2023
The Use of Medical Chaperones During Physical Examinations
Wilson M, Patel S, Langhan M. The Use of Medical Chaperones During Physical Examinations. Pediatric Emergency Care 2023, 40: e46-e51. PMID: 38032984, DOI: 10.1097/pec.0000000000003087.Peer-Reviewed Original ResearchPhysical examinationFemale patientsProvider sexMedical chaperonesPediatric physical examinationCross-sectional studySignificant differencesHealth care practitionersUse of chaperonesChild's physical examinationMale patientsEmergency departmentAmbulatory clinicsInpatient unitPatientsCare practitionersMedical examinationClinical settingMale providersPreferences of parentsPerceptions of adolescentsBody partsExaminationSexAdolescents
2021
Improving Capnography Use for Critically Ill Emergency Patients: An Implementation Study
Shah R, Streat DA, Auerbach M, Shabanova V, Langhan ML. Improving Capnography Use for Critically Ill Emergency Patients: An Implementation Study. Journal Of Patient Safety 2021, 18: e26-e32. PMID: 32175968, PMCID: PMC8719501, DOI: 10.1097/pts.0000000000000683.Peer-Reviewed Original ResearchA Community Emergency Department Rotation for Pediatric Emergency Medicine Fellows
Langhan ML, Woolf S, Tiyyagura G. A Community Emergency Department Rotation for Pediatric Emergency Medicine Fellows. Pediatric Emergency Care 2021, 37: e1521-e1523. PMID: 32941360, DOI: 10.1097/pec.0000000000002103.Peer-Reviewed Original ResearchConceptsCommunity emergency departmentsEmergency departmentPEM fellowsPediatric emergency medicine specialistsAcademic children's hospitalChildren's emergency departmentEmergency medicine specialistsLower patient acuityPediatric emergency medicineChildren's HospitalMajority of participantsMonth-long rotationPEM fellowship programsEmergency carePatient acuityEmergency department rotationMedicine specialistsWeb-based surveyMajority of trainingEmergency medicineCare environmentHospital leadershipHospitalNeeds assessmentFellowship programsExploring the Effect of Mindfulness on Burnout in a Pediatric Emergency Department
Wong KU, Palladino L, Langhan ML. Exploring the Effect of Mindfulness on Burnout in a Pediatric Emergency Department. Workplace Health & Safety 2021, 69: 467-473. PMID: 33845687, DOI: 10.1177/21650799211004423.Peer-Reviewed Original ResearchConceptsMaslach Burnout InventoryMindfulness activitiesBurnout levelsPediatric emergency departmentEffect of mindfulnessMindfulness-based activitiesEmergency departmentHigher burnout levelsCONCLUSION/APPLICATIONEmotional exhaustionPostintervention surveysPersonal accomplishmentPED providersBurnout InventoryBurnoutMindfulnessEmergency department staffHealth care providersMental healthShift interventionsMajority of staffEligible staffNurse practitionersCare providersClinical acumenAn evidence-based approach to nontraumatic ocular complaints in children.
Iqbal A, Langhan ML, Rotruck J, Soma G. An evidence-based approach to nontraumatic ocular complaints in children. Pediatric Emergency Medicine Practice 2021, 18: 1-28. PMID: 33476507.Peer-Reviewed Original Research
2020
Seizures in neonates: diagnosis and management in the emergency department.
