Research

The Gulf Coast is at risk for hurricanes and flooding, and BCM faculty are in the unique position to develop educational modalities and implementation science to improve the care of children in the setting of natural and man-made disasters. Our disaster medicine lead is Dr. Brent Kaziny, who developed his passion for disaster preparedness while a Tulane resident during Hurricane Katrina. He is a subject matter expert for FEMA’s Pediatric Disaster Response and Emergency Preparedness Course, the co-director of the disaster domain for the Emergency Medical Services for Children Innovations and Improvement Center (EIIC), and the Medical Director of Emergency Management for Texas Children’s Hospital.

Texas Children’s Hospital is a Pediatric Disaster Center of Excellence. The Gulf 7 Pediatric Disaster Network (G7), led by Dr. Kaziny, covers 6 U.S. states (Alabama, Florida, Georgia, Louisiana, Mississippi, and Texas) and Puerto Rico. It is funded through the Administration for Strategic Preparedness and Response (ASPR). The G7’s goal is to improve regional capacity to care for children during and after large-scale crises. The G7 is a core partner in the Pediatric Pandemic Network. The PPN was established through HRSA during the COVID-19 pandemic to address gaps in pediatric care and to allow for system-wide coordination through children’s hospitals serving as regional hubs.

Faculty with a research focus on disaster medicine:

Nichole Davis, MD, MEd: pandemic preparedness, disaster response
- Email: nxgubbin@texaschildrens.org
Brent Kaziny, MD, MA: pediatric-specific disaster response
- Email: kaziny@bcm.edu
- Twitter: @disasterpeds

Li J, Kaziny BD, Perron C, Downey D, Monuteaux MC, Chung S. The first 15 minutes: a novel disaster simulation exercise. Disaster Med Public Health Prep. 2022; PMID 35332862.

Bechtold HD, Cruz AT, Kaziny BD. From World War II to COVID-19: a historical perspective on the American medical supply chain. Disaster Med Public Health Prep. 2021. PMID 33762064.

Tanner TE, Davis NR, Kaziny BD, Endom EE, Sampayo EM. Challenges created by the COVID-19 pandemic: pediatric emergency medicine and disaster management perspectives. Disaster Med Public Health Prep. 2022; PMID 35678417.

Fanny SA, Kaziny BD, Cruz AT, Camp EA, Murray KO, Nichols TJ, Chumpitazi CE. Pediatric emergency departments and urgent care visits in Houston after Hurricane Harvey. West J Emerg Med. 2021. PMID 34125058.

Davis NR, Doughty CB, Kerr T, Elegores G, Davis KI, Kaziny BD. Rapidly building surge capacity within a pandemic response using simulation-based clinical systems testing. BMJ Simul Technol Enhanc Learn. 2020. PMID 35515735.

The emergency department is often the first location children with newly-diagnosed diabetes or those with complications from their diabetes, including diabetic ketoacidosis (DKA), receive care. In partnership with colleagues in the Pediatric Emergency Care Applied Research Network (PECARN), Texas Children's Hospital and BCM prospectively enrolled children in a clinical trial to determine the association between fluid composition and volume in correcting DKA and preventing the cognitive sequelae that can be seen with individual and repetitive episodes of DKA.

Faculty with a research focus on endocrinology

Julie McManemy, M.D., MSPH: fluid resuscitation in children in diabetic ketoacidosis
- Email: Julie.McManemy@bcm.edu

Trainor JL, Glaser NS, Tzimenatos L, Stoner MJ, Brown KM, McManemy JK, Schunk JE, Quayle KS, Nigrovic LE, Rewers A, Myers SR, Bennett JE, Kwok MY, Olsen CS, Casper TC, Ghetti S, Kuppermann N; Pediatric Emergency Care Applied Research Network (PECARN) DKA FLUID Study Team. Clinical and laboratory predictors of dehydration severity in children with diabetic ketoacidosis. Ann Emerg Med. 2023. PMID 37024382.

Ghetti S, Kuppermann N, Rewers A, Myers SR, Schunk JE, Stoner MJ, Garro A, Quayle KS, Brown KM, Trainor JL, Tzimenatos L, DePiero AD, McManemy JK, Nigrovic LE, Kwok MY, Olsen CS, Casper TC, Glaser NS; Pediatric Emergency Care Applied Research Network (PECARN) DKA FLUID Study Team. Cognitive function following diabetic ketoacidosis in young children with type 1 diabetes. Endocrinol Diabetes Metab. 2023. PMID 36788736.

Glaser NS, Stoner MJ, Kwok MY, Quayle KS, Brown KM, Schunk JE, Trainor JL, McManemy JK, Tzimenatos L, Rewers A, Nigrovic LE, Bennett JE, Myers SR, Smith M, Casper TC, Kuppermann N. Relationships among biochemical measures in children with diabetic ketoacidosis. J Pediatr Endocrinol Metab. 2023. PMID 36637392.

Glaser NS, Quayle KS, McManemy JK, Nigrovic LE, Tzimenatos L, Stoner MJ, Bennett JE, Trainor JL, Rewers A, Schunk JE, Myers SR, Kwok MY, Brown KM, Gheetti S, Casper TC, Olsen CS, Kuppermann N; Pediatric Emergency Care Applied Research Network (PECARN) DKA FLUID Study Team. Clinical characteristic of children with cerebral injury preceding treatment of diabetic ketoacidosis. J Pediatr. 2022; PMID 35944716. 8/6/22.

Glaser NS, Stoner MJ, Garro A, Baird S, Myers SR, Rewers A, Brown KM, Trainor JL, Quayle KS, McManemy JK, et al. Serum sodium concentration and mental status in children with diabetic ketoacidosis. Pediatrics. 2021;148(3):e2021050243. E_pub 9/9/21. PMID 34373322.

Rewers A, Kuppermann N, Stoner MJ, Garro A, Bennett JE, Quayle KS, Schunk JE, Myers SR, McManemy JK, et al. Effects of fluid rehydration strategy on correction of acidosis and electrolyte abnormalities in children with diabetic ketoacidosis. Diabetes Care. 2021;44(9):2061-2068. E-pbu /29/21. PMID 34187840.

Myers SR, Glaser NS, Trainor JL, Nigrovic LE, Garro A, Tzimenatos L, Quayle KS, Kwok MY, Rewers A, Stoner MJ, Schunk JE, McManemy JK, Brown KM, DePiero AD, Olsen CS, Casper TC, Ghetti S, Kuppermann N; Pediatric Emergency Care Applied Research Network (PECARN) DKA FLUID Study Group. Frequency and Risk Factors of Acute Kidney Injury During Diabetic Ketoacidosis in Children and Association With Neurocognitive Outcomes. JAMA Netw Open. 2020. PMID: 33275152.

Ghetti S, Kuppermann N, Rewers A, Myers SR, Schunk JE, Stoner MJ, Garro A, Quayle KS, Brown KM, Trainor JL, Tzimenatos L, DePiero AD, McManemy JK, Nigrovic LE, Kwok MY, Perry CS 3rd, Olsen CS, Casper TC, Glaser NS; Pediatric Emergency Care Applied Research Network (PECARN) DKA FLUID Study Group. Cognitive Function Following Diabetic Ketoacidosis in Children With New-Onset or Previously Diagnosed Type 1 Diabetes. Diabetes Care. 2020. PMID: 32962981.

DePiero A, Kuppermann N, Brown KM, Schunk JE, McManemy JK, Rewers A, Stoner MJ, Tzimenatos L, Garro A, Myers SR, Quayle KS, Trainor JL, Kwok MY, Nigrovic LE, Olsen CS, Casper TC, Ghetti S, Glaser NS; Pediatric Emergency Care Applied Research Network (PECARN) DKA FLUID Study Group. Hypertension during Diabetic Ketoacidosis in Children. J Pediatr. 2020. PMID: 32387716.

