Rachael Dedlow is seeking a position as a sonographer. She is expected to graduate from Rochester Institute of Technology in May 2015 with a Bachelor's degree in Diagnostic Medical Sonography. She has clinical experience performing ultrasounds at both West Ridge Obstetrics & Gynecology and Rochester Regional Health Systems. She also has pharmacy technician experience at Rite Aid Pharmacy.
Rachael Dedlow is seeking a position as a sonographer. She is expected to graduate from Rochester Institute of Technology in May 2015 with a Bachelor's degree in Diagnostic Medical Sonography. She has passed her SPI and OB/GYN examinations. She has clinical experience at West Ridge Obstetrics & Gynecology and Rochester Regional Health Systems, where she has performed various ultrasound exams. She is proficient in ultrasound equipment from Phillips, Siemens, and other manufacturers. Additionally, she has worked as a pharmacy technician at Rite Aid Pharmacy since 2009.
HXR 2016: Human Focused Innovation in a Clinical Setting -Jennie Kung, UCLA H...HxRefactored
This section of the agenda will feature leaders in innovation, patient experience, and design within a clinical setting. Each panelist will present the current state of experiential innovation at their organization, what successes they have seen, what situations they have learned from, and what their challenges and obstacles are, and where they would like to see things head in the future. Then Amy Cueva will guide the group in a discussion around strategy, measurement, culture change, and other important topics relevant to delivering phenomenal experiences.
This document discusses handoffs between medical providers. It notes that inadequate or ineffective handoffs can lead to problems like medical errors, delays in treatment, and increased costs. It identifies issues that can undermine effective handoffs, such as lack of standard procedures, distractions, poor communication, and insufficient knowledge of the patient. The document recommends standardizing the handoff process, allowing time for questions, and educating staff to help reduce errors and ensure continuity of care as patients move between medical providers and facilities.
This document summarizes the ASTER study, which tested a new automated system for generating and reporting adverse drug event reports directly from electronic health records. The study found that the new system:
- Required minimal physician time and interaction, typically less than 60 seconds per report.
- Generated over 200 reports over 3 months from physicians who had submitted no reports previously.
- Included more detailed patient information like lab results compared to traditional reporting methods.
- Was well received by participating physicians who saw its potential for improving post-marketing drug safety monitoring using digitized healthcare data sources.
Melaney J. Rayburn has over 15 years of experience in clinical research and nursing. She holds a B.S. in Biopsychology and Cognitive Sciences and a M.S. in Nursing. Currently, she works as a registered nurse in oncology and bone marrow transplant at Banner Healthcare. Previously, she has held roles as a clinical research associate and coordinator managing studies in oncology. Her experience includes data management, regulatory compliance, patient recruitment and care, and presenting research findings.
This document discusses the potential for telemedicine to address healthcare access issues. It notes that there will be a shortage of 150,000 physicians in the next decade. Specialty care is becoming more complex and patients often have to travel long distances to receive it. However, technology now allows remote exams and treatments to be conducted with the same standard of care. The document argues that telemedicine can bring specialized medical expertise and experience to more patients, improving access and lowering costs compared to building more brick-and-mortar clinics or training additional providers. Several examples involving neurology and multiple sclerosis care are provided.
Rachael Dedlow is seeking a position as a sonographer. She is expected to graduate from Rochester Institute of Technology in May 2015 with a Bachelor's degree in Diagnostic Medical Sonography. She has clinical experience performing ultrasounds at both West Ridge Obstetrics & Gynecology and Rochester Regional Health Systems. She also has pharmacy technician experience at Rite Aid Pharmacy.
Rachael Dedlow is seeking a position as a sonographer. She is expected to graduate from Rochester Institute of Technology in May 2015 with a Bachelor's degree in Diagnostic Medical Sonography. She has passed her SPI and OB/GYN examinations. She has clinical experience at West Ridge Obstetrics & Gynecology and Rochester Regional Health Systems, where she has performed various ultrasound exams. She is proficient in ultrasound equipment from Phillips, Siemens, and other manufacturers. Additionally, she has worked as a pharmacy technician at Rite Aid Pharmacy since 2009.
HXR 2016: Human Focused Innovation in a Clinical Setting -Jennie Kung, UCLA H...HxRefactored
This section of the agenda will feature leaders in innovation, patient experience, and design within a clinical setting. Each panelist will present the current state of experiential innovation at their organization, what successes they have seen, what situations they have learned from, and what their challenges and obstacles are, and where they would like to see things head in the future. Then Amy Cueva will guide the group in a discussion around strategy, measurement, culture change, and other important topics relevant to delivering phenomenal experiences.
This document discusses handoffs between medical providers. It notes that inadequate or ineffective handoffs can lead to problems like medical errors, delays in treatment, and increased costs. It identifies issues that can undermine effective handoffs, such as lack of standard procedures, distractions, poor communication, and insufficient knowledge of the patient. The document recommends standardizing the handoff process, allowing time for questions, and educating staff to help reduce errors and ensure continuity of care as patients move between medical providers and facilities.
This document summarizes the ASTER study, which tested a new automated system for generating and reporting adverse drug event reports directly from electronic health records. The study found that the new system:
- Required minimal physician time and interaction, typically less than 60 seconds per report.
- Generated over 200 reports over 3 months from physicians who had submitted no reports previously.
- Included more detailed patient information like lab results compared to traditional reporting methods.
- Was well received by participating physicians who saw its potential for improving post-marketing drug safety monitoring using digitized healthcare data sources.
Melaney J. Rayburn has over 15 years of experience in clinical research and nursing. She holds a B.S. in Biopsychology and Cognitive Sciences and a M.S. in Nursing. Currently, she works as a registered nurse in oncology and bone marrow transplant at Banner Healthcare. Previously, she has held roles as a clinical research associate and coordinator managing studies in oncology. Her experience includes data management, regulatory compliance, patient recruitment and care, and presenting research findings.
This document discusses the potential for telemedicine to address healthcare access issues. It notes that there will be a shortage of 150,000 physicians in the next decade. Specialty care is becoming more complex and patients often have to travel long distances to receive it. However, technology now allows remote exams and treatments to be conducted with the same standard of care. The document argues that telemedicine can bring specialized medical expertise and experience to more patients, improving access and lowering costs compared to building more brick-and-mortar clinics or training additional providers. Several examples involving neurology and multiple sclerosis care are provided.
