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
Parents’ Perceptions of Infant Crying: A Possible Path to Preventing Abusive Head Trauma
Wiley M, Schultheis A, Francis B, Tiyyagura G, Leventhal JM, Rutherford H, Mayes LC, Bechtel K. Parents’ Perceptions of Infant Crying: A Possible Path to Preventing Abusive Head Trauma. Academic Pediatrics 2019, 20: 448-454. PMID: 31629119, DOI: 10.1016/j.acap.2019.10.009.Peer-Reviewed Original ResearchOral 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
2017
Nonaccidental Injury in Pediatric Patients: Detection, Evaluation, and Treatment
Tiyyagura G, Beucher M, Bechtel K. Nonaccidental Injury in Pediatric Patients: Detection, Evaluation, and Treatment. Pediatric Emergency Medicine Practice 2017, 14: 1-32. PMID: 28665574.Peer-Reviewed Original ResearchMeSH KeywordsBurnsChildChild AbuseChild, PreschoolContusionsCraniocerebral TraumaDiagnosis, DifferentialEmergency Medical ServicesEvidence-Based MedicineFemaleFractures, BoneGuidelines as TopicHumansInfantIntensive Care Units, PediatricMaleMandatory ReportingPhysical ExaminationPhysician's RolePractice Patterns, Physicians'Retinal HemorrhageUnited StatesWounds and InjuriesPrevention of Pediatric Abusive Head Trauma: Time to Rethink Interventions and Reframe Messages
Leventhal JM, Asnes AG, Bechtel K. Prevention of Pediatric Abusive Head Trauma: Time to Rethink Interventions and Reframe Messages. JAMA Pediatrics 2017, 171: 218-220. PMID: 28135369, DOI: 10.1001/jamapediatrics.2016.4512.Peer-Reviewed Original Research
2016
Development of a Child Abuse Checklist to Evaluate Prehospital Provider Performance
Alphonso A, Auerbach M, Bechtel K, Bilodeau K, Gawel M, Koziel J, Whitfill T, Tiyyagura GK. Development of a Child Abuse Checklist to Evaluate Prehospital Provider Performance. Prehospital Emergency Care 2016, 21: 222-232. PMID: 27700209, DOI: 10.1080/10903127.2016.1229824.Peer-Reviewed Original ResearchConceptsInter-rater reliabilityClinical experiencePrehospital providersLight's kappaEmergency medical services (EMS) providersCronbach's alphaAuthors' clinical experienceOverall Cronbach's alphaOverall inter-rater reliabilityInternal consistencyChild abuseSubstantial inter-rater reliabilityDelphi review processStrong content validityMedical service providersSemi-structured qualitative interviewsFinal checklistSelf-reported confidenceProvider experienceParticipant characteristicsItem completionLevel of trainingDelphi reviewContent validityProvider performanceBarriers and Facilitators to Recognition and Reporting of Child Abuse by Prehospital Providers
Tiyyagura GK, Gawel M, Alphonso A, Koziel J, Bilodeau K, Bechtel K. Barriers and Facilitators to Recognition and Reporting of Child Abuse by Prehospital Providers. Prehospital Emergency Care 2016, 21: 46-53. PMID: 27436455, DOI: 10.1080/10903127.2016.1204038.Peer-Reviewed Original ResearchConceptsPrehospital care providersCare providersChief complaintInfant abusive head traumaReal-time decision supportPresence of caregiversAbusive head traumaPediatric patientsHead traumaPatient's airwayProtective servicesRecognition of signsDecision supportHospital providersPatients' thoughtsPrehospital providersCaregiver reactionsThematic saturationChild protective servicesChild abuseFocused educationKey taskAirwayPatientsScene safety
2015
Barriers and Facilitators to Detecting Child Abuse and Neglect in General Emergency Departments
Tiyyagura G, Gawel M, Koziel JR, Asnes A, Bechtel K. Barriers and Facilitators to Detecting Child Abuse and Neglect in General Emergency Departments. Annals Of Emergency Medicine 2015, 66: 447-454. PMID: 26231409, DOI: 10.1016/j.annemergmed.2015.06.020.Peer-Reviewed Original ResearchConceptsChild abuseRecognizing Victims of Human Trafficking in the Pediatric Emergency Department
