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Article ; Online: Pyridoxine-Dependent Epilepsy as a Cause of Neonatal Seizures.

Tsao, Hoi See / Case, Sarah D

Rhode Island medical journal (2013)

2022 Volume 105, Issue 2, Page(s) 17–21

Abstract: Pediatric seizures are a common reason for emergency department visits. The highest risk of seizures in children is during the neonatal period. A low index of suspicion is important to facilitate the early assessment, workup, and treatment of inborn ... ...

Abstract	Pediatric seizures are a common reason for emergency department visits. The highest risk of seizures in children is during the neonatal period. A low index of suspicion is important to facilitate the early assessment, workup, and treatment of inborn errors of metabolism to optimize developmental outcomes. We present the rare case of a 9-day-old with seizures refractory to multiple anticonvulsant medications who was diagnosed with pyridoxine-dependent epilepsy. We review differences in the management of neonatal seizures from older patients, the utility of a trial of pyridoxine in refractory neonatal seizures, and the importance of preparing for emergent airway management given pyridoxine's ability to cause apnea and central nervous system depression.
MeSH term(s)	Epilepsy/complications ; Epilepsy/diagnosis ; Epilepsy/drug therapy ; Humans ; Infant, Newborn ; Pyridoxine/metabolism ; Pyridoxine/therapeutic use ; Seizures/etiology
Chemical Substances	Pyridoxine (KV2JZ1BI6Z)
Language	English
Publishing date	2022-03-01
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	419430-5
ISSN	2327-2228 ; 0363-7913
ISSN (online)	2327-2228
ISSN	0363-7913
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: COVID-19 Pneumonia and Status Asthmaticus With Respiratory Failure in a Pediatric Patient

Hoi See Tsao / Mariann Nocera Kelley / Lauren Allister / Robyn Wing

MedEdPORTAL, Vol

A Simulation for Emergency Medicine Providers

2022 Volume 18

Abstract: Introduction During COVID-19 surges, medical trainees may perform patient care outside typical clinical responsibilities. While respiratory failure in pediatric patients secondary to COVID-19 is rare, it is critical that providers can effectively care ... ...

Abstract	Introduction During COVID-19 surges, medical trainees may perform patient care outside typical clinical responsibilities. While respiratory failure in pediatric patients secondary to COVID-19 is rare, it is critical that providers can effectively care for these children while protecting the health care team. Simulation is an important tool for giving learners a safe environment in which to learn and practice these new skills. Methods In this simulation, learners provided care to a 13-year-old male with obesity, COVID-19 pneumonia, status asthmaticus, and respiratory failure. Target learners were pediatric emergency medicine fellows and emergency medicine residents. Providers were expected to identify the signs and symptoms of status asthmaticus, pneumonia, and respiratory failure and demonstrate appropriate evaluation and management while minimizing COVID-19 exposure. Participants completed a postsimulation survey on their satisfaction and confidence in performing the objectives. Results Twenty-eight PGY 1-PGY 6 learners participated in this simulation. The postsimulation survey showed that most learners felt the simulation was effective in teaching the evaluation and management of respiratory failure due to COVID-19 (M = 5.0; 95% CI, 4.9-5.0) and was relevant to their work (M = 5.0; 95% CI, 5.0-5.0). Discussion Learners felt that the case was effective in teaching the skills needed to care for a child with COVID-19 pneumonia, status asthmaticus, and respiratory failure. Future directions include updating the case with new COVID-19 knowledge and personal protective equipment practices gained over time, using hybrid telesimulation to increase learners’ exposure to the case, and adapting the case for other health care providers.
Keywords	Asthma ; Pneumonia ; Personal Protective Equipment ; COVID-19 ; SARS-CoV-2 ; Respiratory Failure ; Medicine (General) ; R5-920 ; Education ; L
Subject code	650
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Association of American Medical Colleges
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: COVID-19 Pneumonia and Status Asthmaticus With Respiratory Failure in a Pediatric Patient: A Simulation for Emergency Medicine Providers.