This document summarizes the work of Dr. Elizabeth Alpern and the Pediatric Emergency Care Applied Research Network (PECARN) to develop an emergency care visit registry using data from electronic health records. The registry collects over 60 quality performance measures across multiple pediatric emergency departments. It provides timely reports to individual clinicians and sites on their performance benchmarks compared to peers. The registry data has been used to study topics like antibiotic prescribing patterns and identify opportunities to improve sepsis screening and management. The goal is to continuously evaluate and improve pediatric emergency care through data-driven quality improvement efforts.
The document discusses telegenetics services provided by the Division of Pediatric Genetics & Metabolism at the University of Florida. It summarizes that the division provides genetic diagnoses and treatment for patients in underserved areas of Florida using telemedicine. The division has been providing telemedicine evaluations since 2005 and has found no decrease in accuracy of diagnoses or patient/provider satisfaction compared to in-person visits. The division currently offers various telegenetics programs at primary, secondary, and tertiary care levels using different telemedicine technologies. Expanding tele-specialty clinics statewide presents challenges including physician participation and scheduling across multiple sites.
This document provides a summary of Katherine Crumpler's professional background and experience as a radiation therapist spanning over 20 years. It outlines her extensive clinical experience working with various radiation equipment, treatment planning software, and imaging systems. It also lists her educational background and certifications in radiation therapy and radiography.
Michael Clark is an experienced Radiation Therapist seeking new opportunities in direct patient care. He has over 12 years of experience in direct patient care and 8 years of experience as a Radiation Therapist. He is committed to providing quality care and ensuring patients are informed. Clark has excellent communication skills and experience working in interdisciplinary teams. He also has computer skills relevant to healthcare documentation.
How and why you (individually and collectively) should promote your neuraxial labor analgesia service. Talk from Sol Shnider
Conference in San Francisco, 2018. http://anesthesiaill.wpengine.com/portfolio/promoting-your-neuraxial-labor-analgesia-service/
The document describes a proposed web-based application for electronic referral, risk assessment, and real-time audit of cataract surgery. The application would allow for instant online referral, personalized risk analysis based on medical history and validated references, and automated generation of forms and reports. It aims to streamline the referral and pre-operative process, provide better data for audit and quality improvement, and ultimately enable safer, faster cataract surgery with less complications.
This document is a resume for Rae-Lynn Maine, seeking employment as a registered radiologic technologist. She has a Bachelor of Science degree in Radiography from York College of Pennsylvania and is certified by the ARRT. Her clinical experience includes working as a registered radiologic technologist at Kennedy University Hospital and completing clinical rotations through WellSpan Health's radiography program. She has skills in operating various radiographic equipment, digital imaging systems, and safety procedures.
This document is a resume for Christopher O'Brien that summarizes his education and qualifications as a radiation therapist. It outlines his associate's degree in radiation therapy from Bellevue College where he graduated with honors, as well as internship experience in clinical settings. It also lists relevant work history in patient registration and as a volunteer at medical centers to demonstrate strong communication skills and attention to detail in healthcare roles.
Initial stages of patient engagement using web portal and case management use...Jeffrey Harris
This document summarizes a case study of using digital health records and care coordination to help a patient with complex medical and social needs. The case manager collected the patient's health data from various sources and providers, assembled it into an online health record using the Mayo Clinic PHR. This coordinated record helped facilitate improved care as the patient transitioned to a new healthcare system. The document advocates for greater interoperability, public education, and a patient-centered approach to digital health adoption and meaningful use.
A medical protocol-based enterprise application to improve maternal healthcare management in Mumbai, India. At the MIT Global Challenge: http://globalchallenge.mit.edu/teams/view/209
This summary presentation covered several topics:
- The presenter's background in healthcare finance and strategy consulting.
- How regional extension centers can help with electronic health record implementation and clinic workflow changes.
- Examples of improving diabetes management at a community health center through targeted quality improvement efforts.
- Using an electronic health record and algorithms to identify and follow up with patients who are out of range on key health metrics.
- Presenting health information and educating participants through effective online portals and avatars.
- Mapping multi-morbidity and emergency department utilization patterns in Medicaid to identify priority areas.
- Challenges and opportunities for mobile health initiatives in developing countries where non-communicable diseases are rising issues.
Jeanne Anderson has over 15 years of experience as a diagnostic medical sonographer and echocardiographer. She holds a Bachelor's degree in diagnostic medical sonography and has published papers in the field. Her experience includes positions at Vassar Brothers Medical Center, S&J Imaging Solutions, and Benedictine Hospital where she performed various types of echocardiograms and ultrasound exams. She is skilled in 3D ultrasound, strain analysis, and digital imaging and reporting systems.
The document discusses challenges with achieving interoperability in healthcare systems. It notes that interoperability is difficult to achieve due to clinical ego, vendor lock-in, and differences in how information is structured between organizations. The document advocates for a more open and collaborative approach to developing clinical standards that involves stakeholders from all levels and allows for diverse models to be captured and incorporated over time through consensus building. This evolutionary approach could help address interoperability challenges by democratizing how clinical content is modeled to reflect real-world practice.
Grace Ku is a hospitalist at Sound Physicians in Seattle, WA. She received her D.O. from Western University of Health Sciences and completed her internal medicine residency at Camden Clark Medical Center. Her experience includes medical volunteering in Zimbabwe and Haiti. She is proficient in EMR systems and has held leadership roles on various medical committees. In her free time, she enjoys cooking, singing, live music, dancing, and outdoor activities.
The document is an objective and experience summary for a medical assistant seeking to enhance their skills. It outlines over 5 years of experience as a clinical and medical assistant at Stanford Psychiatry and Menlo Medical Clinic, including tasks like patient charting, prescription refills, monitoring patients, and assisting in minor procedures. It also lists an associate's diploma from Everest College in 2007 with CPR certification and awards. References are provided.
Huong Vy Tran is a radiation therapy student at the University of Texas Southwestern Medical Center. She has experience delivering radiation treatments and educating patients. Her training includes the use of various treatment machines and techniques such as IMRT, IGRT, SBRT and SRS. Previously, she worked as a medical assistant and laboratory supervisor, gaining experience in patient care and laboratory procedures. She is a member of professional radiation therapy organizations and volunteers teaching Vietnamese.