Langhan ML, Stanton B. Seizures in neonates: diagnosis and management in the emergency department. Pediatric Emergency Medicine Practice 2020, 17: 1-20. PMID: 32470245.Peer-Reviewed Original ResearchConceptsNeonatal seizuresEmergency departmentPhysical examination findingsEmergency department managementSeizure cessationAntiepileptic medicationsTreatable causeCommon presentationExamination findingsHigh morbidityPatient stabilizationFurther managementDepartment managementSeizuresSubtle signsNeonatesCauseDepartmentMedicationsMorbidityEtiologySymptomsManagementMortalityDiagnosis
2019
Oral 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 childrenInjuryPatients
2018
End-Tidal Carbon Dioxide Use for Tracheal Intubation
Langhan ML, Emerson BL, Nett S, Pinto M, Harwayne-Gidansky I, Rehder KJ, Krawiec C, Meyer K, Giuliano JS, Owen EB, Tarquinio KM, Sanders RC, Shepherd M, Bysani GK, Shenoi AN, Napolitano N, Gangadharan S, Parsons SJ, Simon DW, Nadkarni VM, Nishisaki A. End-Tidal Carbon Dioxide Use for Tracheal Intubation. Pediatric Critical Care Medicine 2018, 19: 98-105. PMID: 29140968, DOI: 10.1097/pcc.0000000000001372.Peer-Reviewed Original ResearchConceptsCapnography useTracheal intubationCardiac arrestEmergency departmentEsophageal intubationOxygen desaturationWaveform capnographyAdverse tracheal intubation-associated eventsMulticenter retrospective cohort studyNational Emergency Airway RegistryTracheal intubation-associated eventsEnd-tidal carbon dioxide measurementPrimary tracheal intubationsRetrospective cohort studyUse of capnographyTracheal intubation procedureQuality improvement initiativesAirway RegistryCohort studyProvider characteristicsSafety outcomesIntubationIntubation procedureCapnographyImprovement initiatives
2017
Management of airway obstruction and stridor in pediatric patients
Marchese A, Langhan ML. Management of airway obstruction and stridor in pediatric patients. Pediatric Emergency Medicine Practice 2017, 14: 1-24. PMID: 29045097.Peer-Reviewed Original ResearchLife-threatening etiologiesAirway obstructionUpper airway obstructionAirway inflammationAirway stabilizationInitial managementPediatric patientsSurgical managementEmergency departmentChronic stridorCongenital conditionBacterial infectionsStridorObstructionEtiologyManagementInflammationPatientsCroupInfectionTracheaCapnography Use During Intubation and Cardiopulmonary Resuscitation in the Pediatric Emergency Department
Bullock A, Dodington JM, Donoghue AJ, Langhan ML. Capnography Use During Intubation and Cardiopulmonary Resuscitation in the Pediatric Emergency Department. Pediatric Emergency Care 2017, 33: 457-461. PMID: 27455341, PMCID: PMC5259553, DOI: 10.1097/pec.0000000000000813.Peer-Reviewed Original ResearchConceptsCapnography useEmergency departmentHospital emergency departmentCardiopulmonary resuscitationSpontaneous circulationAHA recommendationsAcademic children's hospital emergency departmentChildren's hospital emergency departmentAmerican Heart Association guidelinesImplementation of capnographyIll pediatric patientsHeart Association guidelinesRetrospective chart reviewUse of capnographyPediatric emergency departmentChart reviewAdverse eventsPatient characteristicsPediatric patientsIntubated patientsEndotracheal intubationTraumatic causesAssociation guidelinesIll childrenPatientsVascular Access in Pediatric Patients in the Emergency Department: Types of Access, Indications, and Complications.
Whitney R, Langhan M. Vascular Access in Pediatric Patients in the Emergency Department: Types of Access, Indications, and Complications. Pediatric Emergency Medicine Practice 2017, 14: 1-20. PMID: 28562239.Peer-Reviewed Original ResearchMeSH KeywordsAnesthetics, LocalArteriovenous Shunt, SurgicalCatheterization, Central VenousCatheterization, PeripheralCentral Venous CathetersChildChild, PreschoolEmergency Service, HospitalHumansInfantInfant, NewbornInfusions, IntraosseousInfusions, IntravenousPain ManagementPediatric Emergency MedicineSurgery, Computer-AssistedUltrasonographyVascular Access DevicesVenous CutdownConceptsVascular accessDifficult access patientsPeripheral intravenous accessCentral venous accessLife-saving procedurePain control techniquesProvider-specific factorsEmergency medicine practiceRoute of accessIntravenous accessPediatric patientsVenous accessEmergency departmentIntraosseous accessMedicine practicePatientsComplicationsType of accessIndicationsContraindicationsMainstayAcute Kidney Injury in Pediatric Patients: Diagnosis and Management in the Emergency Department.