Baylor College of Medicine / Texas Children's Hospital (BCM/TCH) is revolutionizing global pediatric emergency care. In sub-Saharan Africa, children have a 12 times higher chance of dying by their 5th birthday compared to the United States. Latin America is the continent which exhibits the highest disparities in child mortality rates between countries in the world. Although there have been significant improvements to global child survival over the last 20 years through improved access to care and stabilizing the HIV/AIDS epidemic, children still die of preventable, treatable diseases and injuries at staggeringly high numbers (5.9 million each year or >16,000/day). We know that interventions aimed at early recognition and management of injury and illness can profoundly decrease child mortality.

Launched in 2005, the BCM/TCH Global Pediatric Emergency Medicine (PEM) program, through ethical and committed bidirectional partnerships, aims to develop initiatives that promote collaboration and foster partnerships with existing BCM/TCH Global Health (GH) programs and external domestic and global partners focused on training and education, health systems strengthening, clinical care and treatment, advocacy, and research to improve emergency care of children worldwide.

With over 15 years of experience working in a variety of low-middle income countries (LMICs), endorsements by Latin American and African healthcare leaders, and in collaboration with the Pan American Health Organization (PAHO) and local Ministries of Health, Global PEM has had dramatic success providing over 25,000 hours of clinical care and shoulder-to-shoulder mentoring for emergently ill children alongside our global partners and training over 5,000 health professionals in 25 countries. Nearly 50% of Division faculty have contributed clinically or academically to the PEM-GH program since 2015. Collaboratively with our fellows (we have 1 PEM / global health fellow each year), this Global PEM work has resulted in 62 distinct manuscripts, 71 academic presentations and service on 41 local, national, and international GH-related committees.

Our group currently works in Argentina, Belize, Colombia, Cote d'Ivoire, El Salvador, Guatemala, Malawi, Nicaragua, Panama, Puerto Rico, Rwanda, and South Africa. In addition, our clinicians provide care to newly arrived immigrant children at the South Texas border through the Texas Children's Hospital Program for Immigrant and Refugee Child Health (PIRCH).

Since 2005, funding for this program has been supported through a combination of extramural grants totaling more than $4 million with approximately $1 million coming directly to the institution, internal grants as well as generous division, department and institutional support.

Faculty with a research focus on global and immigrant health:

Heather Crouse, M.D.: global health training and partnerships
- Email: crouse@bcm.edu
Andrea Cruz, M.D., MPH: prediction rules for infectious diseases, tuberculosis
- Email: acruz@bcm.edu
- Twitter: @atcruz97
Shubhada Hooli, M.D., MPH: pneumonia in low- and middle-income countries
- Email: Shubhada.Hooli@bcm.edu
- Twitter: @ShubhadaH
Marideth Rus, M.D., MEd: simulation-based training in global health settings
- Email: rus@bcm.edu
- Twitter: @marideth_rus
Eric Russell, M.D.: care of the immigrant child
- Email: erussell@bcm.edu
- Twitter: @EricRussell873

McCollum ED, Ahmed S, Roy AD, Islam AA, Schuh HB, King C, Hooli S, Quaiyum MA, Ginsburg AS, Checkley W, Baqui AH, Colburn T. Risk and accuracy of outpatient-identified hypoxaemia for death among suspected child pneumonia cases in rural Bangladesh: a multifacility prospective cohort study. Lancet Respir Med. 2023. PMID 37037207.

Lonquich B, Camp E, Fredricks K, Russell EA. Medicaid/CHIP Eligibility and Insurance Status in Foreign-Born Children Living in the United States. J Health Care Poor Underserved. 2023.

Hooli S, King C, McCollum ED, Colubourn T, Lufesi N, Mwansambo C, Gregory CJ, Thamthitiwat S, Cutland C, Madhi SA, Nunes MC, Gessner BD, Hazir T, Mathew JL, Addo-Yobo E, Chisaka N, Hassan M, Hibberd PL, Jeena P, Lozano JM, MacLeod WB, Patel A, Thea DM, Nguyen NTV, Zaman SM, Ruvinsky RO, Lucero M, Kartasasmita CB, Turner C, Asghar R, Banajej S, Iqbal I, Maluen-Radovan I, Mino-Leon G, Saha SK, Santosham M, Singhi S, Awasthi S, Bavdekar A, Chou M, Nymadawa P, Pape JW, Paranhos-Baccala G, Picot VS, Rakoto-Andrianarivelo M, Rouzier V, Russomando G, Sylla M, Vanhems P, Wang J, Basnet S, Strand TA, Neuman MI, Arroyo LM, Echavarria M, Bhatnagar S, Wadhwa N, Lodha R, Aneja S, Gentile A, Chadha M, Hirve S, O'Grady KF, Clara AW, Rees CA, Campbell H, Nair H, Falconer J, Williams LJ, Horne M, Qazi SA, Nisar YB; Pneumonia REsearch Partnership to Assess WHO REcommendations (PREPARE) study group. In-hospital mortality risk stratification in children aged under 5 years with pneumonia with or without pulse oximetry: A secondary analysis of the Pneumonia REsearch Partnership to Assess WHO REcommendations (PREPARE) dataset. Int J Infect Dis. 2023. PMID 36805325.

Hooli S, Makwenda C, Lufesi N, Colbourn T, Mvalo T, McCollum E, King C. Implication of the 2014 World Health Organization Integrated Management of Childhood Illness Pneumonia Guidelines with and without pulse oximetry use in Malawi: A retrospective cohort study. Gates Open Research. 2023. DOI: 10.12688/gatesopenres.13963.1

Hooli S, Schuh HB, Ahmed S, King C, Roy AD, Lufesi N, Ashraful Islam ASM.D., Mvalo T, Chowdhury NH, Ginsburg AS, Colbourn T, Checkley W, Baqui AH, McCollum ED. Clinical hypoxemia score for outpatient child pneumonia care lacking pulse oximetry in Africa and South Asia. medRxiv .2023. https://doi.org/10.1101/2023.02.25.23286448

Martin H, Falconer J, Addo-Yobo E, Aneja S, Arroyo LM, Asghar R, Awasthi S, Banajeh S, Bari A, Basnet S, Bavdekar A, Bhandari N, Bhatnagar S, Bhutta ZA, Brooks A, Chadha M, Chisaka N, Chou M, Clara AW, Colbourn T, Cutland C, D'Acremont V, Echavarria M, Gentile A, Gessner B, Gregory CJ, Hazir T, Hibberd PL, Hirve S, Hooli S, Iqbal I, Jeena P, Kartasasmita CB, King C, Libster R, Lodha R, Lozano JM, Lucero M, Lufesi N, MacLeod WB, Madhi SA, Mathew JL, Maulen-Radovan I, McCollum ED, Mino G, Mwansambo C, Neuman MI, Nguyen NTV, Nunes MC, Nymadawa P, O'Grady KF, Pape JW, Paranhos-Baccala G, Patel A, Picot VS, Rakoto-Andrianarivelo M, Rasmussen Z, Rouzier V, Russomando G, Ruvinsky RO, Sadruddin S, Saha SK, Santosham M, Singhi S, Soofi S, Strand TA, Sylla M, Thamthitiwat S, Thea DM, Turner C, Vanhems P, Wadhwa N, Wang J, Zaman SM, Campbell H, Nair H, Qazi SA, Nisar YB; World Health Organization Pneumonia Research Partnership to Assess WHO Recommendation (PREPARE) study group. Assembling a global database of child pneumonia studies to inform WHO pneumonia management algorithm: methodology and applications. J Glob Health. 2022. PMID 36579417.