Cloud envision ivf electronic medical recordsarunsahayakumar
CloudEnvision offers a mobile and web-based holistic IVF Electronic Medical Record system that manages the entire IVF treatment cycle and optimizes clinical and administrative functions. Their IVF EMR solutions are used in over 1000 clinics internationally. It tracks patient history, manages multiple clinics and departments, guarantees quality of care, protects from legal issues, and improves operational efficiency. The system provides fertility medical record templates, a patient portal, donor and surrogate management, clinical decision rules, and billing functionality.
The document discusses the VEPeds program which aims to evaluate and enhance pediatric emergency services by conducting assessments of emergency departments, providing education and resources, and working with hospitals over 12 months to implement recommendations to improve pediatric care and become "Kid-Qualified" in meeting national guidelines for emergency care of children. The program led by Dr. Ronald Dieckmann provides hospitals with tools like the PEMSoft database and ongoing support to help emergency departments strengthen their pediatric emergency services and preparedness.
This document summarizes the work of Dr. Elizabeth Alpern and the Pediatric Emergency Care Applied Research Network (PECARN) to develop an emergency care visit registry using data from electronic health records. The registry collects over 60 quality performance measures across multiple pediatric emergency departments. It provides timely reports to individual clinicians and sites on their performance benchmarks compared to peers. The registry data has been used to study topics like antibiotic prescribing patterns and identify opportunities to improve sepsis screening and management. The goal is to continuously evaluate and improve pediatric emergency care through data-driven quality improvement efforts.
The document discusses telegenetics services provided by the Division of Pediatric Genetics & Metabolism at the University of Florida. It summarizes that the division provides genetic diagnoses and treatment for patients in underserved areas of Florida using telemedicine. The division has been providing telemedicine evaluations since 2005 and has found no decrease in accuracy of diagnoses or patient/provider satisfaction compared to in-person visits. The division currently offers various telegenetics programs at primary, secondary, and tertiary care levels using different telemedicine technologies. Expanding tele-specialty clinics statewide presents challenges including physician participation and scheduling across multiple sites.
This document provides a summary of Katherine Crumpler's professional background and experience as a radiation therapist spanning over 20 years. It outlines her extensive clinical experience working with various radiation equipment, treatment planning software, and imaging systems. It also lists her educational background and certifications in radiation therapy and radiography.
Michael Clark is an experienced Radiation Therapist seeking new opportunities in direct patient care. He has over 12 years of experience in direct patient care and 8 years of experience as a Radiation Therapist. He is committed to providing quality care and ensuring patients are informed. Clark has excellent communication skills and experience working in interdisciplinary teams. He also has computer skills relevant to healthcare documentation.
How and why you (individually and collectively) should promote your neuraxial labor analgesia service. Talk from Sol Shnider
Conference in San Francisco, 2018. http://anesthesiaill.wpengine.com/portfolio/promoting-your-neuraxial-labor-analgesia-service/
The document describes a proposed web-based application for electronic referral, risk assessment, and real-time audit of cataract surgery. The application would allow for instant online referral, personalized risk analysis based on medical history and validated references, and automated generation of forms and reports. It aims to streamline the referral and pre-operative process, provide better data for audit and quality improvement, and ultimately enable safer, faster cataract surgery with less complications.
This document is a resume for Rae-Lynn Maine, seeking employment as a registered radiologic technologist. She has a Bachelor of Science degree in Radiography from York College of Pennsylvania and is certified by the ARRT. Her clinical experience includes working as a registered radiologic technologist at Kennedy University Hospital and completing clinical rotations through WellSpan Health's radiography program. She has skills in operating various radiographic equipment, digital imaging systems, and safety procedures.
This document is a resume for Christopher O'Brien that summarizes his education and qualifications as a radiation therapist. It outlines his associate's degree in radiation therapy from Bellevue College where he graduated with honors, as well as internship experience in clinical settings. It also lists relevant work history in patient registration and as a volunteer at medical centers to demonstrate strong communication skills and attention to detail in healthcare roles.
Initial stages of patient engagement using web portal and case management use...Jeffrey Harris
This document summarizes a case study of using digital health records and care coordination to help a patient with complex medical and social needs. The case manager collected the patient's health data from various sources and providers, assembled it into an online health record using the Mayo Clinic PHR. This coordinated record helped facilitate improved care as the patient transitioned to a new healthcare system. The document advocates for greater interoperability, public education, and a patient-centered approach to digital health adoption and meaningful use.
A medical protocol-based enterprise application to improve maternal healthcare management in Mumbai, India. At the MIT Global Challenge: http://globalchallenge.mit.edu/teams/view/209
This summary presentation covered several topics:
- The presenter's background in healthcare finance and strategy consulting.
- How regional extension centers can help with electronic health record implementation and clinic workflow changes.
- Examples of improving diabetes management at a community health center through targeted quality improvement efforts.
- Using an electronic health record and algorithms to identify and follow up with patients who are out of range on key health metrics.
- Presenting health information and educating participants through effective online portals and avatars.
- Mapping multi-morbidity and emergency department utilization patterns in Medicaid to identify priority areas.
- Challenges and opportunities for mobile health initiatives in developing countries where non-communicable diseases are rising issues.
Jeanne Anderson has over 15 years of experience as a diagnostic medical sonographer and echocardiographer. She holds a Bachelor's degree in diagnostic medical sonography and has published papers in the field. Her experience includes positions at Vassar Brothers Medical Center, S&J Imaging Solutions, and Benedictine Hospital where she performed various types of echocardiograms and ultrasound exams. She is skilled in 3D ultrasound, strain analysis, and digital imaging and reporting systems.
The document discusses challenges with achieving interoperability in healthcare systems. It notes that interoperability is difficult to achieve due to clinical ego, vendor lock-in, and differences in how information is structured between organizations. The document advocates for a more open and collaborative approach to developing clinical standards that involves stakeholders from all levels and allows for diverse models to be captured and incorporated over time through consensus building. This evolutionary approach could help address interoperability challenges by democratizing how clinical content is modeled to reflect real-world practice.
Grace Ku is a hospitalist at Sound Physicians in Seattle, WA. She received her D.O. from Western University of Health Sciences and completed her internal medicine residency at Camden Clark Medical Center. Her experience includes medical volunteering in Zimbabwe and Haiti. She is proficient in EMR systems and has held leadership roles on various medical committees. In her free time, she enjoys cooking, singing, live music, dancing, and outdoor activities.
The document is an objective and experience summary for a medical assistant seeking to enhance their skills. It outlines over 5 years of experience as a clinical and medical assistant at Stanford Psychiatry and Menlo Medical Clinic, including tasks like patient charting, prescription refills, monitoring patients, and assisting in minor procedures. It also lists an associate's diploma from Everest College in 2007 with CPR certification and awards. References are provided.
