National Healthcare Quality and Disparities Report
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- Access to Care (1)
- Adverse Drug Events (ADE) (1)
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- (-) Children/Adolescents (23)
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- Implementation (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 23 of 23 Research Studies DisplayedWnorowska JH, Naik V, Ramgopal S
Characteristics of pediatric behavioral health emergencies in the prehospital setting.
This retrospective cross-sectional study aimed to characterize pediatric behavioral health encounters in the United States and assess factors associated with sedative medication administration and physical restraint use. Analyzing data from 2019 to 2020, among 2,740,271 pediatric EMS encounters, 11.3% were for behavioral health. Sedatives were used in 2.2% and restraints in 3.0% of these encounters. Factors influencing medication and restraint use included age, disabilities, geographic region, and EMS system type.
AHRQ-funded; HS026385.
Citation: Wnorowska JH, Naik V, Ramgopal S .
Characteristics of pediatric behavioral health emergencies in the prehospital setting.
Acad Emerg Med 2024 Feb; 31(2):129-39. doi: 10.1111/acem.14833.
Keywords: Children/Adolescents, Behavioral Health, Emergency Medical Services (EMS)
Bahr N, Meckler G, Hansen M
Evaluating pediatric advanced life support in emergency medical services with a performance and safety scoring tool.
This study used simulation to evaluate Pediatric Advanced Life Support (PALS) guideline performance in pediatric emergency medical service (EMS) care and to introduce this easy-to-use tool to score guideline compliance and patient safety. Standard pediatric resuscitation simulations with a child manikin were created. The manikin was presented as a choking 6-year-old with a complex medical history who is unconscious and apneic, with bradycardic pulse. Teams were expected to monitor vitals, initiate airway management and CPR, and establish vascular access and administer epinephrine based on PALS guidelines. The authors observed 34 EMS teams providing care in P-OHCA simulations. Teams were found to be proficient in assessing vitals, using correct-sized equipment, intubation, and confirmation of tube placement. The teams were delayed in initiating positive pressure ventilation (PPV) and chest compressions, with many teams (53%) deviating from guidelines in chest compression. Half the teams performed continuous compressions before establishing an advanced airway and one team did not perform compressions. Twenty teams also deviated from medication guidelines with 12 teams failing to administer epinephrine, six teams underdosing, and two teams overdosing by more than 20%.
AHRQ-funded; HS025590.
Citation: Bahr N, Meckler G, Hansen M .
Evaluating pediatric advanced life support in emergency medical services with a performance and safety scoring tool.
Am J Emerg Med 2021 Oct;48:301-06. doi: 10.1016/j.ajem.2021.06.061.
AHRQ-funded; HS025590..
AHRQ-funded; HS025590..
Keywords: Children/Adolescents, Emergency Medical Services (EMS), Critical Care, Cardiovascular Conditions
Adelgais KM, Hansen M, Lerner EB
Establishing the key outcomes for pediatric emergency medical services research.
The evidence supporting best practices when treating children in the prehospital setting or even the effect emergency medical services (EMS) has on patient outcomes is limited. This article describes a consensus process among stakeholders in the pediatric emergency medicine and EMS community that identified the critical outcomes for EMS care in five clinical areas (traumatic brain injury, general injury, respiratory disease/failure, sepsis, and seizures).
AHRQ-funded; HS026101.
Citation: Adelgais KM, Hansen M, Lerner EB .
Establishing the key outcomes for pediatric emergency medical services research.
Acad Emerg Med 2018 Dec;25(12):1345-54. doi: 10.1111/acem.13637..
Keywords: Children/Adolescents, Emergency Medical Services (EMS), Evidence-Based Practice, Health Services Research (HSR), Outcomes, Patient-Centered Outcomes Research
Mbachu SN, Pieribone VA, Bechtel KA
Optimizing recruitment and retention of adolescents in ED research: findings from concussion biomarker pilot study.
The authors conducted a pilot study to optimize screening, recruitment, and enrollment strategies for a larger, fully-powered study that seeks to identify proteins in the blood of adolescent athletes following a concussion that are significantly and consistently altered compared with age- and gender-matched controls with isolated extremity injuries. They found that EHR-based notifications and financial incentives for participation in ED research on prolonged recovery in adolescents with concussion increased participant identification and enrollment and retention rates to inform and optimize the enrollment and recruitment strategies for a larger study. There was a clear trend for participants to present to the ED on nights or weekends, likely reflecting the time of sport play.