Becker HJ, Bechtel K. Recognizing Victims of Human Trafficking in the Pediatric Emergency Department. Pediatric Emergency Care 2015, 31: 144-147. PMID: 25651385, DOI: 10.1097/pec.0000000000000357.Peer-Reviewed Original Research
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
2011
Impact of an Educational Intervention on Caregivers’ Beliefs About Infant Crying and Knowledge of Shaken Baby Syndrome
Bechtel K, Le K, Martin KD, Shah N, Leventhal JM, Colson E. Impact of an Educational Intervention on Caregivers’ Beliefs About Infant Crying and Knowledge of Shaken Baby Syndrome. Academic Pediatrics 2011, 11: 481-486. PMID: 21940233, DOI: 10.1016/j.acap.2011.08.001.Peer-Reviewed Original ResearchConceptsShaken baby syndromeHospital dischargeIntervention groupEducational interventionAnticipatory guidanceUrban primary care centerPediatric residentsInfant cryingNewborn hospital dischargeHistorical control groupPrimary care centersIntervention group caregiversBeliefs/knowledgePostpartum interventionsCare centerAdjusted associationsInfant deathBaby syndromeShaken BabyHospital staffControl groupYoung infantsMore mothersInfantsLogistic regression
2009
Utility of Hepatic Transaminases to Recognize Abuse in Children
Lindberg D, Makoroff K, Harper N, Laskey A, Bechtel K, Deye K, Shapiro R. Utility of Hepatic Transaminases to Recognize Abuse in Children. Pediatrics 2009, 124: 509-516. PMID: 19620197, DOI: 10.1542/peds.2008-2348.Peer-Reviewed Original ResearchMeSH KeywordsAbdominal InjuriesAlanine TransaminaseAspartate AminotransferasesChild AbuseChild, PreschoolEmergency Service, HospitalFemaleHumansInfantInfant, NewbornLiver Function TestsMagnetic Resonance ImagingMaleMass ScreeningPhysical ExaminationPredictive Value of TestsProspective StudiesReference ValuesReferral and ConsultationROC CurveTomography, X-Ray ComputedConceptsIU/LAbdominal injuriesAbdominal bruisingHepatic transaminasesPhysical abuseElevated transaminase levelsClinical examination findingsStandard of careChild abuse teamPopulation of childrenPossible physical abuseSubspecialty evaluationALT levelsTransaminase levelsClinical findingsExamination findingsObservational studyRoutine screeningAbdominal imagingImportant causeInjuryUniversal imagingTransaminaseChild physical abusePatients
2004
Characteristics That Distinguish Accidental From Abusive Injury in Hospitalized Young Children With Head Trauma
Bechtel K, Stoessel K, Leventhal JM, Ogle E, Teague B, Lavietes S, Banyas B, Allen K, Dziura J, Duncan C. Characteristics That Distinguish Accidental From Abusive Injury in Hospitalized Young Children With Head Trauma. Pediatrics 2004, 114: 165-168. PMID: 15231923, DOI: 10.1542/peds.114.1.165.Peer-Reviewed Original ResearchConceptsAbusive head injuryAccidental head injuryAbnormal mental statusMonths of ageUnilateral retinal hemorrhageRetinal hemorrhagesHead injuryProportion of childrenScalp hematomaMental statusHead traumaOutcome measuresSecondary outcome measuresHead injury groupSerial neurologic examinationsMain outcome measuresAbusive head traumaChild abuse specialistInjury groupEye examinationVitreous hemorrhageClinical featuresInitial presentationNeurologic examinationOphthalmoscopic examination
2003
Accidental and abusive head injury in young children
Listman DA, Bechtel K. Accidental and abusive head injury in young children. Current Opinion In Pediatrics 2003, 15: 299-303. PMID: 12806261, DOI: 10.1097/00008480-200306000-00013.Peer-Reviewed Original Research
2002
Abuse or not abuse: That is the question
ISAACMAN D, POIRIER M, BAXTER A, BECHTEL K, PIERCE M. Abuse or not abuse: That is the question. Pediatric Emergency Care 2002, 18: 203-208. PMID: 12066010, DOI: 10.1097/00006565-200206000-00014.Peer-Reviewed Original Research