Huong Vy Tran is a radiation therapy student at the University of Texas Southwestern Medical Center. She has experience delivering radiation treatments and educating patients. Her training includes the use of various treatment machines and techniques such as IMRT, IGRT, SBRT and SRS. Previously, she worked as a medical assistant and laboratory supervisor, gaining experience in patient care and laboratory procedures. She is a member of professional radiation therapy organizations and volunteers teaching Vietnamese.
Cloud envision ivf electronic medical recordsarunsahayakumar
CloudEnvision offers a mobile and web-based holistic IVF Electronic Medical Record system that manages the entire IVF treatment cycle and optimizes clinical and administrative functions. Their IVF EMR solutions are used in over 1000 clinics internationally. It tracks patient history, manages multiple clinics and departments, guarantees quality of care, protects from legal issues, and improves operational efficiency. The system provides fertility medical record templates, a patient portal, donor and surrogate management, clinical decision rules, and billing functionality.
The document discusses the VEPeds program which aims to evaluate and enhance pediatric emergency services by conducting assessments of emergency departments, providing education and resources, and working with hospitals over 12 months to implement recommendations to improve pediatric care and become "Kid-Qualified" in meeting national guidelines for emergency care of children. The program led by Dr. Ronald Dieckmann provides hospitals with tools like the PEMSoft database and ongoing support to help emergency departments strengthen their pediatric emergency services and preparedness.
This document discusses nursing care for pediatric respiratory emergencies. It covers assessing respiratory rate by age, performing a physical assessment, using pulse oximetry and blood gas analysis. Nursing care includes managing the airway through techniques like suctioning and using an oropharyngeal airway. It also discusses providing oxygen therapy through various devices at appropriate flow rates based on the patient's condition. Nurses are responsible for properly assessing patients, ensuring oxygen therapy is administered correctly, monitoring delivery systems, and recommending changes to the treatment plan.
This document provides information on burn injuries including:
1. Burn injuries cause cell destruction of the skin layers and fluid/electrolyte depletion. Large burns over 25% of total body surface area can cause systemic effects impacting major body systems.
2. Burn size is classified as minor (<15% TBSA), moderate (15-25% TBSA) or major (>25% TBSA) based on characteristics such as burn depth, area, and presence of inhalation injury.
3. Initial management focuses on airway maintenance, fluid resuscitation to prevent shock, pain relief and infection prevention. Later phases emphasize wound care, nutrition, rehabilitation and scar management.
This document discusses burn management and treatment. It defines burns and their causes, classifying them as physical (thermal, electrical) or chemical. Burn depth is classified in 4 degrees based on skin layer involvement. Extent of burn surface area is estimated using the Rule of Nines. Large burns can cause shock due to fluid loss, pain, or infection. Initial fluid resuscitation is crucial using formulas like Parkland to replace lost fluid volume over the first 24 hours. Wound care and infection control are also important for management.
Nt current principles, practices and trends in pediatric nursing (2)muruganandan natesan
Pediatrics is the branch of medicine that deals with the care of children from conception to adolescence. It focuses on preventative, curative, and rehabilitative care of children. Pediatrics is important because children make up a large portion of the population and are more vulnerable to health problems. Pediatric nursing aims to provide comprehensive, family-centered care to children while they are healthy and sick. It focuses on promoting growth and optimal functioning. Key aspects of pediatric nursing include family-centered care, minimizing trauma to children, and coordinating care through case management.
Pediatrics is the branch of medicine concerned with the health of children from birth through adolescence. It aims to ensure the healthy growth and development of children as well as prevent, diagnose, and treat illnesses. The field has grown significantly throughout history as more emphasis has been placed on children's health, welfare programs have been established, medical science has advanced, and societies have changed in their view of protecting younger generations. Modern pediatric nursing focuses on advocacy, communication, education, and collaborative care for the child and family.
This document discusses several common pediatric emergencies including fever, febrile seizures, dehydration, airway obstruction from croup, epiglottitis or foreign body aspiration, asthma, meningitis, submersion injury, poisoning, sudden infant death syndrome, and child abuse. For each condition, the document outlines signs and symptoms and recommended emergency care focusing on the ABCs (airway, breathing, circulation), passive cooling, oxygen administration, positioning, and transport as needed. Respiratory arrest is identified as the most frequent cause of cardiac arrest in pediatrics.
The document discusses the care of common pediatric emergencies including asthma, bronchiolitis, pneumonia, croup, and foreign body obstruction. It covers the pathophysiology, assessment, history, physical exam findings, and management considerations for each condition. The care of the normal newborn is also summarized, outlining the immediate attention, transition care, attention in the postpartum period, and follow up consultations needed after birth and during early childhood.
The document discusses the field of pediatrics, including:
1. It outlines the different stages of childhood by age, from fetal period to adolescence, describing key features and health care needs at each stage.
2. It describes the characteristics of pediatrics, highlighting differences between pediatric and adult patients in areas like anatomy, physiology, immunology and types of diseases seen.
3. It discusses the scope and tasks of pediatrics, which involves caring for infants, children and adolescents, and promoting their growth, development and overall health.
1. The document discusses pediatric emergencies including injury risk factors, foreign body accidents, burns, near-drownings, and poisonings. It provides guidelines for rapidly assessing and stabilizing a pediatric patient's airway, breathing, circulation, and neurological status.
2. Fluid resuscitation guidelines are given for hemorrhagic shock in pediatric trauma. Control of external hemorrhage, cervical spine immobilization, and management of life-threatening chest injuries are also summarized.
3. Strategies for injury prevention include education, product design modifications, environmental changes, and applying Haddon's matrix to separate hazards and protect those at risk.
This document provides an overview of key differences between pediatric and adult patients and discusses approaches to common pediatric emergencies. It notes that children differ anatomically, physiologically and developmentally from adults. Common pediatric emergencies addressed include shock, trauma, respiratory issues like croup and asthma, burns, febrile seizures, gastroenteritis and meningitis. Management of these emergencies is aimed at stabilization of vital signs and rapid transport to the hospital.
This document summarizes the pathophysiology and classification of burns. It describes how burns are caused by thermal, radiation or chemical injury, leading to tissue destruction. Burn depth is classified as superficial, deep partial thickness, or full thickness depending on the extent of epidermal and dermal damage. Burn extent is estimated using methods like the Rule of Nines or Lund-Browder chart based on percentage of total body surface area affected. Classification determines burn management and predicts healing outcomes.