AHRQ-funded; HS021271.
Citation: Mbachu SN, Pieribone VA, Bechtel KA .
Optimizing recruitment and retention of adolescents in ED research: findings from concussion biomarker pilot study.
Am J Emerg Med 2018 May;36(5):884-87. doi: 10.1016/j.ajem.2017.09.014.
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Keywords: Children/Adolescents, Emergency Department, Emergency Medical Services (EMS), Health Services Research (HSR), Research Methodologies
Ray KN, Olson LM, Edgerton EA
Access to high pediatric-readiness emergency care in the United States.
The researchers determined the geographic accessibility of emergency departments (EDs) with high pediatric readiness by assessing the percentage of US children living within a 30-minute drive time of an ED with high pediatric readiness, as defined by collaboratively developed published guidelines. They concluded that a significant proportion of US children do not have timely access to EDs with high pediatric readiness.
AHRQ-funded; HS022989.
Citation: Ray KN, Olson LM, Edgerton EA .
Access to high pediatric-readiness emergency care in the United States.
J Pediatr 2018 Mar;194:225-32.e1. doi: 10.1016/j.jpeds.2017.10.074.
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Keywords: Access to Care, Children/Adolescents, Emergency Department, Emergency Medical Services (EMS), Children/Adolescents
Robinson M, Greenhawt M, Stukus DR
Factors associated with epinephrine administration for anaphylaxis in children before arrival to the emergency department.
Researchers evaluated factors associated with anaphylaxis management before arrival at the emergency department (ED) or urgent care center (UCC). Reactions occurring at home were less likely to be treated with epinephrine compared with reactions occurring at school. The odds of receiving epinephrine before arrival at the ED or UCC were significantly lower with a 2-organ system or 3-organ system presentation compared with 1-organ system involvement.
AHRQ-funded; HS024599.
Citation: Robinson M, Greenhawt M, Stukus DR .
Factors associated with epinephrine administration for anaphylaxis in children before arrival to the emergency department.
Ann Allergy Asthma Immunol 2017 Aug;119(2):164-69. doi: 10.1016/j.anai.2017.06.001.
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Keywords: Children/Adolescents, Emergency Medical Services (EMS), Healthcare Utilization, Medication, Patient-Centered Outcomes Research
Corrado MM, Shi J, Wheeler KK
Emergency medical services (EMS) versus non-EMS transport among injured children in the United States.
This study assessed the proportions of injured children transported to trauma centers by different transportation modes and evaluated the effect of transportation mode on inter-facility transfer rates using the US national trauma registry. Over one third of US pediatric trauma patients used non-EMS transport to arrive at trauma centers. Moderate to severely injured children benefit from EMS transport and professional field triage.
AHRQ-funded; HS024263.
Citation: Corrado MM, Shi J, Wheeler KK .
Emergency medical services (EMS) versus non-EMS transport among injured children in the United States.
Am J Emerg Med 2017 Mar;35(3):475-78. doi: 10.1016/j.ajem.2016.11.059.
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Keywords: Emergency Medical Services (EMS), Children/Adolescents, Trauma, Critical Care
Michelson KA, Bachur RG, Levy JA
The impact of critically ill children on paediatric ED medication timeliness.
The presence of critically ill patients may impact care for other ED patients. The researchers evaluated whether the presence of a critically ill child was associated with the time to (1) receipt of the first medication among other patients, and (2) administration of diagnosis-specific medications. They concluded that the presence of critically ill patients was associated with a delay in medication administration to others.
AHRQ-funded; HS000063.
Citation: Michelson KA, Bachur RG, Levy JA .
The impact of critically ill children on paediatric ED medication timeliness.
Emerg Med J 2017 Jan;34(1):8-12. doi: 10.1136/emermed-2016-205989.
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Keywords: Children/Adolescents, Critical Care, Medication, Emergency Medical Services (EMS), Healthcare Delivery
Johnson SA, Shi J, Groner JI
Inter-facility transfer of pediatric burn patients from U.S. Emergency Departments.
This study described the epidemiology of pediatric burn patients seen in U.S. emergency departments (EDs) in order to determine factors associated with inter-facility transfer. It concluded that over 90 percent of pediatric burn ED patients meet ABA burn referral criteria but are not transferred from low volume hospitals.
