEC.0000000000003347
Meylakh Barshay, Maiya Cowan, Meghan Beucher
{"title":"Dieulafoy Lesion in a Pediatric Patient.","authors":"Meylakh Barshay, Maiya Cowan, Meghan Beucher","doi":"10.1097/PEC.0000000000003347","DOIUrl":"10.1097/PEC.0000000000003347","url":null,"abstract":"<p><strong>Objective: </strong>Our aim is to describe a rare etiology of an upper gastrointestinal bleeding (UGIB) to help pediatric emergency medicine clinicians improve their understanding of its presentation as well as the standard therapeutic approach to UGIB.</p><p><strong>Methods: </strong>This is a retrospective case report of a patient who presented to the Pediatric Emergency Department of Hasbro Children's Hospital and who was found to have a UGIB secondary to a Dieulafoy lesion.</p><p><strong>Results: </strong>The etiology of UGIBs varies by geography and patient age but includes esophagitis, Mallory-Weiss tears, gastritis, peptic ulcers, and foreign body ingestion. Given the overlapping presenting symptoms, history and physical are critical to identifying likely etiology and guiding treatment. This patient improved after definitive treatment with endoscopy and hemo-clips.</p><p><strong>Conclusions: </strong>Children with symptoms of UGIB should receive prompt resuscitation and stabilization, and clinicians should maintain an index of clinical suspicion for less common pediatric pathologies, such as malignancy or arterial bleeding.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"496-498"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Antivenom Administration Strategies in Pediatric Snake Envenomation. 抗蛇毒血清给药策略在儿童蛇中毒。
IF 1.2 4区 医学
Pediatric emergency care Pub Date : 2025-06-01 Epub Date: 2025-03-03 DOI: 10.1097/PEC.0000000000003361
Kevin Baumgartner, David B Liss, Michael E Mullins
{"title":"Antivenom Administration Strategies in Pediatric Snake Envenomation.","authors":"Kevin Baumgartner, David B Liss, Michael E Mullins","doi":"10.1097/PEC.0000000000003361","DOIUrl":"10.1097/PEC.0000000000003361","url":null,"abstract":"","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"e30"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of the Coronavirus Disease 2019 Pandemic on Clinical Trends in Pediatric Intentional Self-Poisonings. 2019冠状病毒病大流行对儿童故意自我中毒临床趋势的影响
IF 1.2 4区 医学
Pediatric emergency care Pub Date : 2025-06-01 Epub Date: 2025-03-20 DOI: 10.1097/PEC.0000000000003376
Hannah Wilkins, Jennifer Perry, Chary Akmyradov, Erica Liebelt
{"title":"Impact of the Coronavirus Disease 2019 Pandemic on Clinical Trends in Pediatric Intentional Self-Poisonings.","authors":"Hannah Wilkins, Jennifer Perry, Chary Akmyradov, Erica Liebelt","doi":"10.1097/PEC.0000000000003376","DOIUrl":"10.1097/PEC.0000000000003376","url":null,"abstract":"<p><strong>Objectives: </strong>During the coronavirus disease 2019 pandemic, there was a significant increase in pediatric emergency department visits and hospital admissions for suicidality and self-harm, including deliberate self-poisoning. This study compares demographics, clinical characteristics, management, and outcome data of pediatric patients with intentional self-poisonings before and during the pandemic. A secondary aim is to identify predictors of severe outcomes.</p><p><strong>Methods: </strong>De-identified data were retrieved from the Toxicology Investigators Consortium registry of patients ages 6 to 18 years presenting with intentional self-poisoning. χ 2 analyses and Fisher exact test were performed to determine associations among variables between the \"pre-pandemic\" (April 2017 to February 2020) and \"pandemic\" (March 2020 to October 2022) periods, with P value <0.05 considered statistically significant. Multivariable logistic regression analysis was conducted to explore correlates of severe outcomes.</p><p><strong>Results: </strong>There were 7034 cases identified, 3480 pre-pandemic and 3604 pandemic. The pandemic group was associated with a higher percentage of patients aged 7 to 12 years, patients identifying as transgender or gender non-conforming, and the use of non-opioid analgesics as a primary agent. The pre-pandemic group had more frequent polysubstance ingestions and severe outcomes. Subgroup analysis of severe outcomes showed few differences between pre-pandemic and pandemic groups. No demographic characteristics were strongly associated with severe outcomes.