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
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
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 Injuries
2016
Drugs, 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 lawsPreventionAdolescents
2010
Hepatosplenomegaly and Reticulocytopenia as Prominent Features of Atypical Hemolytic Uremic Syndrome
Bechtel K, Iragorri S. Hepatosplenomegaly and Reticulocytopenia as Prominent Features of Atypical Hemolytic Uremic Syndrome. Pediatric Emergency Care 2010, 26: 510-511. PMID: 20622633, DOI: 10.1097/pec.0b013e3181e5bffb.Peer-Reviewed Original ResearchConceptsHemolytic uremic syndromeAtypical hemolytic uremic syndromeUremic syndromeDiagnosis of HUSIncorrect initial diagnosisInvasive pneumococcal diseaseProminent clinical featureClinical characteristicsPneumococcal diseaseRenal injuryClinical featuresInitial diagnosisAcute leukemiaHematologic malignanciesDifferential diagnosisAtypical casesDiagnosisHepatosplenomegalyReticulocytopeniaSyndromeMorbidityMalignancyInjuryLeukemiaProminent feature
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
2006
Duodenal Hematoma After Upper Endoscopy and Biopsy in a 4-Year-Old Girl
Bechtel K, Moss RL, Leventhal JM, Spiro D, Abo A. Duodenal Hematoma After Upper Endoscopy and Biopsy in a 4-Year-Old Girl. Pediatric Emergency Care 2006, 22: 653-654. PMID: 16983252, DOI: 10.1097/01.pec.0000235840.52072.0c.Peer-Reviewed Original ResearchInflicted 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
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