AHRQ-funded; HS022277.
Citation: Johnson SA, Shi J, Groner JI .
Inter-facility transfer of pediatric burn patients from U.S. Emergency Departments.
Burns 2016 Nov;42(7):1413-22. doi: 10.1016/j.burns.2016.06.024.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Transitions of Care, Children/Adolescents, Emergency Medical Services (EMS), Guidelines
Bonafide CP, Roland D, Brady PW
Rapid response systems 20 years later: new approaches, old challenges.
In this article, the authors propose a set of recommendations for a research agenda aimed at pursuing the work of optimizing the identification of deteriorating children. They recommend that the second generation of pediatric rapid response systems continue to build on past achievements while further optimizing use of the data, tools, and people available at the bedside to take the next leap forward.
AHRQ-funded; HS023827.
Citation: Bonafide CP, Roland D, Brady PW .
Rapid response systems 20 years later: new approaches, old challenges.
JAMA Pediatr 2016 Aug;170(8):729-30. doi: 10.1001/jamapediatrics.2016.0398.
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Keywords: Children/Adolescents, Clinical Decision Support (CDS), Shared Decision Making, Emergency Medical Services (EMS), Hospitals
Shah MP, Tate JE, Steiner CA
AHRQ Author: Steiner CA
Decline in emergency department visits for acute gastroenteritis among children in 10 US states after implementation of rotavirus vaccination, 2003-2013.
The researchers compared the rates of gastroenteritis- and rotavirus-coded ED visits among children <5 years of age in pre-rotavirus vaccine (2003 to 2006) with those in postvaccine (2008-2013) years; 2007 was excluded as a transition year They concluded that. ED visits for gastroenteritis in US children have declined since the introduction of rotavirus vaccine.
AHRQ-authored.
Citation: Shah MP, Tate JE, Steiner CA .
Decline in emergency department visits for acute gastroenteritis among children in 10 US states after implementation of rotavirus vaccination, 2003-2013.
Pediatr Infect Dis J 2016 Jul;35(7):782-6. doi: 10.1097/inf.0000000000001175.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Vaccination, Emergency Medical Services (EMS), Digestive Disease and Health
Byczkowski TL, Gillespie GL, Kennebeck SS
Family-centered pediatric emergency care: a framework for measuring what parents want and value.
The objective of this study was to identify dimensions of family-centered care important to parents in pediatric emergency care and compare them to those currently defined. The authors concluded that the resulting dimensions provide a framework for measuring and improving the delivery of family-centered pediatric emergency care.
AHRQ-funded; HS019037.
Citation: Byczkowski TL, Gillespie GL, Kennebeck SS .
Family-centered pediatric emergency care: a framework for measuring what parents want and value.
Acad Pediatr 2016 May-Jun;16(4):327-35. doi: 10.1016/j.acap.2015.08.011.
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Keywords: Healthcare Delivery, Children/Adolescents, Emergency Medical Services (EMS), Patient Experience, Children/Adolescents
McCabe AM, Kuppermann N
Generation of evidence and translation into practice: Lessons learned and future directions.
This article describes the experience of the Pediatric Emergency Care Applied Research Network (PECARN) in deriving and validating the traumatic brain injury prediction rules and how PECARN is translating these prediction rules into clinical practice. Furthermore, it discusses the potential for patient/parent shared decision-making with a focus on patient-centered outcomes in Emergency department research.
AHRQ-funded; HS023498.
Citation: McCabe AM, Kuppermann N .
Generation of evidence and translation into practice: Lessons learned and future directions.
Acad Emerg Med 2015 Dec;22(12):1372-9. doi: 10.1111/acem.12819.
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Keywords: Implementation, Evidence-Based Practice, Emergency Medical Services (EMS), Brain Injury, Children/Adolescents
Stevens AD, Hernandez C, Jones S
Color-coded prefilled medication syringes decrease time to delivery and dosing errors in simulated prehospital pediatric resuscitations: a randomized crossover trial.
The study’s goal was to evaluate novel, prefilled medication syringes labeled with color-coded volumes corresponding to the weight-based dosing of the Broselow Tape, compared to conventional medication administration, in simulated prehospital pediatric resuscitation scenarios. It found that the novel syringes decreased time to medication administration and significantly reduced critical dosing errors by paramedics during simulated prehospital pediatric resuscitations.
