Melissa Langhan, MD, MHS
Associate Professor of Pediatrics (Emergency Medicine) and of Emergency Medicine; Director of Operations, Pediatric Emergency Medicine; Fellowship Director, Pediatric Emergency Medicine; Director of Education, Pediatric Emergency Medicine
Research & Publications
Biography
News
Research Summary
Dr. Langhan is interested in performing clinical research to improve the safety of acutely ill children and develop objective measurements of illness. She is also performing medical education research across specialties.
Specialized Terms: Pediatric Emergency Medicine; End-tidal carbon dioxide monitoring; Capnography; Acute exacerbations of asthma; Prehospital care; Patient safety; Objective measures of severity
Extensive Research Description
I plan to devote my academic clinical research career to applying new, noninvasive technologies to the clinical problems seen acutely in children by designing and executing carefully planned patient-oriented research. During the past several years I have been able to successfully complete several research projects using new technologies in the pediatric emergency department such as capnography and portable spirometry. Furthermore, I have been able to document that capnography is not being utilized to its full potential in both the emergency and critical care settings. My goal is to continue patient oriented research using noninvasive technologies that provide us with objective patient assessment and can be used to make timely clinical decisions, improve patient safety and reduce medical costs.
- Can end-tidal carbon dioxide monitoring reduce the frequency of hypoxia during moderate sedation with ketamine in children?
- Identifying the barriers and facilitators to the implementation of new technology in acute care areas
- A qualitative study regarding providers perceptions on capnography use during moderate sedation
- Evaluating trainees' ability to normally ventilate children via bag-valve mask ventilation through capnography
- Assessing the use of capnography during critical events in the Emergency Department
I have also been involved in medical education research. Along with the fellowship directors in pediatric emergency medicine across the country, we worked to map out Entrustable Professional Activities for our specialty. We are now evaluating our fellow Milestones, clinical work hours, and levels of autonomy. As a representative on the Subspecialty Pediatric Investigative Network, I help to implement multicenter medical educations studies across all pediatric specialties.
- Utilization of EPAs in the Pediatric Subspecialties
- Factors Important in Determining Simple vs. Complex Cases for the Pediatric Subspecialty Entrustable Professional Activity (EPA) Levels of Supervision
- Are Graduating Pediatric Fellows Meeting the Expected Level of Supervision for the Common Subspecialty Entrustable Professional Activities (EPAs)?
- Longitudinal Evaluation of the Required Levels of Supervision for Pediatric Fellows
- Use of Structured Interviews to Reduce Bias in Trainee Evaluations
Coauthors
Research Interests
Asthma; Carbon Dioxide; Education, Medical; Emergency Medicine; Pediatrics; Severity of Illness Index; Capnography; Patient Safety; Mindfulness
Selected Publications
- Terminal Ileitis Presenting With a Spontaneously Reduced Ileocolic Intussusception Diagnosed by Point-of-Care Ultrasonography.Riera A, Langhan M, Silva CT. Terminal Ileitis Presenting With a Spontaneously Reduced Ileocolic Intussusception Diagnosed by Point-of-Care Ultrasonography. Pediatric Emergency Care 2020, 36:e30-e32.
- Differences in Frequency of Visits to Pediatric Primary Care Practices and Emergency Departments by Body Mass Index.Kovalerchik O, Powers E, Holland ML, Sharifi M, Langhan ML. Differences in Frequency of Visits to Pediatric Primary Care Practices and Emergency Departments by Body Mass Index. Academic Pediatrics 2020, 20:532-539.
- 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 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.
- A Community Emergency Department Rotation for Pediatric Emergency Medicine Fellows: Development and Evaluation.Langhan ML, Woolf S, Tiyyagura G. A Community Emergency Department Rotation for Pediatric Emergency Medicine Fellows: Development and Evaluation. Pediatric Emergency Care 2020.
- A 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 2019, 35:856-861.
- 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.
- Use of Capnography to Optimize Procedural Sedation in the Emergency Department Pediatric Population.Rose Bovino L, Brainard C, Beaumier K, Concetti V, Lefurge N, Mittelstadt E, Wilson T, Langhan ML. Use of Capnography to Optimize Procedural Sedation in the Emergency Department Pediatric Population. Journal Of Emergency Nursing: JEN : Official Publication Of The Emergency Department Nurses Association 2018, 44:110-116.
