Background: The COVID-19 pandemic has necessitated rapid changes in healthcare delivery in the United States, including changes in the care of hospitalized children. Our study aimed to identify the major changes in inpatient pediatric healthcare delivery and potential learnings from these changes. Methods: We conducted semi-structured interviews for this qualitative study. We purposefully sampled hospitals [...]

Background: Mentorship can help accelerate career advancement and professional development for pediatric hospitalists; thus, many Pediatric Hospital Medicine (PHM) divisions are creating formal mentorship programs. However, it is not currently known how many PHM divisions have mentorship programs or what aspects of mentorship are needed for hospitalists. Our study aimed to understand the current landscape [...]

Background: Orbital cellulitis/abscess (OC) is an infection of eye tissues posterior to the orbital septum. OC can have significant morbidities such as vision loss, cavernous sinus thrombosis, and intracranial infection if treatment is not initiated promptly. While some patients with orbital cellulitis complicated by subperiosteal abscess require surgical drainage, many are managed with intravenous (IV) [...]

Background: The transition from adolescent to adult care has been associated with worse outcomes including increased mortality (1). Improved patient experience (PEX) correlates with decreased inpatient mortality rates and better adherence to quality guidelines (2) as well as lower 30- day readmission rates for patients with heart failure, acute MI and pneumonia (3). Hospitalized adolescents [...]

Background: E-cigarette or vaping-associated lung injury (EVALI) was first reported in 2019 in the United States (1-2). Reported lung findings in this disease include acute respiratory distress syndrome, acute eosinophilic pneumonia, hypersensitivity pneumonia, and giant cell interstitial pneumonitis (3-5). Considering the additional reports of diffuse alveolar hemorrhage and hemoptysis (6-11), we obtained coagulation studies prior [...]

Background: An average of 10% of patients in the U.S. report having a penicillin allergy yet the Centers for Disease Control estimates that less than 1% of the population are truly allergic. It is well described in adult literature that broad spectrum antibiotics are often used as penicillin alternatives and this may contribute to negative [...]

Background: Sleep is critical to children’s health and recovery, but pediatric inpatient sleep is often disrupted by nonessential overnight interruptions. The COVID-19 pandemic necessitated social distancing policies which minimized contact with low-risk patients. These policies have the potential to decrease overnight disruptions and improve sleep for hospitalized patients. Methods: This cohort study compared sleep disruptions [...]

Background: Bronchiolitis is one of the most common reasons for hospitalizations in children with > 100,000 admissions each year. High-flow nasal cannula (HFNC) therapy has been widely adopted to treat bronchiolitis with increasing use outside of the pediatric intensive care unit (PICU). The use of oral feeding while on HFNC has been questioned due to [...]

Background: Pediatric orbital cellulitis/abscess (OC) is a known complication of sinusitis that can have detrimental outcomes such as vision loss and intracranial extension if not diagnosed and treated promptly. In many patients with OC, the microbiologic data is not available to guide provider selection of targeted antibiotics, so variation in prescribing patterns exists. Many institutions [...]

Background: The indications for lumbar puncture (LP) among febrile infants 29-60 days old continue to evolve. We studied febrile infants age 29-60 days with an ED visit and compared the characteristics and outcomes of those with and without an LP. We also describe the clinical course of infants receiving antibiotics before or after the LP. [...]