This document provides an overview of pediatric emergencies and assessments. It discusses pediatric development across different age groups and how that impacts examinations. Key points include how trauma is the leading cause of death for children, the importance of involving parents in assessments, and anatomical and physiological differences between children and adults that providers must consider. Proper communication and understanding a child's development level are essential for pediatric assessments.
Social Media Data: Opportunities and Insights for Clinical ResearchInsideScientific
Many new data are emerging in recent years - real time data is collected through digital health technologies, including apps and wearables, monitoring data, social media data, public datasets, and patient organization data, in addition to primary and secondary datasets.
Real life data are highly informative and can be used to address a range of challenges throughout the product life cycle. Data from social media can generate valuable insights as patients often gather in digital communities to get answers and share their experiences. Conversations on social networks merit special consideration as they can have real world influence over treatment management decisions.
Social media data can reveal the motivations that impact patient healthcare decisions and behaviors through each stage of the care pathway. These data provide both the patient and caregiver perspectives at the same time. For this reason, conversations on social networks offer an opportunity to deepen our understanding on:
- The fears and hopes associated with patient treatments
- Daily needs and difficulties patients are facing in managing their disease
- The impact of disease on patient health related quality of life
- Identification in real life of the stages of the care pathway and patient perceptions
- Reactions to health policies
Watch this webinar for insights on how to collect, use, analyze, and interpret social media data in different contexts. Our experts share knowledge from over fifteen years of successfully developing and adapting algorithms to treat this kind of data.
Health IT Summit Beverly Hills 2014 – Case Study “The Progression of Predictive Analytics: The Rothman Index” with Mark Headland, VP & CIO, Children’s Hospital of Orange County
This document describes the Pediatrix Clinical DataWarehouse and its role in quality improvement initiatives for neonatal medicine. The Clinical DataWarehouse contains clinical data on over 700,000 patients and is one of the largest databases for neonatal outcomes. Data from electronic medical records is extracted and analyzed to identify areas for improvement. Quality improvement projects are developed and tracked using the QualitySteps system. Analyzing outcomes data allows Pediatrix to benchmark performance and drive continuous quality improvement that improves patient care.
MeHI Regional Health IT Meetings - Worcester, MA - Nov, 2013MassEHealth
Presentation from the Massachusetts eHealth Institute Regional Health IT meeting in Worcester, MA in November, 2013. Featuring Larry Garber from Reliant Medical Group.
Latest Learning and Resources for iCCM_Jennifer Winestock Luna_5.5.14CORE Group
This document provides an overview of the Sick Child Module for the KPC (Knowledge, Practice, and Coverage) survey tool. The Sick Child Module assesses interventions for malaria, diarrhea, and pneumonia delivered by community health workers. It contains indicators related to integrated Community Case Management (iCCM) and broader child health issues. Developing the module involves input from various organizations and considers challenges such as variations in iCCM implementation and balancing information needs across technical areas.
Implementation of Timely and Effective Transitional Care Management ProcessesCHC Connecticut
Join us to discuss best practices for integrating daily follow-ups for patients recently hospitalized for health emergencies. Effectively following up with patients is a critical responsibility for integrated care teams.
Experts will share how their teams respond to patients to identify care gaps and support the transition of care. Workflow descriptions will provide participants with the tools to support their work to adapt specific steps into their model of team-based care.
Panelists:
• Mary Blankson, DNP, APRN, FNP-C, FAAN, Chief Nursing Officer, Community Health Center, Inc.
• Veena Channamsetty, MD, FAAFP, Chief Medical Officer, Community Health Center, Inc.
• Bibian Ladino-Davis, Behavioral Health Coordinator, Weitzman Institute
This document provides an update on the Pediatric Vasculitis Initiative (PedVas) from its meeting at the 2015 CORD Rare Disease Conference. PedVas is an international collaboration between clinicians and researchers studying childhood vasculitis. It aims to support existing clinical networks through collection and analysis of biological samples and knowledge translation. The update describes two case studies of children diagnosed with vasculitis, preliminary clinical data on outcomes in pediatric systemic vasculitis, biomarker research identifying elevated S100A12 levels in active vasculitis, and gene expression profiling of samples collected through the initiative.
Neonatologists and Rural Providers Collaborate to Provide Neonatal Care in a ...TAOklahoma
Dr. Arlen Foulks
Children’s Hospital at the University of Oklahoma Health Sciences Center
Mike McCoy, MSN, APRN-CNP
Lead Practitioner
Level II NICU at Comanche County Memorial Hospital
Oklahoma Telemedicine Conference 2014: Telehealth Transition
October 16, 2014
Larry Garber, Medical Director for Informatics at Reliant Medical Group, presented on how the organization has used health information technology to improve quality, efficiency, and safety. Key points include:
- Reliant implemented an electronic health record system in 2007 that is now used by all physicians and staff.
- The EHR integrates with other technologies like patient portals, health information exchange, clinical decision support, and analytics tools.
- These technologies help improve care processes like diabetes and hypertension management, follow-up of abnormal test results, and medication management.
- The investments have helped lower Reliant's average annual costs per patient compared to other organizations in Massachusetts.
5 years of “Rare” Progress Research: Cheryl Rockman-Greenberg, Max Rady College of Medicine, University of Manitoba
Rare Disease Day Conference 2020 March 9-10
InfoRehab is a research program that uses data from the interRAI Home Care assessment tool (RAI-HC) to identify home care clients who could benefit from rehabilitation services and those at risk for poor health outcomes. The research found that machine learning algorithms were better able to predict rehabilitation potential than current clinical methods. Analyzing RAI-HC data from over 24,000 clients identified various risk factors for hip fractures and helped develop a manageable list of important risk factors. Presenting results to stakeholders showed potential for using machine learning in home care planning and decision support.
This document provides a summary of a presentation on utilizing health data from across the University of California system to enable precision medicine research and applications. It notes that the UC Health system has over 700 trillion data points from electronic health records, genomics, imaging, and other sources from its six medical centers. This data is being housed in a centralized data warehouse to allow integrated analysis. The speaker discusses several early applications including diabetes research, COVID research, and clinical decision support. Collaborations with other academic institutions are also mentioned.