- End-Tidal Carbon Dioxide Use for Tracheal Intubation: Analysis From the National Emergency Airway Registry for Children (NEAR4KIDS) Registry.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: Analysis From the National Emergency Airway Registry for Children (NEAR4KIDS) Registry. Pediatric Critical Care Medicine : A Journal Of The Society Of Critical Care Medicine And The World Federation Of Pediatric Intensive And Critical Care Societies 2018, 19:98-105.
- Acute 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.
- Can Providers Use Clinical Skills to Assess the Adequacy of Ventilation in Children During Bag-Valve Mask Ventilation?Becker HJ, Langhan ML. Can Providers Use Clinical Skills to Assess the Adequacy of Ventilation in Children During Bag-Valve Mask Ventilation? Pediatric Emergency Care 2020, 36:e695-e699.
- Management of airway obstruction and stridor in pediatric patientsMarchese A, Langhan ML. Management of airway obstruction and stridor in pediatric patients Pediatric Emergency Medicine Practice 2017, 14:1-24.
- Vascular 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.
- Vascular access in pediatric patients in the emergency department: types of access, indications, and complications [digest].Whitney R, Langhan M, Pade KH. Vascular access in pediatric patients in the emergency department: types of access, indications, and complications [digest]. Pediatric Emergency Medicine Practice 2017, 14:S1-S2.
- Acute kidney injury in pediatric patients: diagnosis and management in the emergency department [digest].Mohrer D, Langhan M, Chaudhari P. Acute kidney injury in pediatric patients: diagnosis and management in the emergency department [digest]. Pediatric Emergency Medicine Practice 2017, 14:S1-S2.
- Capnography 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.
- Management of airway obstruction and stridor in pediatric patients [digest].Marchese A, Langhan ML, Pade KH. Management of airway obstruction and stridor in pediatric patients [digest]. Pediatric Emergency Medicine Practice 2017, 14:S1-S2.
- The impact of capnography monitoring among children and adolescents in the postanesthesia care unit: a randomized controlled trial.Langhan ML, Li FY, Lichtor JL. The impact of capnography monitoring among children and adolescents in the postanesthesia care unit: a randomized controlled trial. Paediatric Anaesthesia 2017, 27:385-393.
- Respiratory depression detected by capnography among children in the postanesthesia care unit: a cross-sectional study.Langhan ML, Li FY, Lichtor JL. Respiratory depression detected by capnography among children in the postanesthesia care unit: a cross-sectional study. Paediatric Anaesthesia 2016, 26:1010-7.
- Essentials of PEM Fellowship Part 2: The Profession in Entrustable Professional Activities.Hsu D, Nypaver M, Fein DM, McAneney C, Santen S, Nagler J, Zuckerbraun N, Roskind CG, Reynolds S, Zaveri P, Stankovic C, House JB, Langhan M, Titus MO, Dahl-Grove D, Klasner AE, Ramirez J, Chang T, Jacobs E, Chapman J, Lumba-Brown A, Thompson T, Mittiga M, Eldridge C, Heffner V, Herman BE, Kennedy C, Madhok M, Kou M. Essentials of PEM Fellowship Part 2: The Profession in Entrustable Professional Activities. Pediatric Emergency Care 2016, 32:410-8.
- 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 2015, 39:44-53.
- A 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 2015, 33:25-30.
- 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, 24:2231-8.
- Experiences 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, 29:1035-40.
- Pediatric anaphylaxis management in the prehospital setting.Tiyyagura GK, Arnold L, Cone DC, Langhan M. Pediatric anaphylaxis management in the prehospital setting. Prehospital Emergency Care : Official Journal Of The National Association Of EMS Physicians And The National Association Of State EMS Directors 2014, 18:46-51.
- Capnography in the Pediatric Emergency Department: Clinical Applications.Becker H, Langhan M. Capnography in the Pediatric Emergency Department: Clinical Applications. Pediatric Emergency Medicine Practice 2013; 10(6): 1-26.
- Neonatal seizures: soothing a burning topic.Thornton MD, Chen L, Langhan ML. Neonatal seizures: soothing a burning topic. Pediatric Emergency Care 2013, 29:1107-10.