Mohrer D, Langhan M. Acute Kidney Injury in Pediatric Patients: Diagnosis and Management in the Emergency Department. Pediatric Emergency Medicine Practice 2017, 14: 1-24. PMID: 28447934.Peer-Reviewed Original ResearchConceptsAcute kidney injuryPediatric acute kidney injuryKidney injuryPediatric patientsEmergency departmentChronic kidney diseaseIntravascular volume statusMedication exposureCardiac dysfunctionCommon etiologySignificant morbidityVolume statusKidney diseasePediatric nephrologistsHigh riskInjuryPatientsEtiologyDiagnosisChildrenRiskClassification systemDepartmentSepsisMorbidityA Qualitative Analysis of General Emergency Medicine Providers' Perceptions on Pediatric Emergency Telemedicine.
Kim JW, Tiyyagura G, Langhan M. A Qualitative Analysis of General Emergency Medicine Providers' Perceptions on Pediatric Emergency Telemedicine. Pediatric Emergency Care 2017, Publish Ahead of Print: 856-861. PMID: 28225376, DOI: 10.1097/pec.0000000000001067.Peer-Reviewed Original ResearchConceptsED providersLimitations of telemedicineEmergency departmentTelemedicine programProviders' perceptionsPediatric ED providersAdult stroke patientsGeneral emergency departmentsCritical care settingPatient-related outcomesPediatric emergency patientsPediatric emergency careAudio-recorded semistructured interviewsPediatric telemedicineStroke patientsConnecticut hospitalsApplication of telemedicineCare settingsEmergency patientsEmergency careVideo telemedicineTelemedicine's effectMost childrenPediatric resourcesFurther studies
2015
A qualitative evaluation of capnography use in paediatric sedation: perceptions, practice and barriers
Iyer NS, Koziel JR, Langhan ML. A qualitative evaluation of capnography use in paediatric sedation: perceptions, practice and barriers. Journal Of Clinical Nursing 2015, 24: 2231-2238. PMID: 25926380, DOI: 10.1111/jocn.12848.Peer-Reviewed Original ResearchConceptsPediatric emergency departmentUse of capnographyEmergency departmentCapnography useProcedural sedationAdequacy of ventilationMonitoring of childrenAdverse eventsHead traumaPediatric populationMental statusPediatric sedationLack of comfortModifiable barriersSedationCapnographyQualitative exploratory studyMost participantsLack of availabilityNursesPhysiciansVentilationDepartmentParticipantsAdditional education
2014
Implementation of newly adopted technology in acute care settings: a qualitative analysis of clinical staff
Langhan ML, Riera A, Kurtz JC, Schaeffer P, Asnes AG. Implementation of newly adopted technology in acute care settings: a qualitative analysis of clinical staff. Journal Of Medical Engineering & Technology 2014, 39: 44-53. PMID: 25367721, PMCID: PMC4686128, DOI: 10.3109/03091902.2014.973618.Peer-Reviewed Original ResearchA randomized controlled trial of capnography during sedation in a pediatric emergency setting
Langhan ML, Shabanova V, Li FY, Bernstein SL, Shapiro ED. A randomized controlled trial of capnography during sedation in a pediatric emergency setting. The American Journal Of Emergency Medicine 2014, 33: 25-30. PMID: 25445871, PMCID: PMC4272647, DOI: 10.1016/j.ajem.2014.09.050.Peer-Reviewed Original ResearchConceptsEpisodes of hypoventilationOxygen desaturationIntervention groupStandard monitoringPediatric emergency department patientsEmergency department patientsSedation of childrenPediatric emergency departmentPediatric emergency settingRates of interventionFrequency of interventionsRespiratory depressionPrimary outcomeDepartment patientsEmergency departmentProcedural sedationEmergency settingHigher oddsHypoventilationCapnography monitorControl groupSedationStandard modalityTimely interventionCapnographyExperiences with capnography in acute care settings: A mixed-methods analysis of clinical staff
