Pediatric Emergency and Pediatric Critical Care Considerations

  • Mark A. Del Beccaro
  • Howard E. Jeffries
  • George R. Kim
Part of the Health Informatics book series (HI)


Pediatric emergency medicine (PEM) and pediatric critical care (PCC) provide care for all children in all states of distress. The primary distinction between the two is that PEM must be prepared to locate, stabilize, and transfer children in extremis to appropriate care. Therefore, PEM must extend beyond any single or group of institutions and into the regional community. Thus, PEM and PCC have similar and distinct information needs and workflows, many of which are high-risk.


Pediatric Emergency Computerize Physician Order Entry Medication Reconciliation Computerize Provider Order Entry Computerize Physician Order Entry System 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    American Academy of Pediatrics Committee on Pediatric Emergency Medicine, Frush K. Preparation for emergencies in the offices of pediatricians and pediatric primary care providers. Pediatrics. 2007;120(1):200–212.PubMedCrossRefGoogle Scholar
  2. 2.
    Hazinski MF, Markenson D, Neish S, et al. American Heart Association Emergency Cardiovascular Care Committee. Response to cardiac arrest and selected life-threatening medical emergencies: the medical emergency response plan for schools. A statement for healthcare providers, policymakers, school administrators, and community leaders. Pediatrics. 2004;113(1 Pt 1):155–168.PubMedCrossRefGoogle Scholar
  3. 3.
    Haller JA Jr. The evolution and current status of emergency medical services for children. Surg Clin North Am. 2002;82(2):263–271.PubMedCrossRefGoogle Scholar
  4. 4.
    Klein KR, Herzog P, Smolinske S, White SR. Demand for poison control center services “surged” during the 2003 blackout. Clin Toxicol (Phila). 2007;45(3):248–254.Google Scholar
  5. 5.
    Miller SZ, Rincón H, Kuppermann N. Pediatric emergency care applied research network. Revisiting the emergency medicine services for children research agenda: priorities for multicenter research in pediatric emergency care. Acad Emerg Med. 2008;15(4):377–383.PubMedCrossRefGoogle Scholar
  6. 6.
    American Academy of Pediatrics. Neonatal Resuscitation Program. Available at: http://www. Accessed May 23, 2008.
  7. 7.
    American Heart Association. PALS Course Guide. ISBN 0-87493-527-X; 2006.Google Scholar
  8. 8.
    Hunt EA, Walker AR, Shaffner DH, Miller MR, Pronovost PJ. Simulation of in-hospital pediatric medical emergencies and cardiopulmonary arrests: highlighting the importance of the first 5 minutes. Pediatrics. 2008;121(1):e34–43.PubMedCrossRefGoogle Scholar
  9. 9.
    Gausche M, Seidel JS. Out-of-hospital care of pediatric patients. Pediatr Clin North Am. 1999;46(6):1305–1327.PubMedCrossRefGoogle Scholar
  10. 10.
    Deakin CD, Bennetts SH, Petley GW, Clewlow F. What is the optimal paddle force during paediatric external defibrillation? Resuscitation. 2003;59(1):83–88.PubMedCrossRefGoogle Scholar
  11. 11.
    Pons PT. Esophageal obturator airway. Emerg Med Clin North Am. 1988;6(4):693–698.PubMedGoogle Scholar
  12. 12.
    König B, Benger J, Goldsworthy L. Automatic external defibrillation in a 6 year old. Arch Dis Child. 2005;90(3):310–311.PubMedCrossRefGoogle Scholar
  13. 13.
    Martin C, Falcone RA Jr. Pediatric traumatic brain injury: an update of research to understand and improve outcomes. Curr Opin Pediatr. 2008;20(3):294–299.PubMedCrossRefGoogle Scholar
  14. 14.
    Odd DE, Rasmussen F, Gunnell D, Lewis G, Whitelaw A. A cohort study of low Apgar scores and cognitive outcomes. Arch Dis Child Fetal Neonatal Ed. 2008;93(2):F115–120.PubMedCrossRefGoogle Scholar
  15. 15.
    Slater A, Shann F, ANZICS Paediatric Study Group. The suitability of the Pediatric Index of Mortality (PIM), PIM2, the Pediatric Risk of Mortality (PRISM), and PRISM III for monitoring the quality of pediatric intensive care in Australia and New Zealand. Pediatr Crit Care Med. 2004;5(5):447–454.PubMedCrossRefGoogle Scholar
  16. 16.
    Fairbanks RJ, Bisantz AM, Sunm M. Emergency department communication links and patterns. Ann Emerg Med. 2007;50(4):396–406.PubMedCrossRefGoogle Scholar
  17. 17.