</p><p><strong>Conclusions: </strong>The demographic differences between time periods suggest the pandemic may have had a disparate impact on these vulnerable populations. Identifying trends in pediatric self-poisonings may help guide public health strategies and resources for prevention and harm reduction.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"470-474"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Drivers of Bronchodilator Use in Bronchiolitis: Analyzing Treatment Trends From Pediatric Emergency Department Practices. 细支气管炎使用支气管扩张剂的驱动因素:分析儿科急诊科实践的治疗趋势。
IF 1.2 4区 医学
Pediatric emergency care Pub Date : 2025-06-01 Epub Date: 2025-02-28 DOI: 10.1097/PEC.0000000000003360
Andrea Rivera-Sepulveda, Timothy Maul, Anna Jurlina, Kathryn V Blake, Matthew M Davis, Kenneth Alexander
{"title":"Drivers of Bronchodilator Use in Bronchiolitis: Analyzing Treatment Trends From Pediatric Emergency Department Practices.","authors":"Andrea Rivera-Sepulveda, Timothy Maul, Anna Jurlina, Kathryn V Blake, Matthew M Davis, Kenneth Alexander","doi":"10.1097/PEC.0000000000003360","DOIUrl":"10.1097/PEC.0000000000003360","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate patient characteristics associated with bronchodilator (BD) use at various stages of bronchiolitis illness and evaluate corresponding patient outcomes in the emergency department (ED).</p><p><strong>Methods: </strong>This retrospective, cross-sectional study involves secondary data analysis from a sample of 932 children ages 3 to 24 months who received a diagnosis of bronchiolitis during an ED visit (1057 cases). Predictor variables included demographics, past medical history, family history, physical findings, medication use, and disposition. Outcomes included BD use for bronchiolitis symptoms in the pre-ED and ED settings, and associated care outcomes in the ED. Predictors of BD use in the ED with statistical significance were incorporated in a predictive multivariable logistic regression model with a training-validation split of 70% to 30%.</p><p><strong>Results: </strong>Children with prior BD use were significantly more likely than children without such history to receive BD treatment during their current bronchiolitis illness before the ED [odds ratio (OR): 23.7, 95% CI: 14.4-39], in the ED (OR: 2.6, 95% CI: 1.76-3.77), and as a prescription upon discharge from the ED (OR: 3.7, 95% CI: 2.49-5.58). In multivariable regression analyses, older age, parental asthma history, and wheezes and retractions on ED physical examination were significantly associated with BD use in the ED ( P <0.05). The area under the curve for the validation model with these variables was 0.826 (95% CI: 0.794-0.858).</p><p><strong>Conclusions: </strong>Prior BD use was associated with subsequent use during the current illness, during ED care, and subsequent prescription, forming a cyclical pattern. A perceived bronchospastic phenotype of bronchiolitis may influence clinical practice in ED settings.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"448-455"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Interplay of Pollution, Child Opportunity, and High Health Care Utilization in Children With Asthma in San Diego County. 圣地亚哥县哮喘儿童污染、儿童机会和高卫生保健利用率的相互作用
IF 1.2 4区 医学
Pediatric emergency care Pub Date : 2025-06-01 Epub Date: 2025-03-11 DOI: 10.1097/PEC.0000000000003365
Tatyana G Mills, Kelly Robinson, Suzan Mahdai, Sweta Parija, Jacob Parker, Manaswitha Khare, Margaret Nguyen, Sydney Leibel
