Ongoing Research

The PECARN network conducts meaningful and rigorous multi-institutional research into the prevention and management of acute illnesses and injuries in children and youth across the continuum of emergency medicine health care.

The list above is an overview of current and on going research projects. Click on a research area to review its summary.

PECARN Core Data Project

• This project is a cross-sectional study of all pediatric ED visits within the network, which has collected baseline epidemiological and demographic electronic data from each site since 2002 to the present.
• A linked chart review in 2002, focused on children with long bone fractures and asthma, was also performed.
• Participating hospitals include academic, community, general, and free-standing children's hospitals with urban and suburban patients and an annual network census >800,000 visits.
• Variables provided by the database include patient demographics, payor type, ICD-9 discharge diagnosis, procedure codes, e-codes, mode of arrival, and length of ED stay.
• Provides rich epidemiologic data for investigators for hypothesis generation or grant submission
• Provided data for published manuscripts on the epidemiology of pediatric ED visits, practice pattern variation in the care of pediatric ED patients and the availability and validity of data from administrative databases. 
• Used to develop a clinically sensible method for classifying pediatric illnesses in the emergency department.
• Used to develop a severity classification system for pediatric emergency medicine based on ICD-9 codes

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Randomized Trial of Oral Dexamethasone in Acute Bronchiolitis

• Compares 1 mg/kg of oral dexamethasone to placebo in infants with moderate to severe bronchiolitis.
• Primary outcome is hospital admission after 4 hours of observation.
• Enrollment at 18 centers; 3 year study; 600 pts.
• Sufficient power to definitively answer the question of the treatment's effectiveness in a common childhood illness that currently lacks evidence-based treatment.
• Supported by HRSA/MCHB/EMSC and research programs R40 MCO4298
• The main manuscript has been published.

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Childhood Head Trauma: A Neuroimaging Decision Rule

• Prospective study of children with minor-to-moderate blunt head trauma with a goal of identifying high-risk and low-risk indicators of traumatic brain injury (TBI).

• The goal is to derive the evidence on which to base appropriate use of head computerized tomography (CT) in children with acute head injury, which will hopefully reduce the number of unnecessary CT scans for children at very low risk for TBI. This will minimize the exposure of these children to the significant drawbacks related to CT (ionizing radiation, transport of children away from the direct observation of the emergency department, pharmacological sedation, and additional health care costs).

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Predicting Cervical Spine Injury in Children: A Multi-Center Case-Control Analysis

• This study identified a set of variables that separate injured children with negligible risk of CSI from those at non-negligible risk for CSI.
• Project goals are to describe CSI and to identify factors associated with increased risk for CSI among a diverse pediatric population who experience blunt trauma injury.
• Funded by HRSA/MCHB/EMSC grant 1H34MC04372-01-00
• Main manuscript is in development.

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Creating a Diagnosis Grouping System for Child Emergency Department Visits

• This project created a Diagnosis Grouping System based upon ICD-9 codes that describes diagnoses given to children during ED visits in a clinically sensible manner.
• This study also created a general severity of illness classification system for child ED diagnoses
• Both systems have been applied to external national data sets.
• The ICD-9 grouping system is available in the "Tools" section of this website.
• Supported by HRSA/MCHB/EMSC grant 1H34MCO2547

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Referral Patterns and Resource Utilization for Patients Presenting a Psychiatric/ Mental Health Problem

• This was a retrospective review of 120 patients at five hospitals, whose aims were to examine:
• the modes by which children with acute psychiatric emergencies are referred to the ED
• the resources used to care for them and
• the training of the providers who manage these children in the ED.
• Funded by core PECARN network funding (HRSA/MCHB/EMSC)
• Manuscript has been published.

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Pediatric Off-Patent Drug Study-Lorazepam for Status Epilepticus

• This study was funded by NIH under the Best Pharmaceuticals for Children Act.
• Currently, Lorazepam is widely used for the treatment of pediatric status epilepticus (SE). However it is not labeled by the FDA for this use.
• This project will study the pharmacokinetics, safety and efficacy of Lorazepam for the treatment of pediatric SE.
• This project is a 2-part study with study one including a pharmacokinetic analysis of lorazepam to determine optimal dosing and study two a randomized controlled trial that will determine the safety and efficacy of Lorazepam for the treatment of SE.
• The project began in October 2004 and is projected to take about 5 years.
• Funded by NIH HHSN27520040433393C/ABD N01-HD-4-3393

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Ensuring Safety in Pediatric Emergency Medicine

• This multi-phased approach to improving safety began with a study of current safety reporting in network emergency departments.
• Best practices will be identified and used to reduce medical errors throughout the network
• Funded by core PECARN network funding (HRSA/MCHB/EMSC)

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