2023
Improving Care After Sexual Assault: A Needs Assessment for a Standardized, Patient-Centered Educational Resource [ID: 1377465]
Lepore C, Bechtel K, Choi J, Gawel M, Griggs S, Pathy S. Improving Care After Sexual Assault: A Needs Assessment for a Standardized, Patient-Centered Educational Resource [ID: 1377465]. Obstetrics And Gynecology 2023, 141: 91s-91s. DOI: 10.1097/01.aog.0000931112.50405.07.Peer-Reviewed Original ResearchDischarge paperworkTertiary care emergency departmentRetrospective chart reviewInstitutional review board approvalLong-term followReview board approvalWorld Health Organization guidelinesMental health resourcesHealth Organization guidelinesOne-thirdElectronic medical record systemCommunity resourcesChart reviewMedical record systemSSA patientsEmergency departmentPatient morbidityAcute traumaPatient educationAmerican CollegeBoard approvalSuch careMedical followHealth resourcesFollow
2021
Improving Patient Experience Scores in a Pediatric Emergency Department
Emerson BL, Setzer E, Bechtel K, Grossman M. Improving Patient Experience Scores in a Pediatric Emergency Department. Pediatric Quality And Safety 2021, 6: e417. PMID: 34235347, PMCID: PMC8225380, DOI: 10.1097/pq9.0000000000000417.Peer-Reviewed Original ResearchPediatric emergency departmentPatient experienceEmergency departmentMultidisciplinary teamRigorous process evaluationExcellent patient-centred careKey driver diagramPE scoresPatient-centered carePatient experience scoresPositive health outcomesSustained improvementQuality improvement methodsHealth outcomesMedical careTeam huddlesDriver diagramExamination roomProcess evaluationCareExperience scoresPatientsScoresCritical populationMonths
2020
The Use of Experts to Evaluate a Child Abuse Guideline in Community Emergency Departments
Shum M, Asnes A, Leventhal JM, Bechtel K, Gaither JR, Tiyyagura G. The Use of Experts to Evaluate a Child Abuse Guideline in Community Emergency Departments. Academic Pediatrics 2020, 21: 521-528. PMID: 33160081, DOI: 10.1016/j.acap.2020.11.001.Peer-Reviewed Original ResearchConceptsGuideline implementationExpert recommendationsIndeterminate casesCommunity emergency departmentsEvaluation of infantsGold standard testPostguideline implementationProvider adherenceCommunity EDRetrospective reviewED providersEmergency departmentCPS reportingClinical decisionTeam consultationInfantsInjurySignificant increaseAdherenceHigh percentageInterventionConsultationProvidersAbuseGuidelinesChild Protection Team Consultation for Injuries Potentially Due to Child Abuse in Community Emergency Departments
Tiyyagura G, Emerson B, Gaither JR, Bechtel K, Leventhal JM, Becker H, Della Guistina K, Balga T, Mackenzie B, Shum M, Shapiro ED, Auerbach M, McVaney C, Morrell P, Asnes AG. Child Protection Team Consultation for Injuries Potentially Due to Child Abuse in Community Emergency Departments. Academic Emergency Medicine 2020, 28: 70-81. PMID: 32931628, DOI: 10.1111/acem.14132.Peer-Reviewed Original ResearchConceptsCommunity emergency departmentsHigh-risk injuriesChild protection teamSkeletal surveyChild protective servicesEmergency departmentClinical pathway implementationHospital child protection teamInitiation of interventionsStudy-Act approachDetection of abuseChild abuse expertsAbusive injuriesPathway implementationProvider trainingEmergency careInjuryTeam consultationInfantsMonthsProtection teamStatistical process control chartsInterventionSuch interventionsConsultation
2019
Patients Presenting After Sexual Assault: Population Characteristics and Rates of Follow up [1D]
Choi J, Bechtel K, Pathy S. Patients Presenting After Sexual Assault: Population Characteristics and Rates of Follow up [1D]. Obstetrics And Gynecology 2019, 133: 42s-41s. DOI: 10.1097/01.aog.0000558959.60784.2f.Peer-Reviewed Original ResearchOutpatient clinicInclusion criteriaYale New Haven Health SystemRetrospective medical record reviewMedical record reviewICD-10 codesUrban hospital settingWomen's outpatient clinicMental health consequencesPatients 13Patient ageDecrease morbidityRecord reviewAcute careEmergency departmentPatient populationPrimary careHospital settingPatientsDischarge protocolHealth consequencesHealth systemCareOverall rateOne-thirdOral injuries in children less than 24 months of age in a pediatric emergency department
