2024
The Circumstances Surrounding Fatal Pediatric Opioid Poisonings, 2004-2020.
Gaither J, McCollum S, Bechtel K, Leventhal J, Mintz S. The Circumstances Surrounding Fatal Pediatric Opioid Poisonings, 2004-2020. Pediatrics 2024, 154 PMID: 39484873, PMCID: PMC11528886, DOI: 10.1542/peds.2024-067043n.Peer-Reviewed Original ResearchConceptsChild's own homeOpioid poisoningOwn homeHistory of maltreatmentSubstance use/abuseAge groupsDied of homicidePrimary caregiversYears of ageOpioid prescribingChildren 0Opioid fatalitiesHousehold factorsPrescription opioidsSubstance useChild maltreatmentCaregiversDecedentsReporting SystemIllicit fentanylMaltreatmentChildrenFatal opioid poisoningsAgeHome
2023
Spotlighting the imbalance: Gender disparities among speakers and awardees at pediatric emergency medicine conferences
Reichard K, Levine D, Reed J, Barrick‐Groskopf L, Bechtel K, Cooper G, Hall J, White M, Langhan M. Spotlighting the imbalance: Gender disparities among speakers and awardees at pediatric emergency medicine conferences. Academic Emergency Medicine 2023, 30: 1138-1143. PMID: 37550843, DOI: 10.1111/acem.14786.Peer-Reviewed Original Research
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
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
2017
Optimizing recruitment and retention of adolescents in ED research: Findings from concussion biomarker pilot study
Mbachu SN, Pieribone VA, Bechtel KA, McCarthy ML, Melnick ER. Optimizing recruitment and retention of adolescents in ED research: Findings from concussion biomarker pilot study. The American Journal Of Emergency Medicine 2017, 36: 884-887. PMID: 28918968, DOI: 10.1016/j.ajem.2017.09.014.Peer-Reviewed Original ResearchNonaccidental 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 Injuries
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 performanceDrugs, guns and cars: how far we have come to improve safety in the United States; yet we still have far to go
Dodington J, Violano P, Baum CR, Bechtel K. Drugs, guns and cars: how far we have come to improve safety in the United States; yet we still have far to go. Pediatric Research 2016, 81: 227-232. PMID: 27673424, DOI: 10.1038/pr.2016.193.Peer-Reviewed Original ResearchConceptsPoison Prevention Packaging ActMotor vehicle crashesInjury preventionPrevention researchVehicle crashesInjury prevention researchOpioid overdose preventionPublic health approachChild passenger safetySignificant reductionInjury morbidityUnintentional injuriesLeading causeOpiate overdosesFirearm injuriesOverdose preventionInjury dataInjuryHealth approachMajor causeYoung adultsDriver’s license lawChild passenger safety lawsPreventionAdolescentsBarriers 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 safetyIf 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
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 Research
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
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 childrenVenipunctureChildrenUtility 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
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
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 examinationAcute Mental Status Change due to Acute Confusional Migraine
Bechtel K. Acute Mental Status Change due to Acute Confusional Migraine. Pediatric Emergency Care 2004, 20: 238-241. PMID: 15057179, DOI: 10.1097/01.pec.0000121244.99242.67.Peer-Reviewed Original Research