Halden F. Scott
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View article: We Have New Sepsis Criteria for Children…Now What?
We Have New Sepsis Criteria for Children…Now What? Open
View article: Diagnostic Stewardship of Blood Cultures in the Pediatric ICU Using Machine Learning
Diagnostic Stewardship of Blood Cultures in the Pediatric ICU Using Machine Learning Open
OBJECTIVE The medical community recently experienced a severe shortage of blood culture media bottles. Rates of blood stream infection (BSI) among critically ill children are low. We sought to design a machine learning (ML) model able to i…
View article: Urine Complement Factor Ba Identifies Persistent Acute Kidney Injury and Organ Failures in Critically Ill Adults
Urine Complement Factor Ba Identifies Persistent Acute Kidney Injury and Organ Failures in Critically Ill Adults Open
Urine Ba is increased in patients with severe AKI and discriminates between patients who have AKI recovery and patients who develop persistent AKI. A doubling of urine Ba was associated with a 6.6-fold increased odds of persistent AKI. Fut…
View article: Digital solutions in paediatric sepsis: current state, challenges, and opportunities to improve care around the world
Digital solutions in paediatric sepsis: current state, challenges, and opportunities to improve care around the world Open
View article: Delays to Antibiotics in the Emergency Department and Risk of Mortality in Children With Sepsis
Delays to Antibiotics in the Emergency Department and Risk of Mortality in Children With Sepsis Open
Importance Pediatric consensus guidelines recommend antibiotic administration within 1 hour for septic shock and within 3 hours for sepsis without shock. Limited studies exist identifying a specific time past which delays in antibiotic adm…
View article: International Consensus Criteria for Pediatric Sepsis and Septic Shock
International Consensus Criteria for Pediatric Sepsis and Septic Shock Open
Importance Sepsis is a leading cause of death among children worldwide. Current pediatric-specific criteria for sepsis were published in 2005 based on expert opinion. In 2016, the Third International Consensus Definitions for Sepsis and Se…
View article: Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock
Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock Open
Importance The Society of Critical Care Medicine Pediatric Sepsis Definition Task Force sought to develop and validate new clinical criteria for pediatric sepsis and septic shock using measures of organ dysfunction through a data-driven ap…
View article: Impact of Time-to-Antibiotic Delivery in Pediatric Patients With Cancer Presenting With Febrile Neutropenia
Impact of Time-to-Antibiotic Delivery in Pediatric Patients With Cancer Presenting With Febrile Neutropenia Open
PURPOSE Febrile neutropenia (FN) in pediatric patients with cancer can cause severe infections, and prompt antibiotics are warranted. Extrapolated from other populations, a time-to-antibiotic (TTA) metric of <60 minutes after medical cente…
View article: Pediatric Sepsis in General Emergency Departments: Association Between Pediatric Sepsis Case Volume, Care Quality, and Outcome
Pediatric Sepsis in General Emergency Departments: Association Between Pediatric Sepsis Case Volume, Care Quality, and Outcome Open
View article: Developing a “Sepsis Never Event” Measure for Our Hospital-wide Improvement Initiative
Developing a “Sepsis Never Event” Measure for Our Hospital-wide Improvement Initiative Open
Background: Historical measure definitions for our sepsis initiative captured intent-to-treat without connection to final diagnosis or patient outcomes. Objectives: To develop a novel sepsis outcome measure capturing confirmed sepsis-relat…
View article: Serum lactate is associated with increased illness severity in immunocompromised pediatric hematology oncology patients presenting to the emergency department with fever
Serum lactate is associated with increased illness severity in immunocompromised pediatric hematology oncology patients presenting to the emergency department with fever Open
Introduction Determining which febrile pediatric hematology/oncology (PHO) patients will decompensate from severe infection is a significant challenge. Serum lactate is a well-established marker of illness severity in general adult and ped…
View article: “These Are Our Kids”: Qualitative Interviews With Clinical Leaders in General Emergency Departments on Motivations, Processes, and Guidelines in Pediatric Sepsis Care
“These Are Our Kids”: Qualitative Interviews With Clinical Leaders in General Emergency Departments on Motivations, Processes, and Guidelines in Pediatric Sepsis Care Open
View article: Machine Learning Approach to Predicting Absence of Serious Bacterial Infection at PICU Admission
Machine Learning Approach to Predicting Absence of Serious Bacterial Infection at PICU Admission Open
BACKGROUND AND OBJECTIVES Serious bacterial infection (SBI) is common in the PICU. Antibiotics can mitigate associated morbidity and mortality but have associated adverse effects. Our objective is to develop machine learning models able to…
View article: Validation of the Pediatric Sequential Organ Failure Assessment Score and Evaluation of Third International Consensus Definitions for Sepsis and Septic Shock Definitions in the Pediatric Emergency Department
Validation of the Pediatric Sequential Organ Failure Assessment Score and Evaluation of Third International Consensus Definitions for Sepsis and Septic Shock Definitions in the Pediatric Emergency Department Open
In a large, multicenter study of pediatric ED visits, a pSOFA score of 2 or more was uncommon and associated with increased hospital mortality yet had poor sensitivity as a screening tool for hospital mortality. Conversely, children with a…
View article: Criteria for Pediatric Sepsis-A Systematic Review and Meta-Analysis by the Pediatric Sepsis Definition Taskforce
Criteria for Pediatric Sepsis-A Systematic Review and Meta-Analysis by the Pediatric Sepsis Definition Taskforce Open
OBJECTIVE To determine the associations of demographic, clinical, laboratory, organ dysfunction, and illness severity variable values with: 1) sepsis, severe sepsis, or septic shock in children with infection and 2) multiple organ dysfunct…
View article: Pediatric Sepsis in Community Emergency Care Settings: Guideline Concordance and Outcomes.