- Bioacoustics, breaths, and biostatistics.Overdyk FJ, Marino J, Langhan M, Dahan A. Bioacoustics, breaths, and biostatistics. Anesthesia And Analgesia 2013, 117:1507-8.
- Acute alcohol intoxication in adolescents: frequency of respiratory depression.Langhan ML. Acute alcohol intoxication in adolescents: frequency of respiratory depression. The Journal Of Emergency Medicine 2013, 44:1063-9.
- Capnography in the pediatric emergency department: clinical applicationsBecker HJ, Langhan M. Capnography in the pediatric emergency department: clinical applications Pediatric Emergency Medicine Practice 2013, 10:1-24.
- Diagnosis of intussusception by physician novice sonographers in the emergency department.Riera A, Hsiao AL, Langhan ML, Goodman TR, Chen L. Diagnosis of intussusception by physician novice sonographers in the emergency department. Annals Of Emergency Medicine 2012, 60:264-8.
- Improving detection by pediatric residents of endotracheal tube dislodgement with capnography: a randomized controlled trial.Langhan ML, Auerbach M, Smith AN, Chen L. Improving detection by pediatric residents of endotracheal tube dislodgement with capnography: a randomized controlled trial. The Journal Of Pediatrics 2012, 160:1009-14.e1.
- Physiologic monitoring practices during pediatric procedural sedation: a report from the Pediatric Sedation Research Consortium.Langhan ML, Mallory M, Hertzog J, Lowrie L, Cravero J. Physiologic monitoring practices during pediatric procedural sedation: a report from the Pediatric Sedation Research Consortium. Archives Of Pediatrics & Adolescent Medicine 2012, 166:990-8.
- Availability and clinical utilization of capnography in the prehospital setting.Langhan M. Availability and clinical utilization of capnography in the prehospital setting. Connecticut Medicine 2011, 75:197-201.
- Detection of hypoventilation by capnography and its association with hypoxia in children undergoing sedation with ketamine.Langhan ML, Chen L, Marshall C, Santucci KA. Detection of hypoventilation by capnography and its association with hypoxia in children undergoing sedation with ketamine. Pediatric Emergency Care 2011, 27:394-7.
- A randomized controlled trial of capnography in the correction of simulated endotracheal tube dislodgement.Langhan ML, Ching K, Northrup V, Alletag M, Kadia P, Santucci K, Chen L. A randomized controlled trial of capnography in the correction of simulated endotracheal tube dislodgement. Academic Emergency Medicine : Official Journal Of The Society For Academic Emergency Medicine 2011, 18:590-6.
- Use of emergency ultrasound in the diagnostic evaluation of an infant with vomiting.Alletag MJ, Riera A, Langhan ML, Chen L. Use of emergency ultrasound in the diagnostic evaluation of an infant with vomiting. Pediatric Emergency Care 2011, 27:986-9.
- Remember the saphenous: ultrasound evaluation and intravenous site selection of peripheral veins in young children.Riera A, Langhan M, Northrup V, Santucci K, Chen L. Remember the saphenous: ultrasound evaluation and intravenous site selection of peripheral veins in young children. Pediatric Emergency Care 2011, 27:1121-5.
- Wheezing in infants and children.Arnold DH, Spiro DM, Langhan ML. Chapter 116: Wheezing in infants and children. Tintinalli’s Emergency Medicine,. 7th ed., 2010. McGraw-Hill, New York. In press.
- Use of bedside ultrasound to assess degree of dehydration in children with gastroenteritis.Chen L, Hsiao A, Langhan M, Riera A, Santucci KA. Use of bedside ultrasound to assess degree of dehydration in children with gastroenteritis. Academic Emergency Medicine : Official Journal Of The Society For Academic Emergency Medicine 2010, 17:1042-7.
- Portable spirometry during acute exacerbations of asthma in children.Langhan ML, Spiro DM. Portable spirometry during acute exacerbations of asthma in children. The Journal Of Asthma : Official Journal Of The Association For The Care Of Asthma 2009, 46:122-5.
- Continuous end-tidal carbon dioxide monitoring in pediatric intensive care units.Langhan M. Continuous end-tidal carbon dioxide monitoring in pediatric intensive care units. Journal Of Critical Care 2009, 24:227-30.