{"title":"The Interplay of Pollution, Child Opportunity, and High Health Care Utilization in Children With Asthma in San Diego County.","authors":"Tatyana G Mills, Kelly Robinson, Suzan Mahdai, Sweta Parija, Jacob Parker, Manaswitha Khare, Margaret Nguyen, Sydney Leibel","doi":"10.1097/PEC.0000000000003365","DOIUrl":"10.1097/PEC.0000000000003365","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to (1) compare air pollution and child opportunity between neighborhoods with and without high health care utilization (HHU) for asthma, and (2) compare health care utilization frequency by race, ethnicity, primary language, and insurance type at the patient level.</p><p><strong>Methods: </strong>This retrospective cohort study examined children with asthma within the Rady Children's Health System (2015-2020) who met HHU criteria [≥2 emergency department (ED) visits in 6 months or ≥2 hospitalizations in 12 mo]. Patient addresses were geocoded to census tracts, and ArcGIS was used to map CalEnviroScore 4.0 and the Child Opportunity Index. Descriptive statistics assessed health care utilization differences based on patient demographics.</p><p><strong>Results: </strong>This study included 1070 individuals. The median HHU asthma rate was 1.7 per 1000 children (interquartile range: 0.9 to 3.1) across 408 census tracts. Pollution burden was significantly higher in tracts with HHU asthma cases than those without ( P = 0.002). Census tracts with HHU asthma cases had lower Child Opportunity Index scores compared with those without ( P < 0.001). Black patients had more ED visits than white patients ( P = 0.002). Hispanic patients had more inpatient hospitalizations than non-Hispanics ( P = 0.043). Medicaid/Medi-Cal patients had more ED and inpatient encounters than those with commercial insurance ( P = 0.001).</p><p><strong>Conclusions: </strong>We identified disparities in pollution and child opportunity among pediatric asthma patients with HHU. These differences are linked to race, ethnicity, and insurance type. These findings can guide efforts to improve child health equity.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"464-469"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ophthalmology Examinations in Children With Skull Fractures and Underlying Focal Hemorrhage. 儿童颅骨骨折及潜在局灶性出血的眼科检查。
IF 1.2 4区 医学
Pediatric emergency care Pub Date : 2025-06-01 Epub Date: 2025-03-12 DOI: 10.1097/PEC.0000000000003334
Karli Breeden, Cindy W Christian, Joanne N Wood, Gil Binenbaum, Daniel M Lindberg, Angela Bachim, Colleen J Bressler, Lori Frasier, Terra Frazier, Nicole R Johnson, Natalie Laub, Megan M Letson, Tagrid Ruiz-Maldonado, Matthew Valente, Jenna Kiely, Jan Leonard, M Katherine Henry
{"title":"Ophthalmology Examinations in Children With Skull Fractures and Underlying Focal Hemorrhage.","authors":"Karli Breeden, Cindy W Christian, Joanne N Wood, Gil Binenbaum, Daniel M Lindberg, Angela Bachim, Colleen J Bressler, Lori Frasier, Terra Frazier, Nicole R Johnson, Natalie Laub, Megan M Letson, Tagrid Ruiz-Maldonado, Matthew Valente, Jenna Kiely, Jan Leonard, M Katherine Henry","doi":"10.1097/PEC.0000000000003334","DOIUrl":"10.1097/PEC.0000000000003334","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the frequency and yield of retinal examination in children below 2 years old undergoing abuse evaluations in the setting of skull fracture(s) and small underlying intracranial hemorrhage.</p><p><strong>Methods: </strong>This cross-sectional study used CAPNET, a multicenter child physical abuse network, to identify children below 2 years with a skull fracture(s) and intracranial injury limited to an underlying small focal intracranial hemorrhage undergoing subspeciality child abuse evaluations. Our outcomes of interest were (1) the performance of a retinal examination, (2) the identification of retinal hemorrhages, and (3) associations of clinical factors and CAPNET site with the performance of retinal examinations. We hypothesized that retinal hemorrhages would be identified in <5% of patients.</p><p><strong>Results: </strong>Of 242 children who met inclusion criteria, the majority (189, 78.1%) presented with a reported history of accidental trauma, and most (211, 87.2%) lacked additional injuries. Only 9 (3.7%) had loss of consciousness and/or seizures/seizure-like activity. The majority (201, 83.1%) had low concern for abuse. Overall, 104 (43.0%) children underwent retinal examinations, of which 0 had retinal hemorrhages (one-sided 95% CI: 0-2.8%). Children without a reported accidental mechanism of injury ( P =0.004), those with intermediate/high concern for abuse ( P <0.001), and children with occipital fractures ( P =0.008) were more likely than their counterparts to undergo retinal examination. The proportion of children undergoing retinal examination varied by CAPNET site ( P <0.001).</p><p><strong>Conclusions: </strong>Our findings suggest that it may be reasonable to forgo retinal examinations in children below 2 years of age with skull fracture(s) and intracranial injury limited to an underlying small focal hemorrhage who are overall neurologically well-appearing.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"407-414"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12272558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reply: Antivenom Administration Strategies in Pediatric Snake Envenomation. 回复:抗蛇毒血清给药策略在儿童蛇中毒。