Moher JM, Morales-Perez L, Chiume M, Crouse HL, Mgusha Y, Betchani F, D'Amico BM, Pediatric Alliance for Child Health Improvement in Malawi at Kamuzu Central Hospital and Environs (PACHIMAKE) Consortium. Point-of-care ultrasound needs assessment in a paediatric acute care setting in Malawi. Trop Med Int Health. 2023. PMID 36416491.

Raees M, Hooli S, et al. An exploratory assessment of the management of pediatric traumatic brain injury in three centers in Africa. Front Pediatr. 2022;10:936150. PMID 36061402.

Rees CA, Colbourn T, Hooli S, et al. Derivation and validation of a novel risk assessment tool to identify children aged 2-59 months at risk of hospitalised pneumonia-related mortality in 20 countries. BMJ Glob Health. 2022. PMID 35428680.

Kortz TB, Nielsen KR, Mediratta RP, Reeves H, O'Brien NF, Lee JH, Attebery JE, Bhutta EG, Biewen C, Coronado Munoz A, deAlmeida ML, Fonseca Y, Hooli S, et al. The burden of critical illness in hospitalized children in low- and middle-income countries: protocol for a systematic review and meta-analysis. Front Pediatr. 2022;10:756643. PMID 35372149.

Abbas Q, Holloway A, Caporal P, Lopez-Baron E, Agulnik A, Remy KE, Appiah JA, Attebery J, Fink EL, Lee JH, Hooli S, et al. Global PARITY: study design for a multicentered, international point prevalence study to estimate the burden of pediatric acute critical illness in resource-limited settings. Front Pediatr. 2022;9:793326. PMID 35155314.

Keating EM, Robison JA, Chiume M, Taddie M, VanDerslice JA, Benson LS, Fitzgerald E, Crouse HL, Eckerle M.D., Ciccione EJ, Porucznik CA. Relationship between distance of referring facilities and haemoglobin change in children in Malawi. Paediatr Int Child Health. 2021. PMID 35230927.

Vonasek BJ, Mhango S, Crouse HL, Nyangulu T, Gaven W, Ciccone E, Kondwani A, Patel B, et al. Improving recognition and management of children with complicated severe acute malnutrition at a tertiary referral hospital in Malawi: a quality improvement initiative. Paediatr Int Child Health. 2021. PMID 34494509.

McHenry MS, Tam RP, Nafiseh AA, Etling MA, Barnes EA, Rule ARL, Crouse HL, et al. Global partnerships during the COVID-19 pandemic: perspectives and insights from international partners. Am J Trop Med Hyg. 2021. PMID 34181576.

Keating EM, Chiume M, Fitzgerald E, Mgusha Y, Mvalo T, Fino N, Crouse HL, et al. Blood transfusion and mortality in children with severe anaemia in a malaria-endemic region. Paediatr Int Child Health. 2021. PMID 33874852.

Rees CA, Hooli S, King C, McCollum ED, Colbourn T, Lufesi N, Mwansambo C, Lazzerini M, Madhi SA, Cutland C, Nunes M, Gessner BD, Basnet S, Kartasasmita CB, Mathew JL, Zaman SMAU, Paranhos-Baccala G, Bhatnagar S, Wadhwa N, Lodha R, Aneja S, Santosham M, Picot VS, Sylla M, Awasthi S, Bavdekar A, Pape JW, Rouzier V, Chou M, Rakoto-Andrianarivelo M, Wang J, Nymadawa P, Vanhems P, Russomando G, Asghar R, Banajeh S, Iqbal I, MacLeod W, Maulen-Radovan I, Mino G, Saha S, Singhi S, Thea DM, Clara AW, Campbell H, Nair H, Falconer J, Williams LJ, Horne M, Strand T, Qazi SA, Nisar YB, Neuman MI; World Health Organization PREPARE study group48. External validation of the RISC, RISC-Malawi, and PERCH clinical prediction rules to identify risk of death in children hospitalized with pneumonia. J Glob Health. 2021. 34737862.

McCollum ED, King C, Ahmed S, Hanif AAM, Roy AD, Islam AA, Colbourn T, Schuh HB, Ginsburg AS, Hooli S, Chowdhury NH, Rizvi SJR, Begum N, Baqui AH, Checkley W. Defining hypoxaemia from pulse oximeter measurements of oxygen saturation in well children at low altitude in Bangladesh: an observational study. BMJ Open Respir Res. 2021. PMID 34728475.

Colbourn T, King C, Beard J, Phiri T, Mdala M, Zadutsa B, Makwenda C, Costello A, Lufesi N, Mwansambo C, Nambiar B, Hooli S, French N, Bar Zeev N, Qazi SA, Bin Nisar Y, McCollum ED. Predictive value of pulse oximetry for mortality in infants and children presenting to primary care with clinical pneumonia in rural Malawi: a data linkage study. PLoS Med. 2020. PMID 33095763.

Crouse HL, Watts J, St Clair NE, Batra M, McGuinness G, Keating EM, Russ CM, Farr KM, Steenhoff AP, Schubert CJ, Leslie LK, Woods SK, Wilson KA, Camp EA, Butteris SM. Global Health Opportunities in Pediatric Fellowships. Pediatrics. 2020. PMID: 32001489.

Ciccone EJ, Tilly AE, Chiume M, Mgusha Y, Eckerle M, Namuku H, Crouse HL, Mkaliainga TB, Robison JA, Schubert CJ, Mvalo T, Fitzgerald E. Lessons learned from the development and implementation of an electronic paediatric emergency and acute care database in Lilongwe, Malawi. BMJ Glob Health. 2020. PMID: 32675067.

Genisca AE, Sampayo EM, Mackey JM, Johnson L, Crouse HL. Assessment of Attitudes Toward the Emergency Triage System in Belize. Glob Pediatr Health. 2020. PMID: 32313821.

Colbourn T, King C, Beard J, Phiri T, Mdala M, Zadutsa B, Makwenda C, Costello A, Lufesi N, Mwansambo C, Nambiar B, Hooli S, French N, Bar Zeev N, Qazi SA, Bin Nisar Y, McCollum ED. Predictive value of pulse oximetry for mortality in infants and children presenting to primary care with clinical pneumonia in rural Malawi: A data linkage study. PLoS Med. 2020. PMID: 33095763.

Ahmed S, Mvalo T, Akech S, Agweyu A, Baker K, Bar-Zeev N, Campbell H, Checkley W, Chisti MJ, Colbourn T, Cunningham S, Duke T, English M, Falade AG, Fancourt NS, Ginsburg AS, Graham HR, Gray DM, Gupta M, Hammitt L, Hesseling AC, Hooli S, Johnson AB, King C, Kirby MA, Lanata CF, Lufesi N, Mackenzie GA, McCracken JP, Moschovis PP, Nair H, Oviawe O, Pomat WS, Santosham M, Seddon JA, Thahane LK, Wahl B, Van der Zalm M, Verwey C, Yoshida LM, Zar HJ, Howie SR, McCollum ED. Protecting children in low-income and middle-income countries from COVID-19. BMJ Glob Health. 2020. PMID: 32461228.

Hooli S, King C. Generalizability of Coronavirus Disease 2019 (COVID-19) Clinical Prediction Models. Clin Infect Dis. 2020. PMID: 32271865.

Hooli S, King C, Zadutsa B, Nambiar B, Makwenda C, Masache G, Lufesi N, Mwansambo C, Malla L, Costello A, Colbourn T, McCollum ED. The Epidemiology of Hypoxemic Pneumonia among Young Infants in Malawi. Am J Trop Med Hyg. 2020. PMID: 31971153.