AHRQ-funded; HS017526.
Citation: Stevens AD, Hernandez C, Jones S .
Color-coded prefilled medication syringes decrease time to delivery and dosing errors in simulated prehospital pediatric resuscitations: a randomized crossover trial.
Resuscitation 2015 Nov;96:85-91. doi: 10.1016/j.resuscitation.2015.07.035..
Keywords: Medication, Emergency Medical Services (EMS), Children/Adolescents, Medical Errors, Comparative Effectiveness
Marin JR, Wang L, Winger DG
Variation in computed tomography imaging for pediatric injury-related emergency visits.
This study assessed variation in the use of computed tomography (CT) for pediatric injury-related emergency department (ED) visits. It found wide variation in CT imaging for pediatric injury-related visits not attributable solely to case mix. In multivariable analysis of nonpediatric EDs, trauma centers and nonacademic EDs were associated with CT use. Higher pediatric volume was associated with any CT use.
AHRQ-funded; HS023498.
Citation: Marin JR, Wang L, Winger DG .
Variation in computed tomography imaging for pediatric injury-related emergency visits.
J Pediatr 2015 Oct;167(4):897-904.e3. doi: 10.1016/j.jpeds.2015.06.052..
Keywords: Emergency Medical Services (EMS), Children/Adolescents, Children/Adolescents, Emergency Department, Imaging
Moreira ME, Hernandez C, Stevens AD
Color-coded prefilled medication syringes decrease time to delivery and dosing error in simulated emergency department pediatric resuscitations.
The study objective was to evaluate novel, prefilled medication syringes labeled with color-coded volumes corresponding to the weight-based dosing of the Broselow Tape, compared with conventional medication administration, in simulated pediatric emergency department (ED) resuscitation scenarios. It found that a novel color-coded, prefilled syringe decreased time to medication administration and significantly reduced critical dosing errors by emergency physician and nurse teams during simulated pediatric ED resuscitations.
AHRQ-funded; HS017526.
Citation: Moreira ME, Hernandez C, Stevens AD .
Color-coded prefilled medication syringes decrease time to delivery and dosing error in simulated emergency department pediatric resuscitations.
Ann Emerg Med 2015 Aug;66(2):97-106.e3. doi: 10.1016/j.annemergmed.2014.12.035..
Keywords: Emergency Medical Services (EMS), Adverse Drug Events (ADE), Medication, Children/Adolescents, Patient Safety
Eckerle MD, Namde M, Holland CK
Opportunities for earlier HIV diagnosis in a pediatric ED.
The researchers sought to determine whether there were opportunities for earlier HIV diagnosis in the PED for a cohort of young adults diagnosed with HIV. They concluded that there are opportunities for earlier diagnosis of HIV in PEDs, affirming the importance of HIV screening implementation in these settings. However, PEDs are unlikely to have the same frequency of contact with undiagnosed individuals as do adult EDs.
AHRQ-funded; HS021749.
Citation: Eckerle MD, Namde M, Holland CK .
Opportunities for earlier HIV diagnosis in a pediatric ED.
Am J Emerg Med 2015 Jul;33(7):917-9. doi: 10.1016/j.ajem.2015.04.006..
Keywords: Human Immunodeficiency Virus (HIV), Diagnostic Safety and Quality, Screening, Children/Adolescents, Emergency Medical Services (EMS)
Marin JR, Lewiss RE
Point-of-care ultrasonography by pediatric emergency medicine physicians.
This article announces that the American Academy of Pediatrics (AAP) has recently published in the journal Pediatrics the first guideline for point-of-care ultrasonography (US) use by pediatric emergency medicine (PEM) physicians. The AAP policy statement and accompanying technical report provide background and a framework for PEM physicians, who currently use or are planning to incorporate point-of-care US into their practice.
AHRQ-funded; HS023498.
Citation: Marin JR, Lewiss RE .
Point-of-care ultrasonography by pediatric emergency medicine physicians.
Acad Emerg Med 2015 May;22(5):623-4. doi: 10.1111/acem.12659..
Keywords: Children/Adolescents, Children/Adolescents, Emergency Medical Services (EMS), Emergency Department, Children/Adolescents
Yang NH, Dharmar M, Kuppermann N
Appropriateness of disposition following telemedicine consultations in rural emergency departments.
