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.