IF 1.2 4区 医学
Pediatric emergency care Pub Date : 2025-06-01 Epub Date: 2025-03-20 DOI: 10.1097/PEC.0000000000003379
Stephen Rohl, Mark Meredith, Tucker Anderson, Mark Snider, Saralyn Williams, Elizabeth Tolley, Donna Seger
{"title":"Reply: Antivenom Administration Strategies in Pediatric Snake Envenomation.","authors":"Stephen Rohl, Mark Meredith, Tucker Anderson, Mark Snider, Saralyn Williams, Elizabeth Tolley, Donna Seger","doi":"10.1097/PEC.0000000000003379","DOIUrl":"10.1097/PEC.0000000000003379","url":null,"abstract":"","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"e31"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Developing the Standardized Workload Assessment Metric for Pediatric Emergency Departments: Initial Steps Using a Modified Delphi Method. 开发儿科急诊科标准化工作量评估指标:使用改进德尔菲法的初步步骤。
IF 1.2 4区 医学
Pediatric emergency care Pub Date : 2025-06-01 Epub Date: 2025-03-11 DOI: 10.1097/PEC.0000000000003353
Jake Rose, Alyssa Chong, Kenneth McKinley, Garth Meckler, Tibor Van Rooij, Matthias Görges, Tania Principi, Jocelyn Gravel, Devin Singh, Katrina Hurley, Bruce Wright, Troy Turner, Ahmed Mater, Brett Burstein, Quynh Doan
{"title":"Developing the Standardized Workload Assessment Metric for Pediatric Emergency Departments: Initial Steps Using a Modified Delphi Method.","authors":"Jake Rose, Alyssa Chong, Kenneth McKinley, Garth Meckler, Tibor Van Rooij, Matthias Görges, Tania Principi, Jocelyn Gravel, Devin Singh, Katrina Hurley, Bruce Wright, Troy Turner, Ahmed Mater, Brett Burstein, Quynh Doan","doi":"10.1097/PEC.0000000000003353","DOIUrl":"10.1097/PEC.0000000000003353","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to develop a comprehensive list of patient care components performed by pediatric emergency department (PED) physicians that could be individually scored on their subjective workload using the National Aeronautics and Space Administration Task Load Index (NASA-TLX). These \"care components,\" alongside patient and environmental factors that influence workload (\"modifiers\"), will form the basis of the Standardized Workload Assessment Metric for Pediatric Emergency Departments (SWAMPED). We sought to obtain preliminary workload scores for each care component and assess the face validity of the NASA-TLX-derived workload tool.</p><p><strong>Methods: </strong>After establishing a working list of \"care elements\" and modifiers, we convened an expert panel during a 3-day workshop to curate a comprehensive list of PED patient care components and modifiers affecting physician workload using a modified Delphi process. Experts completed a pilot version of the NASA-TLX-derived workload survey for each care component. A virtual follow-up was held 5 months after the initial meeting to finalize the list of modifiers and care components.</p><p><strong>Results: </strong>Of the 93 initial care elements and 75 modifiers, 46 care components were retained, alongside 6 final modifiers. Preliminary workload scores showed \"high acuity, low occurrence procedures (cricothyroidotomy, thoracotomy, pericardiocentesis, burr hole, etc.),\" with the highest median workload score of 106, while \"immobilization device simple (prefabricated)\" had the lowest median workload score of 22.</p><p><strong>Conclusions: </strong>The SWAMPED, derived through expert consensus, holds promise as a standardized assessment tool for PED physician workload. Validation studies involving larger cohorts are crucial for refining the SWAMPED and allowing widespread adoption of this novel quantitative workload metric.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"429-435"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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