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  1. Article ; Online: Peering Through the Telescope: Bringing POCUS for Intussusception into Focus.

    Stem, Christopher T / Marin, Jennifer R

    Annals of emergency medicine

    2021  Volume 78, Issue 5, Page(s) 616–618

    MeSH term(s) Humans ; Intussusception/diagnostic imaging ; Intussusception/surgery ; Point-of-Care Systems ; Ultrasonography
    Language English
    Publishing date 2021-08-11
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 603080-4
    ISSN 1097-6760 ; 0196-0644
    ISSN (online) 1097-6760
    ISSN 0196-0644
    DOI 10.1016/j.annemergmed.2021.06.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1344: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Sticking It Straight: Pediatric Procedure Curriculum Initiative.

    Price, Amanda / Greene, H Michelle / Stem, Christopher T / Titus, M Olivia

    Pediatric emergency care

    2021  Volume 38, Issue 2, Page(s) 79–82

    Abstract: Objectives: Literature demonstrates that pediatric residents are not graduating with procedural confidence and competency. This was confirmed with our own institution's Accreditation Council for Graduate Medical Education and internal surveys. Our ... ...

    Abstract Objectives: Literature demonstrates that pediatric residents are not graduating with procedural confidence and competency. This was confirmed with our own institution's Accreditation Council for Graduate Medical Education and internal surveys. Our primary objective was to improve procedural confidence among pediatric residents with the introduction of a mandatory longitudinal pediatric procedural curriculum, including simulation in combination with online modules.
    Methods: We performed a quality improvement intervention to increase resident comfort level performing Accreditation Council for Graduate Medical Education-required procedures. This study involved pediatric residents, postgraduation year (PGY) 1-3, at an academic, tertiary care hospital. Between April 2015 and June 2017, the combination of online self-directed learning modules and hands-on simulation curriculum was implemented for pediatric residents. Surveys were administered at 1-year intervals to assess self-reported comfort level on 12 procedures using a Likert scale (1 for "strongly disagree" to 5 for "strongly agree, maximum score of 60 for all procedures).
    Results: Forty (63%) of 63 participant presurveys and 45 (71%) of 63 postsurveys were available for analysis. The mean comfort level for all procedures demonstrated a statistically significant increase from 32.4 to 37.1, or 12.7% (P = 0.005). By PGY level, the score increased from 24.4 to 30.9 (21%) for PGY1, 34.4 to 37.5 (8.3%) for PGY2, and 38.6 to 42.8 (9.8%) for PGY3 (P < 0.005). Overall, pediatric residents rated the simulation experience very favorably.
    Conclusions: A mandatory longitudinal procedure curriculum improved procedural comfort level among pediatric residents. Iterative curriculum designs found the most productive combination to be deliberate practice within mastery learning simulation sessions with required precourse online modules.
    MeSH term(s) Accreditation ; Child ; Clinical Competence ; Curriculum ; Education, Medical, Graduate ; Humans ; Internship and Residency
    Language English
    Publishing date 2021-01-02
    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.0000000000002324
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2083: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  3. Article ; Online: Effect of ketamine on transcranial Doppler Gosling pulsatility index in children undergoing procedural sedation: A pilot study.

    Stem, Christopher T / Ramgopal, Sriram / Hickey, Robert W / Manole, Mioara D / Balzer, Jeffrey R

    Journal of the American College of Emergency Physicians open

    2022  Volume 3, Issue 4, Page(s) e12760

    Abstract: Objectives: There has been controversy over whether ketamine affects intracranial pressure (ICP) in children. Transcranial Doppler ultrasound (TCD) is a validated technique used to assess ICP changes noninvasively. Gosling pulsatility index (PI) ... ...

    Abstract Objectives: There has been controversy over whether ketamine affects intracranial pressure (ICP) in children. Transcranial Doppler ultrasound (TCD) is a validated technique used to assess ICP changes noninvasively. Gosling pulsatility index (PI) directly correlates with ICP changes. The objective of this study was to quantify PI changes as a surrogate marker for ICP changes in previously healthy children receiving intravenous ketamine for procedural sedation.
    Methods: We performed a prospective, observational study of patients 5-18 years old who underwent sedation with intravenous ketamine as monotherapy. ICP changes were assessed by surrogate PI at baseline, immediately after ketamine administration, and every 5 minutes until completion of the procedure. The primary outcome measure was PI change after ketamine administration compared to baseline (denoted ΔPI).
    Results: We enrolled 15 participants. Mean age was 9.9 ± 3.4 years. Most participants underwent sedation for fracture reduction (87%). Mean initial ketamine dose was 1.4 ± 0.3 mg/kg. PI decreased at all time points after ketamine administration. Mean ΔPI at sedation onset was -0.23 (95% confidence interval [CI] = -0.30 to -0.15), at 5 minutes was -0.23 (95% CI = -0.28 to -0.18), at 10 minutes was -0.14 (95% CI = -0.21 to -0.08), at 15 minutes was -0.18 (95% CI = -0.25 to -0.12), and at 20 minutes was -0.19 (95% CI = -0.26 to -0.12). Using a clinically relevant threshold of ΔPI set at +1 (+8 cm H
    Conclusions: Ketamine did not significantly increase PI, which was used as a surrogate marker for ICP in this sample of previously healthy children. This pilot study demonstrates a model for evaluating ICP changes noninvasively in the emergency department.
    Language English
    Publishing date 2022-07-18
    Publishing country United States
    Document type Journal Article
    ISSN 2688-1152
    ISSN (online) 2688-1152
    DOI 10.1002/emp2.12760
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Point-of-Care Ultrasound for the Evaluation of Neck Masses in the Pediatric Emergency Department: A Case Series.

    Stem, Christopher T / Marin, Jennifer R / Perera, Ag Nuwan D / Azhdam, Devora B

    Pediatric emergency care

    2021  Volume 38, Issue 2, Page(s) e1019–e1021

    Abstract: Abstract: Point-of-care ultrasound can be an effective tool for pediatric emergency medicine providers in the evaluation of soft tissue lesions. We present a series of 4 pediatric patients with neck lesions in whom point-of-care ultrasound identified ... ...

    Abstract Abstract: Point-of-care ultrasound can be an effective tool for pediatric emergency medicine providers in the evaluation of soft tissue lesions. We present a series of 4 pediatric patients with neck lesions in whom point-of-care ultrasound identified the type of lesion, guided decision-making on the need for computed tomography imaging, and led to definitive management.
    MeSH term(s) Child ; Emergency Service, Hospital ; Humans ; Neck/diagnostic imaging ; Point-of-Care Systems ; Point-of-Care Testing ; Ultrasonography
    Language English
    Publishing date 2021-06-17
    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.0000000000002463
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2083: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

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