Tsao, Hoi See / Kelley, Mariann Nocera / Allister, Lauren / Wing, Robyn

MedEdPORTAL : the journal of teaching and learning resources

2022 Volume 18, Page(s) 11214

Abstract: Introduction: During COVID-19 surges, medical trainees may perform patient care outside typical clinical responsibilities. While respiratory failure in pediatric patients secondary to COVID-19 is rare, it is critical that providers can effectively care ... ...

Abstract	Introduction: During COVID-19 surges, medical trainees may perform patient care outside typical clinical responsibilities. While respiratory failure in pediatric patients secondary to COVID-19 is rare, it is critical that providers can effectively care for these children while protecting the health care team. Simulation is an important tool for giving learners a safe environment in which to learn and practice these new skills. Methods: In this simulation, learners provided care to a 13-year-old male with obesity, COVID-19 pneumonia, status asthmaticus, and respiratory failure. Target learners were pediatric emergency medicine fellows and emergency medicine residents. Providers were expected to identify the signs and symptoms of status asthmaticus, pneumonia, and respiratory failure and demonstrate appropriate evaluation and management while minimizing COVID-19 exposure. Participants completed a postsimulation survey on their satisfaction and confidence in performing the objectives. Results: Twenty-eight PGY 1-PGY 6 learners participated in this simulation. The postsimulation survey showed that most learners felt the simulation was effective in teaching the evaluation and management of respiratory failure due to COVID-19 ( Discussion: Learners felt that the case was effective in teaching the skills needed to care for a child with COVID-19 pneumonia, status asthmaticus, and respiratory failure. Future directions include updating the case with new COVID-19 knowledge and personal protective equipment practices gained over time, using hybrid telesimulation to increase learners' exposure to the case, and adapting the case for other health care providers.
MeSH term(s)	Adolescent ; COVID-19 ; Child ; Emergency Medicine ; Humans ; Male ; Respiratory Insufficiency/diagnosis ; Respiratory Insufficiency/etiology ; Respiratory Insufficiency/therapy ; SARS-CoV-2 ; Status Asthmaticus
Language	English
Publishing date	2022-01-21
Publishing country	United States
Document type	Case Reports ; Journal Article
ISSN	2374-8265
ISSN (online)	2374-8265
DOI	10.15766/mep_2374-8265.11214
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Immune Thrombocytopenia (ITP) in a Pediatric Patient Positive for SARS-CoV-2.

Tsao, Hoi See / Chason, Hannah M / Fearon, Deirdre M

Pediatrics

2020 Volume 146, Issue 2

Abstract: Immune thrombocytopenia (ITP) is a potential presentation of COVID-19. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral testing should be considered in these patients to allow for appropriate hospital triaging and isolation to limit ... ...

Abstract	Immune thrombocytopenia (ITP) is a potential presentation of COVID-19. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral testing should be considered in these patients to allow for appropriate hospital triaging and isolation to limit community spread and health care worker infection during epidemics or pandemics. ITP is characterized by isolated thrombocytopenia. Approximately two-thirds of children with primary ITP have a history of a viral infection during the previous month.
MeSH term(s)	Betacoronavirus ; COVID-19 ; Child ; Consensus ; Coronavirus Infections/epidemiology ; Humans ; Pandemics ; Pneumonia, Viral ; Purpura, Thrombocytopenic, Idiopathic ; SARS-CoV-2 ; Thrombocytopenia
Keywords	covid19
Language	English
Publishing date	2020-05-21
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	207677-9
ISSN	1098-4275 ; 0031-4005
ISSN (online)	1098-4275
ISSN	0031-4005
DOI	10.1542/peds.2020-1419
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Article ; Online: Do Unmet Health Needs Drive Pediatric Emergency Department Utilization?: A Population-Based Assessment.