- The 2007-2008 photo competition award winner: Melissa Langhan, MD: A painful scalp rash: cutaneous myiasis secondary to new world screwworm.Langhan ML. The 2007-2008 photo competition award winner: Melissa Langhan, MD: A painful scalp rash: cutaneous myiasis secondary to new world screwworm. Pediatric Emergency Care 2008, 24:502-4.
- Quantitative end-tidal carbon dioxide in acute exacerbations of asthma.Langhan ML, Zonfrillo MR, Spiro DM. Quantitative end-tidal carbon dioxide in acute exacerbations of asthma. The Journal Of Pediatrics 2008, 152:829-32.
- Current utilization of continuous end-tidal carbon dioxide monitoring in pediatric emergency departments.Langhan ML, Chen L. Current utilization of continuous end-tidal carbon dioxide monitoring in pediatric emergency departments. Pediatric Emergency Care 2008, 24:211-3.
- Cutaneous myiasis associated with scalp psoriasis.Mariwalla K, Langhan M, Welch KA, Kaplan DH. Cutaneous myiasis associated with scalp psoriasis. Journal Of The American Academy Of Dermatology 2007, 57:S51-2.
- Clonidine exposures, not toxicity.Langhan M, Chan G. Clonidine exposures, not toxicity. The Journal Of Pediatrics 2006, 148:565.
- Clostridial myonecrosis in an adolescent male.Langhan M, Arnold L. Clostridial myonecrosis in an adolescent male. Pediatrics 2005, 116:e735-7.
- How comfortable are emergency physicians with pediatric patients?Langhan M, Keshavarz R, Richardson LD. How comfortable are emergency physicians with pediatric patients? The Journal Of Emergency Medicine 2004, 26:465-9.
- Pediatric Emergency Medicine Fellowship Directors' Collective Statement on Virtual Interviews.Allister L, Langhan ML, Rose JA, Kane I, Vu T, Ngo TL, Nesiama JA, Blumberg S, Ciener DA, Titus MO, Nagler J. Pediatric Emergency Medicine Fellowship Directors' Collective Statement on Virtual Interviews. Pediatric Emergency Care 2020, 36:549-550.
- An 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.
- Exploring the Effect of Mindfulness on Burnout in a Pediatric Emergency Department.Palladino L, Wong KU, Langhan ML. Exploring the Effect of Mindfulness on Burnout in a Pediatric Emergency Department. Workplace Health & Safety 2021, 21650799211004423.
- Gender Differences Among Milestone Assessments in a National Sample of Pediatric Emergency Medicine Fellowship Programs.Zuckerbraun NS, Levasseur K, Kou M, Rose JA, Roskind CG, Vu T, Baghdassarian A, Leonard K, Shabanova V, Langhan ML. Gender Differences Among Milestone Assessments in a National Sample of Pediatric Emergency Medicine Fellowship Programs. AEM Education And Training 2021, 5:e10543.
- Milestone achievements in a national sample of pediatric emergency medicine fellows: impact of primary residency training.Kou M, Baghdassarian A, Rose JA, Levasseur K, Roskind CG, Vu T, Zuckerbraun NS, Leonard K, Shabanova V, Langhan ML. Milestone achievements in a national sample of pediatric emergency medicine fellows: impact of primary residency training. AEM Education And Training 2021, 5:e10575.
- Milestones comparisons from residency to pediatric emergency medicine fellowship: Resetting expectations.Vu TT, Rose JA, Shabanova V, Kou M, Zuckerbraun NS, Roskind CG, Baghdassarian A, Levasseur K, Leonard K, Langhan ML. Milestones comparisons from residency to pediatric emergency medicine fellowship: Resetting expectations. AEM Education And Training 2021, 5:e10600.
- Pediatric emergency medicine fellows' milestone evaluations: Do they all meet the targets for graduation?Roskind CG, Leonard K, Baghdassarian A, Kou M, Levasseur K, Rose JA, Shabanova V, Vu T, Zuckerbraun NS, Langhan ML. Pediatric emergency medicine fellows' milestone evaluations: Do they all meet the targets for graduation? AEM Education And Training 2021, 5:e10620.