    Brown PJ, Borowitz SM, Novicoff W. Information exchange in the NICU: what sources of patient data do physicians prefer to use? Int J Med Inform. 2004;73(4):349–355.PubMedGoogle Scholar
  18. 18.
    Aronsky D, Jones I, Lanaghan K, Slovis CM. Supporting patient care in the emergency department with a computerized whiteboard system. J Am Med Inform Assoc. 2008;15(2):184–194.PubMedCrossRefGoogle Scholar
  19. 19.
    Zebrack M, Kadish H, Nelson D. The pediatric hybrid observation unit: an analysis of 6477 consecutive patient encounters. Pediatrics. 2005;115(5):e535–542.PubMedCrossRefGoogle Scholar
  20. 20.
    Kanter RK. Strategies to improve pediatric disaster surge response: potential mortality reduction and tradeoffs. Crit Care Med. 2007;35(12):2837–2842.PubMedCrossRefGoogle Scholar
  21. 21.
    Porter SC, Manzi SF, Volpe D, Stack AM. Getting the data right: information accuracy in pediatric emergency medicine. Qual Saf Healthcare. 2006;15(4):296–301.CrossRefGoogle Scholar
  22. 22.
    Kaushal R, Bates DW, Landrigan C, et al. Medication errors and adverse drug events in pediatric inpatients. JAMA. 2001;285:2114–2120.PubMedCrossRefGoogle Scholar
  23. 23.
    Koren G, Zohar BZ, Greenwald M. Tenfold errors in administration of drug doses: a neglected latrogenic disease in pediatrics. Pediatrics. 1986;77:848–849.PubMedGoogle Scholar
  24. 24.
    Menke JA, Broner CW, Campbell DY, et al. Computerized clinical documentation system in the pediatric intensive care unit. BMC Med Inform Decision Making. 2001;1:3CrossRefGoogle Scholar
  25. 25.
    Carroll AE, Tarczy-Hornoch P, O'Reilly E, et al. Resident documentation discrepancies in a neonatal intensive care unit. Pediatrics. 2003;111:976–980.PubMedCrossRefGoogle Scholar
  26. 26.
    Miller SZ, Rincón H, Kuppermann N. Pediatric emergency care applied research network. Revisiting the emergency medicine services for children research agenda: priorities for multicenter research in pediatric emergency care. Acad Emerg Med. 2008;15(4):377–383.PubMedCrossRefGoogle Scholar
  27. 27.
    Folli HL, Poole RL, Benitz WE, et al. Medication error prevention by clinical pharmacists in two children's hospitals. Pediatrics. 1987;79:718–722.PubMedGoogle Scholar
  28. 28.
    Leape LL, Brennan TA, Laird N, et al. The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II. N Engl J Med. 1991;324(6):377–384.PubMedGoogle Scholar
  29. 29.
    Kozer E, Scolnik D, Macpherson A, et al. Variables associated with medication errors in pediatric emergency medicine. Pediatrics. 2002;110:737–742.PubMedCrossRefGoogle Scholar
  30. 30.
    Selbst SM, Fein JA, Osterhoudt K, Ho W. Medication errors in a pediatric emergency department. Pediatr Emerg Care. 1999;15(1):1–4.PubMedCrossRefGoogle Scholar
  31. 31.
    Potts AL, Barr FE, Gregory DF, Wright L, Patel NR. Computerized physician order entry and medication errors in a pediatric critical care unit. Pediatrics. 2004;113(1 Pt 1):59–63.PubMedCrossRefGoogle Scholar
  32. 32.
    Woodward GA, King BR, Garrett AL, Baker MD. Prehospital care and transport medicine. In: Fleisher GR, Ludwig S, Henretig FM, Ruddy RM, Silverman BK, eds. Textbook of Pediatric Emergency Medicine. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2006:93–134.Google Scholar
  33. 33.
    Vaidya V, Pon S. Information technology in the PICU. In: Nichols DG et al., eds. Rogers Textbook of Pediatric Intensive Care. London/Philadelphia, PA: Walter Kluwer/Lippincott Williams & Wilkins 2008;124–135.Google Scholar
  34. 34.
    Dinh M, Chu M. Evolution of health information management and information technology in emergency medicine. Emerg Med Australas. 2006;18(3):289–294.PubMedCrossRefGoogle Scholar
  35. 35.
    Feied CF, Smith MS, Handler JA. Keynote address: medical informatics and emergency medicine. Acad Emerg Med. 2004;11(11):1118–1126.PubMedCrossRefGoogle Scholar
  36. 36.