Langhan ML, Kurtz JC, Schaeffer P, Asnes AG, Riera A. Experiences with capnography in acute care settings: A mixed-methods analysis of clinical staff. Journal Of Critical Care 2014, 29: 1035-1040. PMID: 25129575, PMCID: PMC4194255, DOI: 10.1016/j.jcrc.2014.06.021.Peer-Reviewed Original ResearchConceptsUse of capnographyAcute care areasCare unitCare areasPatient careIntensive care unitAcute care settingAcute care unitsFuture implementation strategiesCapnography useEmergency departmentClinical guidelinesCare settingsNineteen providersClinical staffCapnographyVariable knowledgeConstant comparative methodPurposeful sampleCareVaried responsivenessImplementation strategiesMixed-method analysisHospitalIterative data analysis
2013
Neonatal Seizures
Thornton MD, Chen L, Langhan ML. Neonatal Seizures. Pediatric Emergency Care 2013, 29: 1107-1110. PMID: 24084610, PMCID: PMC3822764, DOI: 10.1097/pec.0b013e3182a62fd6.Peer-Reviewed Original ResearchMeSH KeywordsAntacidsBlood Group IncompatibilityCalcium CarbonateDiabetes, GestationalDiagnosis, DifferentialEmergenciesFemaleGastroesophageal RefluxHumansHyperbilirubinemia, NeonatalHypocalcemiaHypoglycemiaHypoglycemic AgentsHypoparathyroidismInfant, NewbornMagnesiumMaleMaternal-Fetal ExchangeParathyroid HormonePregnancyPregnancy ComplicationsPregnancy Trimester, ThirdPrenatal Exposure Delayed EffectsSeizuresConceptsNeonatal seizuresTertiary pediatric emergency departmentCalcium carbonate intakeLow serum calciumParathyroid hormone concentrationsSeizure-like episodesSerum phosphate concentrationPediatric emergency departmentVariety of causesGastroesophageal refluxSuch patientsDrug withdrawalSerum calciumThird trimesterPotential morbidityBirth traumaCounter medicationsEmergency departmentMaternal ingestionPregnant mothersMale infantMetabolic disturbancesCongenital anomaliesAnticipatory guidanceHormone concentrationsPediatric Anaphylaxis Management in the Prehospital Setting
Tiyyagura GK, Arnold L, Cone DC, Langhan M. Pediatric Anaphylaxis Management in the Prehospital Setting. Prehospital Emergency Care 2013, 18: 46-51. PMID: 24028748, PMCID: PMC3865171, DOI: 10.3109/10903127.2013.825352.Peer-Reviewed Original ResearchConceptsPediatric emergency departmentEmergency medical servicesAnaphylactic reactionsAllergic reactionsUrban tertiary care pediatric emergency departmentLife-threatening systemic allergic reactionTertiary care pediatric emergency departmentPatients 18 yearsHistory of asthmaRetrospective chart reviewSystemic allergic reactionsPast medical historyTreatment of choiceParents/patientsCases of anaphylaxisAllergy-causing substanceGastrointestinal symptomsChart reviewRespiratory symptomsEarly administrationIntramuscular epinephrinePatient's symptomsEmergency departmentEpinephrine administrationMean ageCapnography in the pediatric emergency department: clinical applications
Becker HJ, Langhan M. Capnography in the pediatric emergency department: clinical applications. Pediatric Emergency Medicine Practice 2013, 10: 1-24. PMID: 31692301.Peer-Reviewed Original ResearchPediatric emergency departmentEmergency departmentEmergency cliniciansConfirmation of intubationUse of capnographyLower respiratory diseaseEnd-tidal carbon dioxide monitoringClinical applicationMaintenance of ventilationInterpretation of waveformsNonintubated childrenPediatric patientsMetabolic derangementsMonitoring of effectivenessSedated childrenCarbon dioxide monitoringCardiopulmonary resuscitationMetabolic parametersRespiratory diseasePediatric subspecialtiesPatient careCapnographyClinical useNoninvasive methodClinicians