ISS Service Innovation Leadership Seminar, 28 March - Mrs Chew Kwee TiangNUS-ISS
ISS Service Innovation Leadership Seminar, 28 March - "Design Thinking and Service Innovation - The Khoo Teck Puat Hospital's Journey" by Mrs Chew Kwee Tiang, CEO, Khoo Tech Puat Hospital
UCSF Informatics Day 2014 - Robert Nussbaum, "The Genomic Medicine Initiative...CTSI at UCSF
- The Genomic Medicine Initiative is an interdepartmental, interdisciplinary effort at UCSF established to create infrastructure allowing the use of genomics in research, clinical trials, and patient care.
- It aims to enhance genomics education and harness campus expertise to efficiently serve UCSF needs through specialized laboratories, collaborations, and an online course.
- The initial components include targeted cancer sequencing through the Clinical Cancer Genetics Laboratory, whole exome and genome sequencing for undiagnosed diseases through the IHG Genomics Services Laboratory, and a collaboration with UCLA for joint variant analysis.
This document describes several family history tools developed to assist primary care providers. It discusses the Pregnancy & Health Profile tool, which was implemented in four clinical settings and evaluated with positive feedback from patients and providers. It also describes the development of a pediatric family history tool in partnership with the AAP to launch in September 2013. Both tools integrate family history data with clinical decision support to help identify genetic risks and improve patient care.
To address family history collection, interpretation, and application in busy primary care practices, NCHPEG has collaborated collaborating with the March of Dimes, Genetic Alliance, Harvard Partners, and the Health Resources and Services Administration to develop and evaluate a novel family history tool that focuses on prenatal and neonatal health. The tool helps to improve health outcomes for the female patient, fetus, and family by providing clinical decision support and educational resources for risk assessment based on family history. A set of screenshots and an overview of the module can be reviewed via this downloadable ppt.
Clinical Innovation Network April 2015 Webinar: Practice Transformation in Re...PrimaryCareProgress
This document summarizes a webinar on collaborations and innovations in residency education. It featured presentations from several speakers on their experiences with primary care medical home collaboratives and transformations in residency training. The Colorado Family Medicine Residency PCMH Project was highlighted, which involved transforming 9 family medicine and 1 internal medicine residency practices into patient-centered medical homes through practice redesign and curriculum changes. Evaluations found improvements in clinical processes and culture, and residents reported the experience prepared them well for practice and influenced where they chose to work. The webinar concluded with information on the Academic Innovations Collaborative involving 20 teaching practices working to improve outcomes through expert consultation and shared learning.
The document provides an overview of the University of California Health's data analytics platform which combines healthcare data from the six University of California medical centers. It includes details on the health data warehouse such as the total number of patients, types of data collected, and tools used. The platform aims to enable researchers across UC to conduct studies using the large collection of standardized clinical data.
A Rare International Dialogue (Saturday May 11, 2019)
Translating Research into Care and Treatment
GenCOUNSEL: Optimizing Genetic Counselling with the Clinical Implementation of Genome-Wide Sequencing - Alison Elliott, University of British Columbia
Similar to Pediatric Emergency Care Applied Research Network (PECARN) by Alexander Rogers (20)
This document provides an agenda for the Eighth Annual Barsan Research Forum in 2023 on supporting the academic biomedical workforce. The forum will discuss career interventions to promote equity, retention and advancement in academic careers. It will also discuss innovative models of care delivery to enhance value across acute care and the use of decision systems. Presentations will focus on hospital variation in emergency care, guideline-discordant care, human factors research and human-enabling technologies. The goal is to support the academic biomedical workforce through discussions of career development and care delivery innovations.
The zebrafish endotoxemia model can model specific features of human sepsis pathogenesis. Both in human sepsis patients and zebrafish exposed to LPS, genes involved in cholesterol metabolism are significantly upregulated, including DHCR7. Inhibition of DHCR7 through use of an inhibitor protected zebrafish from endotoxemia-induced death. Next steps involve investigating how DHCR7 inhibition provides this protective effect and determining if DHCR7 inhibitors could be repurposed to treat human sepsis by testing their effects in mouse models of endotoxemia and sepsis.
This study investigated characteristics of 809 children presenting to the emergency department for epistaxis (nosebleed) between 2013-2022. The majority (92.7%) were treated medically with nasal compression or intranasal medications. Older age, bleeding duration over 30 minutes, and antiplatelet medication use were associated with the 6.3% who received procedural intervention like cauterization. Procedural control led to higher rates of transfusion and admission. The results provide guidance on pediatric epistaxis patients needing emergency referral.
This study compared cardiac arrest outcomes between Detroit, Michigan (DEMCA) and Genesee County, Michigan (GCMCA) from 2017-2021. DEMCA had significantly higher rates of poverty, unemployment, and African American patients compared to GCMCA. While bystander witnessed arrests and CPR rates were higher in DEMCA, survival rates were significantly lower - only 1.9% survived with good neurological outcomes in DEMCA compared to 5.5% in GCMCA. Socioeconomic factors likely contributed to the differences in outcomes between the two regions. Further work is needed to improve cardiac arrest survival, especially in communities with higher poverty and unemployment.
This document summarizes the career of Dr. Rebecca Cunningham in academic emergency medicine and injury prevention research over nearly 30 years. It describes her progression from emergency medicine residency training in the late 1990s to becoming Vice President for Research. As an emergency physician, her research initially focused on preventing firearm injuries and violence among youth. This expanded to larger community-based intervention studies and developing emergency medicine training programs in Ghana. Her current role continues to support injury prevention research and new initiatives in areas like hydrogen energy and bridging the funding gap for university startups.
The document provides information about the University of Michigan StrokeNet Regional Coordinating Center #17 (RCC-17). It discusses the origins and growth of StrokeNet and RCC-17 over time. Currently, RCC-17 coordinates clinical trials across 17 counties in Michigan and Kentucky, enrolling over 270 sites on average. RCC-17 runs both prevention and treatment trials, enrolling nearly 500 subjects total. It aims to improve enrollment diversity and provides fellowships for training in stroke research. RCC-17 also develops new clinical trial proposals and represents the region in national StrokeNet committees.
This document summarizes the experiences of a university-based critical care EMS service in transporting 127 COVID-19 patients between March and December 2020. Key findings include that patients were often severely ill, with most requiring intubation and interventions like nitric oxide. Over 40% of patients died, with mortality higher for those needing more respiratory support or vasopressors. Transports were lengthy, especially for patients receiving multiple interventions. The pandemic challenged procedures but the EMS service was able to adapt and provide high level critical care during transport.