Russell EA, Daza Atehortua C, Attia SL, Genisca AE, Palomino Rodriguez A, Headrick A, Solano L, Camp EA, Galvis AM, Crouse HL, Thomas JA. Childhood malnutrition within the indigenous Wayuú children of northern Colombia. Glob Public Health. 2020. PMID: 31944923.

Thomas VA, Crouse HL, Murray KO, Hsu DC, Camp EA, Cruz AT. Emergency medicine providers' knowledge and management of pediatric tropical diseases: a needs assessment. Pediatr Emerg Care. 2020. PMID 29538263.

Russell EA, Tsai C, Linton JM. Children in Immigrant Families: Advocacy Within and Beyond the Pediatric Emergency Department. Clin Pediatr Emerg Med. 2020. PMID: 32922213.

The role of mental health research in emergency departments for pediatric and adolescent patients is of utmost importance, particularly considering the increased rates of death by suicide and the impact of the COVID-19 pandemic. Mental health disorders among young individuals have been steadily rising, and unfortunately, suicide has become one of the leading causes of death in this population. The COVID-19 pandemic has further exacerbated mental health challenges, with many children and adolescents experiencing heightened stress, anxiety, and depression due to social isolation, disrupted routines, and the overall impact of the pandemic on their lives. Inadequacies in the mental healthcare system contribute to patients seeking care in emergency departments. Long wait times, limited access to mental health professionals, insufficient community-based resources, and stigma surrounding mental health are some of the existing gaps that push individuals to present to emergency departments for immediate assistance. Therefore, mental health research in emergency departments is crucial for developing effective interventions, identifying risk factors, improving screening and assessment tools, and implementing appropriate referral systems to ensure timely and comprehensive mental health support for pediatric and adolescent patients in crisis. By addressing these gaps, we can strive to provide better care and ultimately save lives.

At TCH, investigators have collaborated with other mental health experts to conduct research involving screening youth for suicide, alcohol and drugs in the emergency department. This research has included developing and validating a novel computerized adaptive screen for suicidal youth (CASSY) for use as a universal screen for suicide risk in medical emergency departments. Other research has involved comparing suicide screening measures for their predictive validity, identifying profiles of adolescents at risk for suicide and describing the risk and protective factors for suicide among subgroups at elevated risk for self-harm. Rohit Shenoi has been the PECARN site PI for several studies on mental health, including studies on teen suicide and on substance abuse.

Faculty with a research focus on mental health:

Katherine Guess, M.D.: acute stress disorder after trauma
- Email: Katherine.Guess@bcm.edu
Rohit Shenoi, M.D.: suicidality, substance abuse, opioid stewardship
- Email: rpshenoi@texaschildrens.org

Brent DA, Horowitz LM, Grupp-Phelan J, Bridge JA, Gibbons R, Chernick LS, Rea M, Cwik MF, Shenoi RP, et al. Prediction of suicide attempts and suicide-related events among adolescents seen in emergency departments. JAMA Netw Open. 2023. PMID 36790810.

Shenoi RP, Linakis JG, Bromberg JR, Casper TC, Richards R, Chun TH, Gonzalez VM, Mello MJ, Spirito A. Association of physical activity, sports, and screen time with adolescent behaviors in youth who visit the pediatric emergency department. Clin Pediatr (Phila). 2022. PMID 35152770.

Linakis JG, Thomas SA, Bromberg JR, Casper TC, Chun TH, Mello MJ, Richards R, Ahmad F, Bajaj L, Brown KM, Chernick LS, Cohen DM, Dean JM, Fein J, Horeczko T, Levas MN, McAninch B, Monuteaux MC, Mull CC, Grupp-Phelan J, Powell EC, Rogers A, Shenoi RP, Suffoletto B, Vance C, Spirito A; Pediatric Emergency Care Applied Research Network. Adolescent alcohol use predicts cannabis use over a three-year follow-up period. Subst Abuse. 2022. PMID 34236277.

Chang CD, Saidinejad M, Atanelov D, Dietrich AM, Lam SH, Rose E, Ruttan T, Shahid S, Stoner MJ, Sulton C, Chumpitazi CE; ACEP Pediatric Emergency Medicine Committee. Emergency department strategies to combat the opioid crisis in children and adolescents. J Am Coll Emerg Physicians Open. 2021. PMID 34322681.

Lavingia R, Mondragon E, McFarlane-Johansoon N, Shenoi RP. Improving opioid stewardship in pediatric emergency medicine. Pediatrics. 2021. PMID 34851415.

Brent DA, Grupp-Phelan J, O'Shea BA, Patel JS, Mahabee-Gittens EM, Rogers A, Duffy SJ, Shenoi RP, et al. A comparison of self-reported risk and protective factors and the death implicit association test in the prediction of future suicide attempts in adolescent emergency department patients. Psychol Med. 2021. PMID 33947480.

Chun TH, Chernick LS, Ahmad FA, Ranney ML, Shenoi RP, et al. Adolescent substance abuse risk: a comparison of Pediatric Emergency Care Applied Research Network emergency department patients and 2 nationally representative samples. Pediatr Emerg Care. 2021. PMID 30893225.

Yin HS, Heuspeil DR, Paul IM, Franklin W, Tieder JS, Adirim T, Alvarez F, Brown JM, Bundy DG, Ferguson LE, Gleeson Sp, Leu M, Mueller BU, Connor Phillips S, Quinonez RA, Rea C, Rinke ML, Shaikh U, Shiffman RN, Vickers Saarel E, Spencer Cockerham SP, Mack Walsh K, Jones B, Adler AC, Foster JH, Green TP, Houck CS, Laughon MM, Neville K, Reigart JR, Shenoi R, et al. Preventing home medication administration errors. Pediatrics. 2021. PMID 34851406.

King CA, Brent D, Grupp-Phelan J, Casper TC, Dean JM, Chernick LS, Fein JA, Mahabee-Gittens EM, Patel SJ, Mistry RD, Duffy S, Melzer-Lange M, Rogers A, Cohen DM, Keller A, Shenoi R, et al. Prospective development and validation of the computerized adaptive screen for suicidal youth. JAMA Psychiatry. 2021. PMID 33533908.

Horowitz AG, Grupp-Phelan J, Brent D, Barney BJ, Casper TC, Berona J, Chernick LS, Shenoi R, et al. Risk and protective factors for suicide among sexual minority youth seeking emergency medicine services. J Affect Disord. 2021. PMID 33074141.

The care that patients receive on ambulances is often based on consensus, and pediatric prehospital evidence is limited to inform optimal care for children. By developing, implementing, and studying evidence-based guidelines on pediatric prehospital seizures, airway management, and pain management, our researchers have identified which strategies are most effective at enhancing guideline adherence, improving care, and mitigating disparities. We have also designed clinical trials to close gaps in knowledge for common pediatric emergency medical services (EMS) conditions, have studied effective ways to educate EMS professionals locally and globally, and have published guidance to enhance pediatric readiness in EMS systems across the United States.

The Houston Fire Department is one of the 3 sites in PECARN's prehospital EMS research node, forming the CHaMP node along with Charlotte and Milwaukee. Through this node and each of the other 6 PECARN node's EMS affiliate, prospective interventional and observational studies are conducted in the prehospital setting. Our group has collaborated with hospital-based (PECARN) and prehospital providers to optimize management for children in status epilepticus. We have helped explore optimizing second-line therapy for children with seizures who fail to respond to benzodiazepines as well as standardizing benzodiazepine dosing in the prehospital setting. The latter 20-center study, PediDOSE, is being led by Manish Shah, who has an R01-funded study evaluating age-based dosing to facilitate accurate and timely administration of medications for children in status epilepticus.