Pediatric Sepsis in Community Emergency Care Settings: Guideline Concordance and Outcomes. Open
Emergency care for pediatric sepsis in the community settings studied was concordant with guidelines in only 24% of the cases. Future study is needed to evaluate additional drivers of outcomes and ways to improve sepsis care in community e…
View article: Reducing Time from Antibiotic Order to Administration in Hospitalized Children with Suspected Sepsis
Reducing Time from Antibiotic Order to Administration in Hospitalized Children with Suspected Sepsis Open
The Children’s Hospital Association’s Improving Pediatric Sepsis Outcomes (IPSO) collaborative is a multi-center quality improvement (QI) learning collaborative of 61 U.S. children’s hospitals that seeks to improve sepsis outcomes through …
View article: Confidence-weighted Testing as an Impactful Education Intervention within a Pediatric Sepsis Quality Improvement Initiative
Confidence-weighted Testing as an Impactful Education Intervention within a Pediatric Sepsis Quality Improvement Initiative Open
Introduction: Confidence-weighted testing assesses learners’ beliefs about their knowledge and skills. As part of a hospital-wide quality improvement initiative to enhance care for pediatric patients with suspected sepsis, we developed a n…
View article: Automated emergency department sepsis screening appears superior to manual screening
Automated emergency department sepsis screening appears superior to manual screening Open
View article: Metric Development for the Multicenter Improving Pediatric Sepsis Outcomes (IPSO) Collaborative
Metric Development for the Multicenter Improving Pediatric Sepsis Outcomes (IPSO) Collaborative Open
BACKGROUND: A 56 US hospital collaborative, Improving Pediatric Sepsis Outcomes, has developed variables, metrics and a data analysis plan to track quality improvement (QI)–based patient outcomes over time. Improving Pediatric Sepsis Outco…
View article: Development of a Quality Improvement Learning Collaborative to Improve Pediatric Sepsis Outcomes
Development of a Quality Improvement Learning Collaborative to Improve Pediatric Sepsis Outcomes Open
Pediatric sepsis is a major public health problem. Published treatment guidelines and several initiatives have increased adherence with guideline recommendations and have improved patient outcomes, but the gains are modest, and persistent …
View article: Development and Validation of a Model to Predict Pediatric Septic Shock Using Data Known 2 Hours After Hospital Arrival
Development and Validation of a Model to Predict Pediatric Septic Shock Using Data Known 2 Hours After Hospital Arrival Open
Objectives: To use electronic health record data from the first 2 hours of care to derive and validate a model to predict hypotensive septic shock in children with infection. Design: Derivation-validation study using an existing registry. …
View article: The Need for Risk Stratification Tools in the Pediatric Emergency Department
The Need for Risk Stratification Tools in the Pediatric Emergency Department Open
* Abbreviations: ED — : emergency department LqSOFA — : Liverpool quick Sequential Organ Failure Assessment In this issue of Pediatrics, Romaine et al1 describe the derivation and validation of a novel risk stratification score, the Liverp…
View article: Evaluating Pediatric Sepsis Definitions Designed for Electronic Health Record Extraction and Multicenter Quality Improvement*
Evaluating Pediatric Sepsis Definitions Designed for Electronic Health Record Extraction and Multicenter Quality Improvement* Open
Objectives: To describe the Children’s Hospital Association’s Improving Pediatric Sepsis Outcomes sepsis definitions and the identified patients; evaluate the definition using a published framework for evaluating sepsis definitions. Design…
View article: The Legacy of Pediatric Sepsis State Legislation
The Legacy of Pediatric Sepsis State Legislation Open
In 2013, New York state passed "Rory's Regulations," mandating that every hospital have sepsis protocols and report metrics to the state.1 Several states followed with similar laws including Illinois, Ohio, and Wisconsin.2 Do these regulat…
View article: Disseminated Intravascular Coagulation Is an Independent Predictor of Adverse Outcomes in Children in the Emergency Department with Suspected Sepsis
Disseminated Intravascular Coagulation Is an Independent Predictor of Adverse Outcomes in Children in the Emergency Department with Suspected Sepsis Open
View article: Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children
Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children Open
View article: Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children
Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children Open
Objectives: To develop evidence-based recommendations for clinicians caring for children (including infants, school-aged children, and adolescents) with septic shock and other sepsis-associated organ dysfunction. Design: A panel of 49 inte…
View article: Executive summary: surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children
Executive summary: surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children Open
View article: Executive Summary: Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children
Executive Summary: Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children Open
In 2001, the Surviving Sepsis Campaign (SSC) began to develop evidence-based guidelines and recommendations for the resuscitation and management of patients with sepsis. With the 2016 edition, the Society of Critical Care Medicine and Euro…