The document discusses the Adult ICECAP trial, which aims to study early, high-quality hypothermic temperature management for out-of-hospital cardiac arrest. It notes that no devices are FDA-approved for inducing hypothermia in adults, so the trial is using an investigational device exemption. The goal of the trial is to take better care of patients through new knowledge and design future trials to accomplish this. It then provides rationales for inducing hypothermia to 33°C rather than just controlling fever, and argues for cooling patients early and deeply to give them the best chances of survival based on previous study results.
1) Focused cardiac ultrasound findings suggestive of a patient's ability to tolerate fluid (fluid tolerance) as defined by a normal left ventricular ejection fraction, absence of dilated inferior vena cava, and absence of decreased respiratory variation in inferior vena cava size were associated with greater compliance with administering 30cc/kg of fluid within 3 hours per the SEP-1 sepsis bundle.
2) Patients found to be fluid tolerant on FCU received more fluid within 3 hours and were more likely to meet the 30cc/kg fluid target amount compared to those found to have poor fluid tolerance.
3) The association between FCU findings of fluid tolerance and increased fluid administration was strongest in patients with pre
The document describes a study that provided education on medication for opioid use disorder (MOUD) to emergency residents and found it increased their comfort and confidence in offering treatments like buprenorphine. Clinical process measures showed more patients were offered buprenorphine and referred to outpatient addiction treatment after the educational intervention. The authors conclude targeted education for residents on MOUD and harm reduction holds promise for improving care of patients with opioid use disorder in emergency departments.
This document summarizes the results of a survey of first responders regarding their experiences with a "leave-behind naloxone" program. 56 first responders from EMS and fire departments completed the survey. Key findings include: 23% had previously distributed a naloxone kit, common barriers to distribution were forgetting, patients refusing, and lack of someone to leave the kit with. Most respondents understood the program's purpose and had received related training. Around half expressed interest in additional continuing education on harm reduction and addiction. The study provides insight into facilitators and barriers to naloxone distribution programs from the perspective of first responders.
This study evaluated the impact of combining aortic balloon occlusion with a percutaneous left ventricular assist device (pL-VAD) during cardiopulmonary resuscitation (CPR) in a swine model of cardiac arrest. The addition of transient aortic occlusion to pL-VAD support during CPR led to synergistic improvements in coronary perfusion pressure and cerebral perfusion pressure compared to pL-VAD alone. This enhancement was associated with improved cardiac function recovery and cerebral oxygenation. Post-resuscitation, coronary and cerebral perfusion pressures as well as cardiac function improved more rapidly in groups that received continued pL-VAD support. Further research is needed to evaluate potential long-term benefits
This presentation discusses harm reduction approaches for patients with substance use disorders in emergency departments. It provides background on the opioid epidemic and overdose deaths locally. It describes current harm reduction services at the University of Michigan emergency departments, including social work consultations, syringe access, naloxone distribution, and medication for opioid use disorder initiation. It outlines two research projects - one training emergency medicine residents on medication for opioid use disorder and one evaluating a first responder naloxone leave behind program. It introduces the project team members, which includes house officers, medical students, faculty advisors, and other collaborators from various departments.
1) The document discusses recent applications of machine learning to predict life-threatening bacterial infections, specifically Staphylococcus epidermidis bloodstream infections.
2) Phenotypic measures like antibiotic resistance, biofilm formation, and growth fitness, as well as virulence genes, were used as predictors in machine learning models to classify S. epidermidis isolates as pathogenic, contaminant, or commensal.
3) The best performing model was a conditional inference tree model that achieved 82.4% accuracy in classification.
The document summarizes emerging technology platforms in healthcare, specifically the Mayo Clinic Platform. It discusses how healthcare is transitioning from reactive to preemptive care using molecular data and early detection. The Mayo Clinic Platform aims to discover, develop, validate, and deliver insights and algorithms through collecting, harmonizing and storing diverse data sources. It provides examples like using machine learning for ejection fraction detection in cardiology. Advanced Care at Home is highlighted as a virtual hospital ecosystem to provide 24/7 medical support to patients at home using technologies like mobile imaging and labs. The document emphasizes data transparency and population representation in algorithms.
The document summarizes perspectives from medical students on the culture in emergency medicine (EM). It finds that EM culture includes behaviors perceived as exclusionary and that beliefs about ideal EM physicians have a gendered character. It also discusses distressing patient encounters and unprofessional behaviors witnessed by students, as well as how access to mentors and representation in EM affected their interest in pursuing the specialty.
Determine the frequency of 16 high-risk conditions and associated complications in a Michigan state-wide network of academic and community EDs (MiPEM) during the COVID-19 pandemic
This document summarizes a project aimed at developing and validating a clinical screening tool to predict risk of future firearm violence. The project is led by Dr. Jason Goldstick and involves researchers from Harborview Medical Center, University of Pennsylvania, and Hurley Medical Center. So far, baseline surveys have been completed by 601 participants across the three sites. The team is using various machine learning methods like elastic net regression, random forests, support vector machines, and boosting to analyze the data and develop the screening tool. The ultimate goal is to provide a way to identify individuals at higher risk of firearm violence during emergency department visits to guide intervention efforts.
This document summarizes Dr. Adrianne Haggins' presentation on caring for diverse and vulnerable populations. The presentation covered two main domains: delivering care, including discussions on COVID vaccination studies, facemask policies, and caring for diverse patients; and the physician workforce, including strategies to promote belongingness for underrepresented groups and the value of near-peer mentorship. The presentation also listed collaborations Dr. Haggins has been involved in regarding developing health equity dashboards and understanding root causes for leaks in the career pipeline for women in emergency medicine.