    Shneiderman B. The eyes have it: a task by data type taxonomy for information visualizations. In: Proceedings of the IEEE Symposium on Visual Languages. Washington, DC: IEEE Computer Society Press; 1996:336–343.CrossRefGoogle Scholar
  37. 37.
    Halsted MJ, Perry LA, Perry DJ, Benton C. Development of an interactive model for teaching emergency pediatric radiography: preliminary report. J Am Coll Radiol. 2005;2(8):701–703.PubMedCrossRefGoogle Scholar
  38. 38.
    Shin DI, Huh SJ, Lee TS, Kim I Y. Web-based remote monitoring of infant incubators in the ICU. Int J Med Inform. 2003;71(2–3):151–156.PubMedCrossRefGoogle Scholar
  39. 39.
    Wetzel RC. The virtual pediatric intensive care unit. Practice in the new millennium. Pediatr Clin North Am. 2001;48(3):795–814.PubMedCrossRefGoogle Scholar
  40. 40.
    Bourgeois FT, Olson KL, Brownstein JS, McAdam AJ, Mandl KD. Validation of syndromic surveillance for respiratory infections. Ann Emerg Med. 2006;47(3):265.PubMedCrossRefGoogle Scholar
  41. 41.
    Bradley CA, Rolka H, Walker D, Loonsk J. BioSense: implementation of a national early event detection and situational awareness system. MMWR Morb Mortal Wkly Rep. 2005;54(suppl):11–19.PubMedGoogle Scholar
  42. 42.
    Han YY, Carcillo JA, Venkataraman ST, et al. Unexpected increased mortality after implementation of a commercially sold computerized physician order entry system. Pediatrics. 2005;116(6):1506–1512. (correction published Pediatrics 2006;117:594).PubMedCrossRefGoogle Scholar
  43. 43.
    Del Beccaro MA, Jeffries HE, Eisenberg MA, et al. Computerized provider order entry implementation: no association with increased mortality rates in an intensive care unit. Pediatrics. 2006;118:290–295.PubMedCrossRefGoogle Scholar
  44. 44.
    Kozer E, Seto W, Verjee Z, et al. Prospective observational study on the incidence of medication errors during simulated resuscitation in a paediatric emergency department. BMJ. 2004;329:1321–1326.PubMedCrossRefGoogle Scholar
  45. 45.
    Lehmann CU, Kim GR, Gujral R, Veltri MA, Clark JS, Miller MR. Decreasing errors in pediatric continuous intravenous infusions. Pediatr Crit Care Med. 2006;7(3):225–230.PubMedCrossRefGoogle Scholar
  46. 46.
    Lehmann CU, Conner KG, Cox JM. Preventing provider errors: online total parenteral nutrition calculator. Pediatrics. 2004;113(4):748–753.PubMedCrossRefGoogle Scholar
  47. 47.
    Shoemaker WC, Wo CCJ, Lu K, et al. Outcome prediction by a mathematical model based on hemodynamic monitoring. J Trauma. 2006;60:82–90.PubMedCrossRefGoogle Scholar
  48. 48.
    Resar RK, Rozich JD, Simmonds T, Haraden CR. A trigger tool to identify adverse events in the intensive care unit. Jt Comm J Qual Patient Saf. 2006;32(10):585–590.PubMedGoogle Scholar
  49. 49.
    Sharek PJ, Horbar JD, Mason W, et al. Adverse events in the neonatal intensive care unit: development, testing, and findings of an NICU-focused trigger tool to identify harm in North American NICUs. Pediatrics. 2006;118(4):1332–1340.PubMedCrossRefGoogle Scholar
  50. 50.
    Griffin MP, Lake DE, O'Shea TM, Moorman JR. Heart rate characteristics and clinical signs in neonatal sepsis. Pediatr Res. 2007;61(2):222–227.PubMedCrossRefGoogle Scholar
  51. 51.
    Pronovost P, Berenholtz S, Dorman T, Lipsett PA, Simmonds T, Haraden C. Improving communication in the ICU using daily goals. J Crit Care. 2003;18(2):71–75.PubMedCrossRefGoogle Scholar
  52. 52.
    Arora V, Johnson J. National patient safety goals: a model for building a standardized hand-off protocol. Jt Comm J Qual Patient Saf. 2006;32(11):646–655.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Mark A. Del Beccaro
    • 1
  • Howard E. Jeffries
    • 2
  • George R. Kim
    1. 1.Seattle Children's HospitalSeattle
    2. 2.Continuous Performance ImprovementSeattle Children's HospitalSeattle

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