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.