The researchers compared the overall and stratified observed-to-expected hospital admission ratios between telemedicine and telephone cohorts of acutely ill and injured children. They found that there were no statistically significant differences between the observed-to-expected admission ratios using Pediatric Risk of Admission II and Revised Pediatric Emergency Assessment Tool.
AHRQ-funded; HS013179; HS019712.
Citation: Yang NH, Dharmar M, Kuppermann N .
Appropriateness of disposition following telemedicine consultations in rural emergency departments.
Pediatr Crit Care Med 2015 Mar;16(3):e59-64. doi: 10.1097/pcc.0000000000000337..
Keywords: Children/Adolescents, Emergency Medical Services (EMS), Hospitalization, Rural Health, Telehealth
Brady PW, Zix J, Brilli R
Developing and evaluating the success of a family activated medical emergency team: a quality improvement report.
The researchers aimed to develop a reliable process for family-activated medical emergency teams (METs) and to evaluate its effect on MET call rate and subsequent transfer to the intensive care unit (ICU). They found that children with family-activated METs were transferred to the ICU less commonly than those with clinician MET calls. Families, like clinicians, most commonly called MET for concerns of clinical deterioration; however, families also identified lack of response from clinicians and a dismissive interaction between team and family.
AHRQ-funded; HS021114.
Citation: Brady PW, Zix J, Brilli R .
Developing and evaluating the success of a family activated medical emergency team: a quality improvement report.
BMJ Qual Saf 2015 Mar;24(3):203-11. doi: 10.1136/bmjqs-2014-003001.
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Keywords: Communication, Emergency Medical Services (EMS), Hospitals, Children/Adolescents, Quality Improvement
Johnson MA, Grahan BJ, Haukoos JS
Demographics, bystander CPR, and AED use in out-of-hospital pediatric arrests.
The researchers sought to determine if the 2005 American Heart Association guidelines for routine use of automated external defibrillators during pediatric out-of-hospital arrest are used during resuscitations. They found that young children suffering from presumed out-of-hospital cardiac arrests are less likely to have a shockable rhythm when compared to adults, and are less likely to have an AED used during resuscitation.
AHRQ-funded; HS017526.
Citation: Johnson MA, Grahan BJ, Haukoos JS .
Demographics, bystander CPR, and AED use in out-of-hospital pediatric arrests.
Resuscitation 2014 Jul;85(7):920-6. doi: 10.1016/j.resuscitation.2014.03.044.
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Keywords: Cardiovascular Conditions, Children/Adolescents, Emergency Medical Services (EMS), Guidelines, Patient-Centered Outcomes Research
Cottrell EK, O'Brien K, Curry M
Understanding safety in prehospital emergency medical services for children.
This paper adds to the qualitative understanding of the nature of and contributors to safety events in the prehospital emergency care of children. The findings of this study suggest that factors at the systems, team, child/family, and individual provider level system contribute to errors in prehospital emergency care. These factors may be modifiable through interventions and systems improvements.
AHRQ-funded; HS019456.
Citation: Cottrell EK, O'Brien K, Curry M .
Understanding safety in prehospital emergency medical services for children.
Prehosp Emerg Care 2014 Jul-Sep;18(3):350-8. doi: 10.3109/10903127.2013.869640.
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Keywords: Care Management, Children/Adolescents, Emergency Medical Services (EMS), Quality of Care, Patient Safety
Johnson TJ, Weaver MD, Borrero S
Association of race and ethnicity with management of abdominal pain in the emergency department.
This study, examining racial/ethnic differences in analgesic administration and prolonged length of stay (LOS) in the emergency department (ED) found that among children 21 years of age and younger presenting to EDs with abdominal pain, those who were non-Hispanic black patients were less likely than non-Hispanic white patients to receive any analgesics for pain. They were also more likely to have a prolonged LOS.
AHRQ-funded; HS017587
Citation: Johnson TJ, Weaver MD, Borrero S .
Association of race and ethnicity with management of abdominal pain in the emergency department.
Pediatrics. 2013 Oct;132(4):e851-8. doi: 10.1542/peds.2012-3127..
Keywords: Children/Adolescents, Emergency Medical Services (EMS), Racial and Ethnic Minorities, Disparities, Chronic Conditions