Sojar, Sakina / Gjelsvik, Annie / Tsao, Hoi See / Amanullah, Siraj

Pediatric emergency care

2021 Volume 38, Issue 2, Page(s) e569–e574

Abstract: Objective: Lack of access to basic health services is thought to increase emergency department (ED) utilization. This study assessed the relationship between unmet health care needs and pediatric ED utilization in the United States.: Methods: The ... ...

Abstract	Objective: Lack of access to basic health services is thought to increase emergency department (ED) utilization. This study assessed the relationship between unmet health care needs and pediatric ED utilization in the United States. Methods: The National Survey of Children's Health was used (2016-2017; n = 71,360). Parent/guardians reported number of ED visits and the presence of unmet health needs (medical, dental, mental health, vision, hearing, other) in the last 12 months. Associations were analyzed using multinomial logistic regression modeling and accounted for the weighting and complex survey design of the National Survey of Children's Health. Results: Children with 2 or more unmet health needs had 3.72 times (95% confidence interval, 2.25-6.16) risk of ≥2 ED visits when compared with those with 0 unmet health needs. This risk became nonsignificant when adjusted for race, ethnicity, age, insurance, having asthma, current medication status, health description, number of preventative health visits, and place to go for preventative health (aRR, 1.77; 95% confidence interval, 0.96-3.27). The adjusted association was also nonsignificant for specific types of unmet needs. Race, insurance status, age 0 to 3 years, current medication status, having asthma, ≥2 preventative visits, and poorer health were associated with ≥2 ED visits. Conclusions: Unmet health needs were not found to be a significant driving force for ED utilization. Other factors were found to be more strongly associated with it. Future studies to understand the perception, motives, and complex interaction of various factors leading to ED use in high-risk populations may optimize care for these children.
MeSH term(s)	Child ; Child, Preschool ; Emergency Service, Hospital ; Ethnicity ; Health Care Surveys ; Health Services Accessibility ; Humans ; Infant ; Infant, Newborn ; Insurance Coverage ; Insurance, Health ; United States/epidemiology
Language	English
Publishing date	2021-02-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	632588-9
ISSN	1535-1815 ; 0749-5161
ISSN (online)	1535-1815
ISSN	0749-5161
DOI	10.1097/PEC.0000000000002319
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Immune Thrombocytopenia (ITP) in a SARS-CoV-2 Positive Pediatric Patient

See Tsao, Hoi / M Chason, Hannah / M Fearon, Deirdre

Pediatrics

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #32439817
Database	COVID19

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Article ; Online: Sounding the Alarm on Sleep: A Negative Association Between Inadequate Sleep and Flourishing.

Tsao, Hoi See / Gjelsvik, Annie / Sojar, Sakina / Amanullah, Siraj

The Journal of pediatrics

2020 Volume 228, Page(s) 199–207.e3

Abstract: Objective: To assess the national prevalence of inadequate sleep among school-age children and its relationship with childhood flourishing.: Study design: This cross-sectional study analyzed 49 050 parental responses from the 2016-2017 National ... ...