Kathryn Kothari is the PI of the Emergency Medical Services for Children Texas State Partnership Program. This program seeks to improve pediatric emergency care by increasing pediatric readiness in EMS systems and increasing disaster preparedness.

Faculty with a research focus on prehospital medicine:

Kathryn Kothari, M.D.: analgesia in the prehospital setting
- Email: Kathryn.Kothari@bcm.edu
Manish Shah, M.D., MS: evidence-based guidelines in the prehospital setting, seizure management, pain control
- Email: mxshah@texaschildrens.org
- Twitter: @manishshahtx

Nishijima DK, Tancredi DJ, Adelgais KM, Chadha K, Chang TP, Harris MI, Leonard JC, Lerner EB, Linakis SW, Lowe GS, Magill CF, Schwartz HP, Shah MI, Browne LR. Impact of race and ethnicity on emergency medical services administration of opioid pain medications for injured children. J Emerg Med. 2023. PMID 36641254.

Zorovich EV, Kothari K, Adelgais K, Alter R, Mojica L, Salinas A, Auerbach M, Adams C. Fishe J. Prehospital management of pediatric behavioral health emergencies: a scoping review. Cureus. 2023.

Powell JR, Browne LR, Guild K, Shah MI, Crowe RP, Lindbeck G, Braithwaite S, Lang ES, Panchal AR; Technical Expert Panel. Evidence-based guidelines for prehospital pain management: literature and methods. Prehosp Emerg Care. 2023; PMID 34928783.

Harris MI, Adelgais KM, Linakis SW, Magill CF, Brazauskas R, Shah MI, et al. Impact of prehospital pain management on emergency department management of injured children. Prehosp Emerg Care. 2023. PMID 34734787.

Hanlin ER, Chan HK, Hansen M, Wendelberger B, Shah MI, Bosson N, Gausche-Hill M, vanBuren J, Wang HE. Epidemiology of out-of-hospital pediatric airway management in the 2019 national emergency medical services information system data set. Resuscitation. 2022;173:124-133. PMID 35063620.

Lindbeck G, Shah MI, Braithwaite S, Powell JR, Panchal AR, Browne LR, Lang ES, Burton B, Coughenour J, Crowe RP, Degn H, Hedges M, Gasper J, Guild K, Mattera C, Nasca S, Taillac P, Warth M. Evidence-based guidelines for prehospital pain management: recommendations. Prehosp Emerg Care. 2022; PMID 34928760.

Bosson N, Hansen M, Gausche-Hill M, Lewis RJ, Wendelberger B, Shah MI, VanBuren JM, Wang HE. Design of a novel clinical trial of prehospital pediatric airway management. Clin Trials. 2022. PMID 34875893.

Lerner EB, Browne LR, Studnek JR, Mann NC, Dai M, Hoffman CK, Pilkey D, Adelgais KM, Brown KM, Gaither JB, Leonard JC, Martin-Gill C, Nishijima DK, Owusu Ansah S, Shah ZS, Shah MI. A novel use of NEMSIS to create a PECARN-specific EMS registry. Prehospital Emerg Care. 2022. PMID 34232828.

Hansen M, Bosson N, Gausche-Hill M, Shah MI, et al. Critical factors in planning a pediatric prehospital airway trial. Prehosp Emerg Care. 2022. PMID 33886422.

Schmucker KA, Camp EA, Jones JL, Ostermayer DG, Shah MI. Factors associated with destination of pediatric EMS transports. Am J Emerg Med. 2021. PMID 34455256.

Shah MI, Ostermayer DG, Browne LR, Studnek JR, Carey JM, et al. Multicenter evaluation of prehospital seizure management in children. Prehosp Emerg Care. 2021. PMID 32589502.

Moore B, Shah MI, Owusu-Ansah S, Gross T, Brown K, Gausche-Hill M, Remick K, Adelgais K, Lyng J, Rappaport L, Snow S, Wright-Johnson C, Leonard JC; AMERICAN ACADEMY OF PEDIATRICS, Committee on Pediatric Emergency Medicine and Section on Emergency Medicine EMS Subcommittee; AMERICAN COLLEGE OF EMERGENCY PHYSICIANS, Emergency Medical Services Committee; EMERGENCY NURSES ASSOCIATION, Pediatric Committee; NATIONAL ASSOCIATION OF EMERGENCY MEDICAL SERVICES PHYSICIANS, Standards and Clinical Practice Committee; NATIONAL ASSOCIATION OF EMERGENCY MEDICAL TECHNICIANS, Emergency Pediatric Care Committee; Pediatric Readiness in Emergency Medical Services Systems; POLICY STATEMENT; Organizational Principles to Guide and Define the Child Health Care System and/or Improve the Health of All Children. Pediatric Readiness in Emergency Medical Services Systems. Ann Emerg Med. 2020. PMID: 31866028

Moore B, Shah MI, Owusu-Ansah S, Gross T, Brown K, Gausche-Hill M, Remick K, Adelgais K, Lyng J, Rappaport L, Snow S, Wright-Johnson C, Leonard JC; AMERICAN ACADEMY OF PEDIATRICS COMMITTEE ON PEDIATRIC EMERGENCY MEDICINE AND SECTION ON EMERGENCY MEDICINE EMS SUBCOMMITTEE; AMERICAN COLLEGE OF EMERGENCY PHYSICIANS EMERGENCY MEDICAL SERVICES COMMITTEE; EMERGENCY NURSES ASSOCIATION PEDIATRIC COMMITTEE; NATIONAL ASSOCIATION OF EMERGENCY MEDICAL SERVICES PHYSICIANS STANDARDS AND CLINICAL PRACTICE COMMITTEE; NATIONAL ASSOCIATION OF EMERGENCY MEDICAL TECHNICIANS EMERGENCY PEDIATRIC CARE COMMITTEE. Pediatric Readiness in Emergency Medical Services Systems. Pediatrics. 2020. PMID: 31857380

Owusu-Ansah S, Moore B, Shah MI, Gross T, Brown K, Gausche-Hill M, Remick K, Adelgais K, Rappaport L, Snow S, Wright-Johnson C, Leonard JC, Lyng J, Fallat M; COMMITTEE ON PEDIATRIC EMERGENCY MEDICINE, SECTION ON EMERGENCY MEDICINE; EMS SUBCOMMITTEE, SECTION ON SURGERY. Pediatric Readiness in Emergency Medical Services Systems. Pediatrics. 2020. PMID: 31857378

Moore B, Shah MI, Owusu-Ansah S, Gross T, Brown K, Gausche-Hill M, Remick K, Adelgais K, Lyng J, Rappaport L, Snow S, Wright-Johnson C, Leonard JC; American Academy of Pediatrics Committee on Pediatric Emergency Medicine, Section on Emergency Medicine EMS Committee and Section on Surgery;; American College of Emergency Physicians Emergency Medical Services Committee;; Emergency Nurses Association Pediatric Committee;; National Association of Emergency Medical Services Physicians Standards and Clinical Practice Committee;; National Association of Emergency Medical Technicians Emergency Pediatric Care Committee. Pediatric Readiness in Emergency Medical Services Systems. Prehosp Emerg Care. 2020. PMID: 31854223.

Kothari K, Zuger C, Desai N, et al. Effect of repetitive simulation training on emergency medical services team performance in simulated pediatric medical emergencies. AEM Educ Train. 2020. PMID: 34099990.