Woolf SM, Leventhal JM, Gaither JR, Hardikar P, Langhan ML, Bechtel K, Auerbach MA, Tiyyagura G. Oral injuries in children less than 24 months of age in a pediatric emergency department. Child Abuse & Neglect 2019, 89: 70-77. PMID: 30639971, DOI: 10.1016/j.chiabu.2019.01.006.Peer-Reviewed Original ResearchConceptsPediatric emergency departmentOral injuriesChief complaintEmergency departmentAbuse evaluationsTertiary care pediatric emergency departmentMedical chief complaintsMonths old presentingPediatric emergency medicine physiciansProspective observational studyComplete oral examinationEmergency medicine physiciansMonths of ageYoung childrenOld presentingPatient demographicsInjury detailsChildren 12Children 0Observational studyOral examinationMedicine physiciansNon-mobile childrenInjuryPatientsCharacteristics That Distinguish Abusive From Nonabusive Causes of Sudden Unexpected Infant Deaths
Bechtel K, Derbyshire M, Gaither JR, Leventhal JM. Characteristics That Distinguish Abusive From Nonabusive Causes of Sudden Unexpected Infant Deaths. Pediatric Emergency Care 2019, 37: e780-e783. PMID: 30829845, DOI: 10.1097/pec.0000000000001787.Peer-Reviewed Original ResearchConceptsSudden unexpected infant deathUnexpected infant deathChild protective services involvementTime of deathSentinel injuryManner of deathSpontaneous circulationInfant deathEmergency medical services transportEmergency department settingMaternal substance useCase-control designService involvementMedical examiner recordsClinical outcomesEmergency departmentDepartment settingCardiopulmonary resuscitationFatal child abuseServices transportSubstance useDeathFurther studiesSignificant differencesInfants
2018
Feasibility of providing child restraint devices after a motor vehicle crash in a pediatric emergency department
Violano P, Aysseh N, Lucas M, Gawel M, Morrell P, Norway C, Alfano A, Bechtel K. Feasibility of providing child restraint devices after a motor vehicle crash in a pediatric emergency department. Traffic Injury Prevention 2018, 19: 844-848. PMID: 30657709, DOI: 10.1080/15389588.2018.1496243.Peer-Reviewed Original ResearchConceptsPediatric emergency departmentMotor vehicle crashesChild restraint devicesEmergency departmentLevel 1 trauma centerRestraint devicesVehicle crashesBrief educational interventionTrauma centerChildhood morbidityMedical costsPED providersED personnelEducational interventionAppropriate ageUse statusAppropriate useChildrenPatientsSafety of childrenCaregiversCrash mechanismsGuidelinesEDDepartmentPediatric Bilateral Facial Paralysis: An Unusual Presentation of Lyme Disease
Wong K, Sequeira S, Bechtel K. Pediatric Bilateral Facial Paralysis: An Unusual Presentation of Lyme Disease. Pediatric Emergency Care 2018, Publish Ahead of Print: 1. PMID: 30365410, DOI: 10.1097/pec.0000000000001648.Peer-Reviewed Original ResearchConceptsBilateral facial nerve paralysisFacial nerve paralysisLyme diseaseUnusual presentationHuman immunodeficiency virus (HIV) infectionCommon infectious etiologiesBrain stem encephalitisComplaints of headacheGuillain-Barre syndromeImmunodeficiency virus infectionHistory of rashSerious systemic conditionsErythema chronicum migransRecent tick exposureLyme disease endemic areaDisease-endemic areasInfectious etiologyNerve paralysisPediatric populationEmergency departmentCase reportDiagnostic challengeRare conditionSystemic conditionsDifferential diagnosis
2016
If You Twinkle When You Tinkle, Stones Are Found on Ultrasound
Riera A, Bokhari SA, Bechtel K. If You Twinkle When You Tinkle, Stones Are Found on Ultrasound. Pediatric Emergency Care 2016, 32: 246-249. PMID: 26359827, DOI: 10.1097/pec.0000000000000542.Peer-Reviewed Original Research
2014
Postpartum Depression Screening in the Pediatric Emergency Department
Emerson BL, Bradley ER, Riera A, Mayes L, Bechtel K. Postpartum Depression Screening in the Pediatric Emergency Department. Pediatric Emergency Care 2014, 30: 788-792. PMID: 25343740, DOI: 10.1097/pec.0000000000000260.Peer-Reviewed Original ResearchConceptsEdinburgh Postpartum Depression ScalePediatric emergency departmentPostpartum depressionMental health resourcesYoung infantsPED visitsEmergency departmentRisk mothersTertiary care pediatric emergency departmentTertiary care children's hospitalPrevalence of PPDHealth resourcesBaseline demographic characteristicsInitial ED presentationAdditional mental health needsConvenience samplePostpartum depression screeningPostpartum Depression ScaleNegative predictive valueMental health needsFirst-time mothersSocial work consultationED presentationsChildren's HospitalDepression screening
2013
Management Of Headache In The Pediatric Emergency Department.