Abstract	Objective: To assess the national prevalence of inadequate sleep among school-age children and its relationship with childhood flourishing. Study design: This cross-sectional study analyzed 49 050 parental responses from the 2016-2017 National Survey of Children's Health for school-age children. Inadequate sleep duration was defined as <9 hours for 6- to 12-year-olds and <8 hours for 13- to 17-year-olds on an average weeknight. Five markers of flourishing were examined individually and as a combined measure. Logistic regression was used with complex survey design and applied weights. Results: Inadequate sleep was found in 36.4% of 6- to 12-year-olds and in 31.9% of 13- to 17-year-olds. Compared with children with adequate sleep, 6- to 12-year-olds with inadequate sleep had increased odds of not showing interest and curiosity in learning (aOR, 1.61; 95% CI, 1.34-1.94), not caring about doing well in school (aOR, 1.45; 95% CI, 1.23-1.71), not doing homework (aOR, 1.44; 95% CI, 1.24-1.68), and not finishing tasks (aOR, 1.18; 95% CI, 1.03-1.35). Children aged 13-17 years with inadequate sleep had increased odds of not doing homework (aOR, 1.36; 95% CI, 1.17-1.58), not staying calm and in control when challenged (aOR, 1.34; 95% CI, 1.16-1.54), not showing interest and curiosity in learning (aOR, 1.34; 95% CI, 1.14-1.58), not finishing tasks (aOR, 1.20; 95% CI, 1.03-1.40), and not demonstrating the combined flourishing measure (aOR, 1.35; 95% CI, 1.17-1.56). Conclusions: Nationally representative data show that one-third of school-age children have inadequate sleep. Inadequate sleep is associated with decreased flourishing. These data will help inform sleep policies and optimize child development.
MeSH term(s)	Adolescent ; Child ; Child Development/physiology ; Child Health ; Child, Preschool ; Cross-Sectional Studies ; Female ; Health Surveys ; Humans ; Incidence ; Male ; Prevalence ; Risk Factors ; Schools ; Sleep/physiology ; Sleep Deprivation/epidemiology ; Sleep Deprivation/physiopathology ; United States/epidemiology
Language	English
Publishing date	2020-09-03
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	3102-1
ISSN	1097-6833 ; 0022-3476
ISSN (online)	1097-6833
ISSN	0022-3476
DOI	10.1016/j.jpeds.2020.08.080
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: COVID-19 in Pediatric Patients: Observations from the Initial Phase of the Global Pandemic in Rhode Island.

Levin, Rebecca A / Tsao, Hoi See / Amanullah, Siraj / Genisca, Alicia / Chapman, Laura

Rhode Island medical journal (2013)

2021 Volume 104, Issue 1, Page(s) 55–60

Abstract: Objective: To describe characteristics of children undergoing SARS-CoV-2 testing during the initial wave of infections in Rhode Island.: Methods: This is a descriptive study of 729 children tested for SARS-CoV-2 at four emergency departments April 9 ... ...

Abstract	Objective: To describe characteristics of children undergoing SARS-CoV-2 testing during the initial wave of infections in Rhode Island. Methods: This is a descriptive study of 729 children tested for SARS-CoV-2 at four emergency departments April 9 to May 7, 2020 in Rhode Island. Demographic information and symptoms were cataloged for those tested. Results: 81 (11%) children tested positive for SARS-CoV-2. 94% of positive children were symptomatic. 74% of positive cases had constitutional symptoms and 72% had upper respiratory symptoms. While only 34% of those tested were Hispanic, 68% of the SARS-CoV-2- positive cases occurred in Hispanic children. Conclusion: This study details the pediatric population's experience during the first wave of the pandemic in Rhode Island. It could inform testing allocation strategies in healthcare settings. It also highlights vulnerable populations in need of further public health support in our state.
MeSH term(s)	Adolescent ; Asymptomatic Diseases ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19/pathology ; Child ; Child, Preschool ; Emergency Service, Hospital ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Rhode Island/epidemiology ; SARS-CoV-2 ; Young Adult
Language	English
Publishing date	2021-02-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	419430-5
ISSN	2327-2228 ; 0363-7913
ISSN (online)	2327-2228
ISSN	0363-7913
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Excellence in Communication and Emergency Leadership (ExCEL): Pediatric Critical Care Resource Utilization Workshop for Residents.

Wing, Robyn / Tsao, Hoi See / Carillo, Marie / Mercurio, Laura / Beucher, Meghan / Brown, Linda / Kelley, Mariann Nocera

MedEdPORTAL : the journal of teaching and learning resources

2022 Volume 18, Page(s) 11268

Abstract: Introduction: Efficiently locating critical equipment and prompt defibrillator usage are crucial steps when managing a critically ill patient or a code. However, resident experience in this area is limited. This workshop focused on the identification of ...