Respiratory diseases pose a significant burden in pediatric emergency departments, highlighting the urgent need to address existing gaps in care. One concerning aspect is the high mortality rate associated with pneumonia in children under the age of 5. Pneumonia remains a leading cause of death worldwide among young children, particularly in low-income countries. Despite advances in medical knowledge and treatment options, access to appropriate healthcare, including timely diagnosis, effective antibiotics, and supportive care, remains limited in many regions. Closing this gap requires comprehensive strategies, such as improved access to healthcare facilities, increased vaccination coverage, and enhanced community-based interventions to prevent, diagnose, and manage pneumonia in young children.

Another respiratory condition that significantly impacts pediatric emergency departments is bronchiolitis. This viral infection primarily affects infants and young children, causing inflammation and obstruction in the small airways of the lungs. Bronchiolitis places a considerable burden on healthcare systems, with a substantial number of hospitalizations each year. However, there are inconsistencies in the management of bronchiolitis across different healthcare settings, leading to variations in care and potentially unnecessary interventions. Addressing these gaps necessitates the development and implementation of evidence-based guidelines, standardizing diagnostic criteria, and promoting appropriate supportive care measures to reduce hospitalizations and improve outcomes for children with bronchiolitis.

Asthma, a chronic respiratory condition, also contributes to the workload in pediatric emergency departments. It is one of the most common chronic diseases among children, and its prevalence has been increasing over the years. However, disparities in asthma management and outcomes persist, particularly among marginalized populations. Factors such as limited access to healthcare, inadequate asthma education, environmental triggers, and socioeconomic challenges contribute to these disparities. Efforts to bridge the gaps in asthma care should focus on promoting equitable access to healthcare services, ensuring proper asthma education for patients and caregivers, and implementing comprehensive strategies to address environmental triggers and social determinants of health.

In conclusion, respiratory diseases pose significant challenges in pediatric emergency departments. Gaps in care, including high under 5 pneumonia mortality rates, the burden of bronchiolitis, and disparities in asthma management, demand immediate attention. By implementing evidence-based guidelines, improving access to healthcare services, strengthening preventive measures, and addressing social determinants of health, we can strive towards reducing the burden of respiratory diseases among children and improving their overall outcomes.

Esther Sampayo is the site PI a multi-center international retrospective cohort study of eligible children with acute moderate and severe asthma exacerbations in the tertiary-care pediatric EDs associated with the Pediatric Emergency Medicine Networks (PERN).

Shubhada Hooli has worked extensively on the prevention of morbidity and mortality for young children with pneumonia in low- and middle-income countries (LMICs). She has served as a WHO consultant for childhood pneumonia and is a member of the WHO's Research Partnership to Assess WHO Recommendations (WHO PREPARE) and the Pediatric Acute Lung Injury and Sepsis Investigators Global Health (PALISI-GH) network.

Faculty with a research focus on respiratory disease:

Gina Aloisio, M.D., Ph.D.: organoid respiratory virus models for bronchiolitis
- Email: Gina.Aloisio@bcm.edu
Shubhada Hooli, M.D., MPH: pneumonia diagnosis and management
- Email: Shubhada.Hooli@bcm.edu
- Twitter: @Shubhada
Esther M. Sampayo, M.D., MPH: asthma
- Email: Esther.Sampayo@bcm.edu
- Twitter: @md_ems

Hooli S, King C, McCollum ED, Colubourn T, Lufesi N, Mwansambo C, Gregory CJ, Thamthitiwat S, Cutland C, Madhi SA, Nunes MC, Gessner BD, Hazir T, Mathew JL, Addo-Yobo E, Chisaka N, Hassan M, Hibberd PL, Jeena P, Lozano JM, MacLeod WB, Patel A, Thea DM, Nguyen NTV, Zaman SM, Ruvinsky RO, Lucero M, Kartasasmita CB, Turner C, Asghar R, Banajej S, Iqbal I, Maluen-Radovan I, Mino-Leon G, Saha SK, Santosham M, Singhi S, Awasthi S, Bavdekar A, Chou M, Nymadawa P, Pape JW, Paranhos-Baccala G, Picot VS, Rakoto-Andrianarivelo M, Rouzier V, Russomando G, Sylla M, Vanhems P, Wang J, Basnet S, Strand TA, Neuman MI, Arroyo LM, Echavarria M, Bhatnagar S, Wadhwa N, Lodha R, Aneja S, Gentile A, Chadha M, Hirve S, O'Grady KF, Clara AW, Rees CA, Campbell H, Nair H, Falconer J, Williams LJ, Horne M, Qazi SA, Nisar YB; Pneumonia REsearch Partnership to Assess WHO REcommendations (PREPARE) study group. In-hospital mortality risk stratification in children aged under 5 years with pneumonia with or without pulse oximetry: A secondary analysis of the Pneumonia REsearch Partnership to Assess WHO REcommendations (PREPARE) dataset. Int J Infect Dis. 2023. PMID 36805325.

Hooli S, Makwenda C, Lufesi N, Colbourn T, Mvalo T, McCollum E, King C. Implication of the 2014 World Health Organization Integrated Management of Childhood Illness Pneumonia Guidelines with and without pulse oximetry use in Malawi: A retrospective cohort study. Gates Open Research. 2023. DOI: 10.12688/gatesopenres.13963.1

Hooli S, Schuh HB, Ahmed S, King C, Roy AD, Lufesi N, Ashraful Islam ASM.D., Mvalo T, Chowdhury NH, Ginsburg AS, Colbourn T, Checkley W, Baqui AH, McCollum ED. Clinical hypoxemia score for outpatient child pneumonia care lacking pulse oximetry in Africa and South Asia. medRxiv .2023. https://doi.org/10.1101/2023.02.25.23286448

Martin H, Falconer J, Addo-Yobo E, Aneja S, Arroyo LM, Asghar R, Awasthi S, Banajeh S, Bari A, Basnet S, Bavdekar A, Bhandari N, Bhatnagar S, Bhutta ZA, Brooks A, Chadha M, Chisaka N, Chou M, Clara AW, Colbourn T, Cutland C, D'Acremont V, Echavarria M, Gentile A, Gessner B, Gregory CJ, Hazir T, Hibberd PL, Hirve S, Hooli S, Iqbal I, Jeena P, Kartasasmita CB, King C, Libster R, Lodha R, Lozano JM, Lucero M, Lufesi N, MacLeod WB, Madhi SA, Mathew JL, Maulen-Radovan I, McCollum ED, Mino G, Mwansambo C, Neuman MI, Nguyen NTV, Nunes MC, Nymadawa P, O'Grady KF, Pape JW, Paranhos-Baccala G, Patel A, Picot VS, Rakoto-Andrianarivelo M, Rasmussen Z, Rouzier V, Russomando G, Ruvinsky RO, Sadruddin S, Saha SK, Santosham M, Singhi S, Soofi S, Strand TA, Sylla M, Thamthitiwat S, Thea DM, Turner C, Vanhems P, Wadhwa N, Wang J, Zaman SM, Campbell H, Nair H, Qazi SA, Nisar YB; World Health Organization Pneumonia Research Partnership to Assess WHO Recommendation (PREPARE) study group. Assembling a global database of child pneumonia studies to inform WHO pneumonia management algorithm: methodology and applications. J Glob Health. 2022. PMID 36579417.

Rajan A, Piedra FA, Aideyan L, McBride T, Robertson M, Johnson HL, Aloisio GM, et al. Multiple respiratory syncytial virus (RSV) strains infecting Hep-2 and A549 cells reveal cell line-dependent differences in resistance to RSV infection. J Virol. 2022;96(7):e0190421. PMID 35285685. 4/13/22.

Rajan A, Weaver AM, Aloisio GM, et al. The human nose organoid respiratory virus model: an ex vivo human challenge model to study respiratory syncytial virus (RSV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pathogenesis and evaluate therapeutics. mBio. 2022;13(1):e0351121. PMID 35164569.