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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Pediatric Emergency Care Applied Research Network (PECARN) by Alexander Rogers
1. Pediatric Emergency Care Applied
Research Network (PECARN)
Conducting High Priority High Quality Research in Pediatric
Emergency Care
Alexander Rogers, MD
2. Disclosure
Support from the Great Lakes Emergency Medical Services for
Children Research Network (GLEMSCRN) on behalf of PECARN
PECARN is supported by the Health Resources and Services Administration (HRSA), Maternal and Child
Health Bureau (MCHB), and Emergency Medical Services for Children (EMSC) through the following grants:
DCC-University of Utah (U03MC00008), GLEMSCRN-Nationwide Children’s Hospital (U03-MC00003),
HOMERUN-Cincinnati Children’s Hospital Medical Center (U03-MC22684), PEMNEWS-Columbia University
Medical Center (U03-MC00007), PRIME-University of California at Davis Medical Center (U03-MC00001),
SW NODE-University of Arizona Health Sciences Center (U03MC28845), WBCARN-Children’s National
Medical Center (U03-MC00006), and CHaMP-Medical College of Wisconsin (H3MC26201). MCHB/HRSA
Contact: Elizabeth Edgerton, MD eedgerton@hrsa.gov
3. PECARN History
Funded in 2001 by
HRSA’s EMSC Program
First federally funded
pediatric emergency
care research network
Evidence based research
in emergency care for
kids
U of M’s Dr. Ron Maio
was a founding Nodal
Investigator
4. PECARN History
Funded in 2001 by
HRSA’s EMSC Program
First federally funded
pediatric emergency
care research network
Evidence based research
in emergency care for
kids
U of M’s Dr. Ron Maio
was a founding Nodal
Investigator
5. Why a Network
•Incidence of high impact pediatric emergencies relatively small
●
●
●
■ ●
●
●
●
●
● ●●
●
●
●
●
●
●
● = PRIME Node
● = GLEMSCRN Node
= PEM-NEWS Node
= WBCARN Node
●
●
■ = Data Coordinating Center
= HOMERUN Node●
= SW Node●
●
= CHaMP Node
●
●
●
●
6. Network Structure
PECARN
Steering Committee
Data
Coordinating
Center (DCC)
Pediatric Emergency
Medicine Northeast,
West and South
PEM-NEWS
Hospitals of the Midwest
Emergency Research
Node
HOMERUN
Great Lakes Emergency
Medical Services for
Children Research
Network
GLEMSCRN
Southwest Research
Node
SW-RNC
Washington, Boston,
Chicago Applied Research
Node
WBCARN
Pediatric Research in
Injuries and Medical
Emergencies
PRIME
PI: Peter Dayan
PI: Richard Ruddy
PI: Rachel Stanley
PI: Kurt Denninghoff
PI: James Chamberlain
PI: Nathan Kuppermann
PECARN Subcommittees
Protocol Review
and Development
Quality Assurance,
Safety and
Regulatory
Feasibility
and Budget
Grant
Writing and
Publication
HRSA/
MCHB/
EMSC
PI: J. Michael Dean
Charlotte, Houston and
Milwaukee Prehospital
EMS Research Node
Center
CHaMP
PI: E. Brooke Lerner
7. The PECARN Process
PECARN Research Concept and Protocol Development Process
If approved, protocol may be developed into grant application
Project concept initiated by
PECARN or Non- PECARN
Investigators or a
PECARN Working Group
Submit grant application for funding
Federal Project Officer
review
and approval of project
concept
Steering Committee final approval of grant application
(by electronic vote if necessary)
C oncept approval by Steering Committee(Mtg #1)
Subcommittees review preliminary protocol
Subcommittee Chairs send summary to investigator
within 2 weeks of meeting.
Protocol review/vote for approval by SC (Meeting #3)
Preliminary protocol developed and submitted to
Steering Committee
Investigator refines protocol incorporating
subcommittees’ recommendations.
Meet with
DCC
Consult
FAB
2 weeks prior to subsequent SC meeting:
I nvestigator submits revised protocol toSC
9. PECARN has researched these questions
•Do steroids work for children with bronchiolitis?
•When can you avoid CT scans for kids after head injury?
•When can you avoid CT scans after abdominal injuries?
•Can we use RNA technology to figure out whether infants with fever have
a bacterial or viral infection?
•What are the characteristics of c-spine injuries in children?
•What is the best treatment for children with status epilepticus?
•Can we effectively detect early alcohol use and alcohol problems in teens
presenting the ED? (ASSESS)
11. Current Research at U of M
• Established Status Epilepticus Treatment Trial (ESETT – with
NETT group)
• Probiotics for acute gastroenteritis
• Emergency Department screening tool for suicide risk in
teens (ED-STARS)
• RNA Biosignatures for the detection of bacterial disease in
febrile infants
12. A typical PEM case…
• A 25 day old infant comes into the ED with a fever of 101.5 and a non-
focal exam
• Parents terrified, ED is busy, hospital is full…
• What do we do?
• Catheterized UA/urine culture
• Bloodwork with IV placement
• Lumbar Puncture
• Admit for 48 hours of IV antibiotics awaiting culture results
• WE CAN’T TELL WHICH 5-10% OF INFANTS HAVE SERIOUS
BACERTIAL INFECTION (SBI) IN REAL TIME
• A Clinical Application of RNA Biosignatures for the Diagnosis of Febrile
infants (Mahajan, Ramilo and Kuppermann study PIs)
15. Biosignatures
Current results are from about 250 samples – with another
2000 to be analyzed
• More robust signatures to differentiate viral, bacterial
or co-infections
• Narrow the confidence intervals around biosignatures
• Compare performance to current reference standard
• Define organism specific biosignatures
16. Next steps of Biosignatures
How stable are the RNA Biosignatures?
Does the biosignature remain stable over time?
Does the use of antibiotics alter the biosignature?
Does the use of antipyretics alter the biosignature?
More comprehensive pathogen identification
Biosignatures 2 currently in IRB review with
sequential samples and comprehensive viral testing to
further identify specific pathogens
17. Final Words
PECARN has a wide range of research, and has been a funded
network for 15 years
Goal is to improve evidenced-based care for children
>100 PECARN publications/presentations to date
Many study Principal Investigators from outside of PECARN –
We are always looking for new collaborators!!!
Go to www.PECARN.org for more information
Thank you to Dr. Prashant Mahajan and SJ Zuspan for slides
So Why a network? While children are seen in most emergency departments, incidence rates of pediatric emergency events are relatively small, requiring pooling of sites and treatment experiences to conduct research. Also it’s necessary to have large numbers of children to attain diverse and representative study samples. PECARN creates the infrastructure needed to test the efficacy of treatments. PECARN has 18 sites across the country and 3 Pre Hospital sites all unified to conduct research in pediatric emergency care. Note DCC in Utah. Note Pink dots are the EMS CHAMP sites. Annual population of children coming to PECARN EDs is over a million kids annually. This is the pool from which research studies are conducted. Geographic representation is also an important aspect. PECARN centers are generally Children’s hospital or Adult and Pediatric hospitals that treat children.
9 other were internally funded projects; PCDP, Patient Safety, PCDP Macy, Pregnancy, others
Caveats—outstanding grants