Background: Urgency of and time to antibiotic administration has often been highlighted to prevent complications of community acquired pneumonia (CAP). Adult literature is mixed on whether administration of antibiotics within four hours of diagnosis of CAP reduces morbidity and mortality, however this has not been studied in pediatric patients. We evaluated whether time to antibiotics [...]

Background: Suicide attempt and self-injury (SA/SI) are frequent reasons for medical hospitalizations, yet little is known about length of stay (LOS) among youth hospitalized for SA/SI. LOS is commonly used to measure quality of patient care and resource use within hospitals, and a comprehensive understanding of factors associated with LOS among youth admitted for SA/SI [...]

Background: Mounting evidence supports the use of point-of-care ultrasound (POCUS) in medicine and pediatrics to improve outcomes, maximize patient safety, and increase patient satisfaction and success of procedures.The literature describes the utility of POCUS in several areas of pediatric care (the emergency department, pediatric and neonatal intensive care unit, and post-acute care setting), however, we [...]

Background: In a technology-driven era, it is no surprise that the majority of learners prefer multimodal resources when learning new material. Patient discharge education is no exception to this, and several studies have demonstrated that providing digital discharge education (DDE) can help with patient comprehension, information retention, and patient self-efficacy with medication (1, 2, 3). [...]

Background: Enhanced Recovery After Surgery (ERAS) is a framework or pathway of standardized preoperative, intraoperative, and postoperative elements shown to improve recovery after a surgical operation (Table 1). ERAS has shown benefits in pediatrics by reducing hospital length of stay, opioid use, readmission rates, health care costs and improving patient satisfaction scores(1,2). At our institution, [...]

Background: Effective discharge instructions are critical for safe patient transitions to outpatient care. However, patients may misunderstand the information they receive, particularly those with complex plans and limited English proficiency. The Institute for Healthcare Improvement and Solutions for Patient Safety recommend discharge instructions that outline the patient’s primary issue, care steps, signs of worsening, where [...]

Background: Professional billing is crucial for both division revenue and sustainable healthcare. However, provider knowledge on optimal billing for varied clinical scenarios is often lacking. Critical Care Current Procedural Terminology (CPT) Evaluation and Management (E/M) codes are often appropriate for Hospital Medicine (HM) providers to use when providing critical care services to patients during a [...]

Background: Obtaining timely intravenous (IV) access can be challenging for pediatric patients due to physiological and behavioral differences. Many pediatric patients experience multiple needlesticks, leading to trauma and delays in medical interventions. Prior investigators have attempted to implement standardized IV access algorithms, ultrasound-guided IV placement, and stratification of IV placement difficulty using the Difficult Intravenous [...]

Case Presentation: An 8-year-old female with a history of Guillain-Barre syndrome (GBS) presented with chronic weight loss and constipation for seven months. Exam revealed a small for age, developmentally delayed female with aphasia, inability to ambulate, and a distended but non-tender abdomen. CBC revealed normocytic anemia (Hgb 11.1) and iron deficiency. Additional laboratory testing showed [...]

Case Presentation: 17 year old female with no medical history presented with malaise. Labs were WBC 3.78 with normal differential, a microcytic anemia 7.1, platelets 7, and uric acid 10.6. On admission, she was found to have epistaxis, conjunctival hemorrhage, and hemoptysis. She required escalation to high flow nasal cannula. Chest x-ray was concerning for [...]