McLaughlin P, Banuelos RC, Camp EA, Kancharla V, Sampayo EM. The clinical respiratory score: investigating the reliability of an asthma scoring tool across a multidisciplinary team. J Asthma. 2022;59(10):1915-1922. PMID 34530678.

Moschovis PP, Sampayo EM, et al. The diagnosis of respiratory disease in children using a phone-based cough and symptom analysis algorithm: the smartphone recordings of coughs 2 (SMARTCOUGH-C 2) trial design. Contemp Clin Trials. 2021. PMID 33444779.

Rees CA, Hooli S, King C, McCollum ED, Colbourn T, Lufesi N, Mwansambo C, Lazzerini M, Madhi SA, Cutland C, Nunes M, Gessner BD, Basnet S, Kartasasmita CB, Mathew JL, Zaman SMAU, Paranhos-Baccala G, Bhatnagar S, Wadhwa N, Lodha R, Aneja S, Santosham M, Picot VS, Sylla M, Awasthi S, Bavdekar A, Pape JW, Rouzier V, Chou M, Rakoto-Andrianarivelo M, Wang J, Nymadawa P, Vanhems P, Russomando G, Asghar R, Banajeh S, Iqbal I, MacLeod W, Maulen-Radovan I, Mino G, Saha S, Singhi S, Thea DM, Clara AW, Campbell H, Nair H, Falconer J, Williams LJ, Horne M, Strand T, Qazi SA, Nisar YB, Neuman MI; World Health Organization PREPARE study group48. External validation of the RISC, RISC-Malawi, and PERCH clinical prediction rules to identify risk of death in children hospitalized with pneumonia. J Glob Health. 2021. 34737862.

Lam SHF, Homme J, Avarello J, Heins A, Pauze D, Mace S, Dietrich A, Stoner M, Chumpitazi CE, Saidinejad M. Use of antitussive medications in acute cough in young children. J Am Coll Emerg Physicians Open. 2021. PMID 34179887.

McCollum ED, King C, Ahmed S, Hanif AAM, Roy AD, Islam AA, Colbourn T, Schuh HB, Ginsburg AS, Hooli S, Chowdhury NH, Rizvi SJR, Begum N, Baqui AH, Checkley W. Defining hypoxaemia from pulse oximeter measurements of oxygen saturation in well children at low altitude in Bangladesh: an observational study. BMJ Open Respir Res. 2021. PMID 34728475.

Colbourn T, King C, Beard J, Phiri T, Mdala M, Zadutsa B, Makwenda C, Costello A, Lufesi N, Mwansambo C, Nambiar B, Hooli S, French N, Bar Zeev N, Qazi SA, Bin Nisar Y, McCollum ED. Predictive value of pulse oximetry for mortality in infants and children presenting to primary care with clinical pneumonia in rural Malawi: a data linkage study. PLoS Med. 2020. PMID 33095763.

Kaiser SV, Johnson M.D., Walls TA, Teach SJ, Sampayo EM, Dudley NC, Zorc JJ. Pathways to Improve Pediatric Asthma Care: A Multisite, National Study of Emergency Department Asthma Pathway Implementation. J Pediatr. 2020. PMID: 32409021

McDaniel CE, Jeske M, Sampayo EM, Liu P, Walls TA, Kaiser SV. Implementing Pediatric Asthma Pathways in Community Hospitals: A National Qualitative Study. J Hosp Med. 2020. PMID: 31532746

Foradori DM, Sampayo EM, Fanny SA, Namireddy MK, Kumar AM, Lo HY. Improving Influenza Vaccination in Hospitalized Children With Asthma. Pediatrics. 2020. PMID: 32107285

Colbourn T, King C, Beard J, Phiri T, Mdala M, Zadutsa B, Makwenda C, Costello A, Lufesi N, Mwansambo C, Nambiar B, Hooli S, French N, Bar Zeev N, Qazi SA, Bin Nisar Y, McCollum ED. Predictive value of pulse oximetry for mortality in infants and children presenting to primary care with clinical pneumonia in rural Malawi: A data linkage study. PLoS Med. 2020. PMID: 33095763.

Ahmed S, Mvalo T, Akech S, Agweyu A, Baker K, Bar-Zeev N, Campbell H, Checkley W, Chisti MJ, Colbourn T, Cunningham S, Duke T, English M, Falade AG, Fancourt NS, Ginsburg AS, Graham HR, Gray DM, Gupta M, Hammitt L, Hesseling AC, Hooli S, Johnson AB, King C, Kirby MA, Lanata CF, Lufesi N, Mackenzie GA, McCracken JP, Moschovis PP, Nair H, Oviawe O, Pomat WS, Santosham M, Seddon JA, Thahane LK, Wahl B, Van der Zalm M, Verwey C, Yoshida LM, Zar HJ, Howie SR, McCollum ED. Protecting children in low-income and middle-income countries from COVID-19. BMJ Glob Health. 2020. PMID: 32461228.

Hooli S, King C, Zadutsa B, Nambiar B, Makwenda C, Masache G, Lufesi N, Mwansambo C, Malla L, Costello A, Colbourn T, McCollum ED. The Epidemiology of Hypoxemic Pneumonia among Young Infants in Malawi. Am J Trop Med Hyg. 2020. PMID: 31971153.

Resuscitation research in pediatric emergency medicine plays a crucial role in improving outcomes for critically ill children. However, several existing gaps in care need to be addressed to ensure optimal resuscitation efforts. One significant area that requires attention is the development of pediatric-specific airway protocols. Children have distinct anatomical and physiological differences compared to adults, which necessitate tailored approaches during airway management. Current protocols primarily derive from adult practices, and this lack of pediatric-specific guidelines can lead to suboptimal airway management and potential complications. Therefore, there is a pressing need for research focused on designing evidence-based airway protocols specifically tailored to the unique needs of pediatric patients.

In addition to the lack of pediatric-specific airway protocols, the implementation of recognition tools for early identification of critical illness in children is another crucial area requiring attention. Timely recognition of deteriorating conditions is vital for initiating appropriate resuscitative measures promptly. However, recognizing signs of impending deterioration in children can be challenging due to variations in clinical presentations and the subtle nature of symptoms. Developing and validating reliable recognition tools, such as pediatric early warning scores or clinical decision support systems, can assist healthcare providers in identifying high-risk patients earlier, leading to timely interventions and improved outcomes.

Simulation medicine serves as an invaluable tool in resuscitation research, particularly in pediatric emergency medicine. Simulated scenarios allow healthcare providers to practice critical resuscitation skills, refine their techniques, and gain confidence in managing complex pediatric emergencies. Simulation-based training offers a safe and controlled environment where healthcare teams can learn to work together efficiently, improve communication, and enhance their overall performance during resuscitation efforts. Furthermore, simulation medicine provides an avenue for testing and refining new protocols and technologies before their implementation in real-world clinical settings. Continued investment in simulation-based research and training programs can greatly contribute to advancing pediatric resuscitation practices and ultimately save more lives.

In conclusion, resuscitation research in pediatric emergency medicine is essential for filling the existing gaps in care. Pediatric-specific airway protocols, recognition tools for early identification of critical illness, and the utilization of simulation medicine are all crucial areas that demand attention. By addressing these gaps and investing in research and innovation, we can enhance the quality of care provided to critically ill children, improve outcomes, and ultimately make significant strides in pediatric resuscitation practices.