Abstract	Introduction: Efficiently locating critical equipment and prompt defibrillator usage are crucial steps when managing a critically ill patient or a code. However, resident experience in this area is limited. This workshop focused on the identification of critical care equipment in the pediatric code cart and transport bag along with timely, appropriate, and effective use of the defibrillator when needed. Methods: The workshop utilized a combination of traditional didactics and hands-on skills stations to instruct learners on the location of pediatric critical care equipment and the proper use of a defibrillator. It was designed for residents across all levels of training who care for pediatric patients (including pediatrics, medicine-pediatrics, triple board [pediatrics, psychiatry, and child psychiatry], family medicine, and emergency medicine residents) and can be adapted for different session durations and group sizes. Results: This workshop was conducted at two separate institutions, with a total of 95 resident participant encounters. Participants strongly agreed that the workshop was effective in teaching our learning objectives. Residents reported high levels of confidence in their ability to recognize and identify the location of critical care equipment in the code cart and transport bags and to appropriately use the defibrillator for both defibrillation and synchronized cardioversion. Discussion: This workshop provided residents with instruction and practice in locating and utilizing pediatric critical care equipment. The structure and timetable of this curriculum can be adapted to the needs of individual institutions' programs and different numbers of workshop participants.
MeSH term(s)	Child ; Communication ; Critical Care ; Humans ; Internship and Residency ; Leadership ; Pediatrics
Language	English
Publishing date	2022-08-16
Publishing country	United States
Document type	Journal Article
ISSN	2374-8265
ISSN (online)	2374-8265
DOI	10.15766/mep_2374-8265.11268
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Excellence in Communication and Emergency Leadership (ExCEL)

Robyn Wing / Hoi See Tsao / Marie Carillo / Laura Mercurio / Meghan Beucher / Linda Brown / Mariann Nocera Kelley

MedEdPORTAL, Vol

Pediatric Critical Care Resource Utilization Workshop for Residents

2022 Volume 18

Abstract: Introduction Efficiently locating critical equipment and prompt defibrillator usage are crucial steps when managing a critically ill patient or a code. However, resident experience in this area is limited. This workshop focused on the identification of ... ...

Abstract	Introduction Efficiently locating critical equipment and prompt defibrillator usage are crucial steps when managing a critically ill patient or a code. However, resident experience in this area is limited. This workshop focused on the identification of critical care equipment in the pediatric code cart and transport bag along with timely, appropriate, and effective use of the defibrillator when needed. Methods The workshop utilized a combination of traditional didactics and hands-on skills stations to instruct learners on the location of pediatric critical care equipment and the proper use of a defibrillator. It was designed for residents across all levels of training who care for pediatric patients (including pediatrics, medicine-pediatrics, triple board [pediatrics, psychiatry, and child psychiatry], family medicine, and emergency medicine residents) and can be adapted for different session durations and group sizes. Results This workshop was conducted at two separate institutions, with a total of 95 resident participant encounters. Participants strongly agreed that the workshop was effective in teaching our learning objectives. Residents reported high levels of confidence in their ability to recognize and identify the location of critical care equipment in the code cart and transport bags and to appropriately use the defibrillator for both defibrillation and synchronized cardioversion. Discussion This workshop provided residents with instruction and practice in locating and utilizing pediatric critical care equipment. The structure and timetable of this curriculum can be adapted to the needs of individual institutions’ programs and different numbers of workshop participants.
Keywords	Defibrillator Use ; Code Cart ; Transport Bag ; Critical Care Medicine ; Clinical/Procedural Skills Training ; Pediatric Emergency Medicine ; Medicine (General) ; R5-920 ; Education ; L
Subject code	650
Language	English
Publishing date	2022-08-01T00:00:00Z
Publisher	Association of American Medical Colleges
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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