Alfonzo MJ, Bechtel K, Babineau S. Management Of Headache In The Pediatric Emergency Department. Pediatric Emergency Medicine Practice 2013, 10: 1-25. PMID: 26505695.Peer-Reviewed Original ResearchPediatric emergency departmentEmergency departmentLife-threatening conditionSpectrum of pathologyManagement of headacheBroad differentialPediatric populationComplex patientsEmergency cliniciansCommon complaintAppropriate treatmentSecondary headachesCurrent evidenceEmergency careHeadacheHealthcare providersSchool absencePatientsHealthcare ResearchOne-thirdBest current practicePoor academic achievementChildrenLives of childrenCurrent practice
2012
Sudden Unexpected Infant Death
Bechtel K. Sudden Unexpected Infant Death. Pediatric Emergency Care 2012, 28: 1085-1089. PMID: 23034500, DOI: 10.1097/pec.0b013e31826d1e9a.Peer-Reviewed Original ResearchConceptsSudden unexpected infant deathSudden infant death syndromeInfant death syndromeUnexpected infant deathEmergency departmentInfant deathDeath syndromeInterviews of caregiversChild death review teamsLocal medical examinersObvious causeED practitionersFatal child abuseED guidelinesCompassionate mannerMedical examinersDeathSyndromeReview teamCauseChild abuseInfants
2009
Relationship of Serum S100B Levels and Intracranial Injury in Children With Closed Head Trauma
Bechtel K, Frasure S, Marshall C, Dziura J, Simpson C. Relationship of Serum S100B Levels and Intracranial Injury in Children With Closed Head Trauma. Pediatrics 2009, 124: e697-e704. PMID: 19786430, DOI: 10.1542/peds.2008-1493.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAge FactorsBiomarkersBrain InjuriesCase-Control StudiesChildChild, PreschoolEmergency Service, HospitalFemaleFollow-Up StudiesFractures, BoneGlasgow Coma ScaleHead Injuries, ClosedHumansInjury Severity ScoreMaleMultiple TraumaNerve Growth FactorsPredictive Value of TestsProbabilityRetrospective StudiesRisk AssessmentS100 Calcium Binding Protein beta SubunitS100 ProteinsSex FactorsSurvival AnalysisTomography, X-Ray ComputedConceptsLong bone fracturesTime of venipunctureSerum S100B measurementClosed head traumaIntracranial injurySerum S100B levelsS100B levelsS100B measurementHead traumaUrban pediatric emergency departmentMean S100B levelsLevels of S100BPediatric emergency departmentYears of ageReferral hospitalSerum levelsEmergency departmentCranial CTSkeletal injuriesAnalysis of covarianceBone fracturesInjuryNonwhite childrenVenipunctureChildren
2008
Impact of Sexual Assault Nurse Examiners on the Evaluation of Sexual Assault in a Pediatric Emergency Department
Bechtel K, Ryan E, Gallagher D. Impact of Sexual Assault Nurse Examiners on the Evaluation of Sexual Assault in a Pediatric Emergency Department. Pediatric Emergency Care 2008, 24: 442-447. PMID: 18580706, DOI: 10.1097/pec.0b013e31817de11d.Peer-Reviewed Original ResearchConceptsPediatric emergency departmentMedical recordsMore patientsEmergency departmentGU examinationEligible patientsHepatitis BSexual assault nurse examinersSTI testingGU injuriesC. trachomatisAdolescent sexual assault victimsMedical careN. gonorrhoeaeUrban pediatric emergency departmentSignificant differencesPrescription of prophylaxisProvision of prophylaxisFisher's exact testMedical record documentationPregnancy prophylaxisNurse examinersHIV prophylaxisPatient groupNursing shifts
2006
Inflicted Traumatic Brain Injury: Making the Diagnosis in the Emergency Department
Bechtel K, Berger R. Inflicted Traumatic Brain Injury: Making the Diagnosis in the Emergency Department. Clinical Pediatric Emergency Medicine 2006, 7: 138-142. DOI: 10.1016/j.cpem.2006.05.002.ChaptersTraumatic brain injuryBrain injuryEmergency departmentMinority of patientsSevere brain injuryRetinal hemorrhagesClinical findingsOminous symptomRib fracturesSubdural hemorrhageCommon causeMild formInjuryITBISerious injuriesHemorrhageYoung childrenSymptomsChildrenWide spectrumDepartmentVomitingMorbidityPatientsIrritability