Faculty with a research focus on resuscitation medicine:

Kiyetta Alade, M.D., MEd: POCUS in the unstable child
- Email: alade@bcm.edu
- Twitter: @KiyettaAlade
Andrea Cruz, M.D., MPH: sepsis
- Email: acruz@bcm.edu
- Twitter: @atcruz97
Kathryn Kothari, M.D.: prehospital resuscitation
- Email: Kathryn.Kothari@bcm.edu
Daniel Lemke, M.D.: simulation education for resuscitations
- Email: Daniel.Lemke@bcm.edu
Julie McManemy, M.D., MSPH: sepsis
- Email: jkmcmane@texaschildrens.org
Binita Patel, M.D.: sepsis
- Email: bxpatel@texaschildrens.org
Manish Shah, M.D., MS: prehospital airway and status epilepticus management
- Email: mxshah@texaschildrens.org
- Twitter: @manishshahtx
Bram Welch-Horan, M.D.: simulation medicine
- Email: Bram.Welch-Horan@bcm.edu
- Twitter: @DrBramPedsER

Scott C, Alade K, Leung SK, Vaughan RM, Riley AF. Cardiac point-of-care ultrasound and multi-disciplinary improvement opportunities in acute systolic heart failure management in a pediatric emergency center. Pediatr Cardiol. 2023. PMID 36790508.

Won SK, Doughty CB, Young AL, Welch-Horan TB, Rus MC, Camp EA, Lemke DS. Rapid cycle deliberate practice improves retention of pediatric resuscitation skills compared with post-simulation debriefing. Simul Healthc. 2022. PMID 34009907.

Hanlin ER, Chan HK, Hansen M, Wendelberger B, Shah MI, Bosson N, Gausche-Hill M, vanBuren J, Wang HE. Epidemiology of out-of-hospital pediatric airway management in the 2019 national emergency medical services information system data set. Resuscitation. 2022;173:124-133. PMID 35063620.

Bosson N, Hansen M, Gausche-Hill M, Lewis RJ, Wendelberger B, Shah MI, VanBuren JM, Wang HE. Design of a novel clinical trial of prehospital pediatric airway management. Clin Trials. 2022. PMID 34875893.

Hansen M, Bosson N, Gausche-Hill M, Shah MI, et al. Critical factors in planning a pediatric prehospital airway trial. Prehosp Emerg Care. 2022. PMID 33886422.

Depinet H, Macias CG, Balamuth F, Lane RD, Luria J, Melendez E, Myers SR, Patel B, Richardson T, Zaniletti I, Paul R; American Academy of Pediatrics Pediatric Septic Shock Collaborative (PSSC) Investigators. Pediatric septic shock collaborative improves emergency department sepsis care in children. Pediatrics. 2022. PMID 35229124.

Shah MI, Ostermayer DG, Browne LR, Studnek JR, Carey JM, et al. Multicenter evaluation of prehospital seizure management in children. Prehosp Emerg Care. 2021. PMID 32589502.

Lemke DS, Young AL, Won SK, Rus MC, Villarreal NN, Camp EA, Doughty C. Rapid-cycle deliberate practice improves time to defibrillation and reduces workload: a randomized controlled trial of simulation-based education. AEM Educ Train. 2021. PMID 34901686.

Hamad A, Ng C, Alade K, D'Amico B, Morales-Perez L, Price J, Leung SK, Diagnosing acute heart failure in the pediatric emergency department using point-of-care ultrasound. J Emerg Med. 2021. PMID 34092442.

Lemke DS. Rapid Cycle Deliberate Practice for Pediatric Intern Resuscitation Skills. MedEdPORTAL. 2020. PMID: 33241116.

Kessler DO, Lemke DS, Jani P, Dewan ML, Moore-Clingenpeel M, Chang TP, Pirie J, Lovett ME, Harwayne-Gidansky I, Wolfe HA; Quality Cardiopulmonary Resuscitation (QCPR) leaderboard investigators of the International Network for Simulation-based Pediatric Innovation, Research, and Education (INSPIRE). Caregiver Characteristics Associated With Quality of Cardiac Compressions on an Adult Mannequin With Real-Time Visual Feedback: A Simulation-Based Multicenter Study. Simul Healthc. 2020. PMID: 32168293.

Weiss SL, Peters MJ, Alhazzani W, Agus MSD, Flori HR, Inwald DP, Nadel S, Schlapbach LJ, Tasker RC, Argent AC, Brierley J, Carcillo J, Carrol ED, Carroll CL, Cheifetz IM, Choong K, Cies JJ, Cruz AT, De Luca D, Deep A, Faust SN, De Oliveira CF, Hall MW, Ishimine P, Javouhey E, Joosten KFM, Joshi P, Karam O, Kneyber MCJ, Lemson J, MacLaren G, Mehta NM, Møller MH, Newth CJL, Nguyen TC, Nishisaki A, Nunnally ME, Parker MM, Paul RM, Randolph AG, Ranjit S, Romer LH, Scott HF, Tume LN, Verger JT, Williams EA, Wolf J, Wong HR, Zimmerman JJ, Kissoon N, Tissieres P. Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children. Pediatr Crit Care Med. 2020. PMID: 32032273.

Souganidis E, Abbadessa MK, Ku B, Minich C, Lavelle J, Zorc J, Balamuth F. Analysis of Missed Sepsis Patients in a Pediatric Emergency Department With a Vital Sign-Based Electronic Sepsis Alert. Pediatr Emerg Care. 2020. PMID: 33003131.

Moore B, Shah MI, Owusu-Ansah S, Gross T, Brown K, Gausche-Hill M, Remick K, Adelgais K, Lyng J, Rappaport L, Snow S, Wright-Johnson C, Leonard JC; AMERICAN ACADEMY OF PEDIATRICS, Committee on Pediatric Emergency Medicine and Section on Emergency Medicine EMS Subcommittee; AMERICAN COLLEGE OF EMERGENCY PHYSICIANS, Emergency Medical Services Committee; EMERGENCY NURSES ASSOCIATION, Pediatric Committee; NATIONAL ASSOCIATION OF EMERGENCY MEDICAL SERVICES PHYSICIANS, Standards and Clinical Practice Committee; NATIONAL ASSOCIATION OF EMERGENCY MEDICAL TECHNICIANS, Emergency Pediatric Care Committee; Pediatric Readiness in Emergency Medical Services Systems; POLICY STATEMENT; Organizational Principles to Guide and Define the Child Health Care System and/or Improve the Health of All Children. Pediatric Readiness in Emergency Medical Services Systems. Ann Emerg Med. 2020. PMID: 31866028.

Weiss SL, Peters MJ, Alhazzani W, Agus MSD, Flori HR, Inwald DP, Nadel S, Schlapbach LJ, Tasker RC, Argent AC, Brierley J, Carcillo J, Carrol ED, Carroll CL, Cheifetz IM, Choong K, Cies JJ, Cruz AT, De Luca D, Deep A, Faust SN, De Oliveira CF, Hall MW, Ishimine P, Javouhey E, Joosten KFM, Joshi P, Karam O, Kneyber MCJ, Lemson J, MacLaren G, Mehta NM, Møller MH, Newth CJL, Nguyen TC, Nishisaki A, Nunnally ME, Parker MM, Paul RM, Randolph AG, Ranjit S, Romer LH, Scott HF, Tume LN, Verger JT, Williams EA, Wolf J, Wong HR, Zimmerman JJ, Kissoon N, Tissieres P. Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children. Intensive Care Med. 2020. PMID: 32030529.

Kothari K, Zuger C, Desai N, et al. Effect of repetitive simulation training on emergency medical services team performance in simulated pediatric medical emergencies. AEM Educ Train. 2020. PMID: 34099990.

General Inquiries

Department of Pediatrics

Dr. Andrea Cruz

Pediatric Emergency Medicine Research

Research Areas