Research Highlights
At Children's Hospital Research Foundation of Cincinnati, the Division of Emergency Medicine's research goals reflect the areas of interest of the faculty and our collaborations within the Department of Pediatrics and the larger university community.
The current areas of work include:
Injury Prevention and Control
Over the past years the division has continued research targeted towards prevention of injuries and reduction of morbidity to those suffering a primary injury. Current goals are to expand the expertise with a multidisciplinary team to further Cincinnati Children's becoming an Injury Prevention Center. The Hamilton County Department of Health released the first report of geo-coded data on patients of all ages hospitalized during 1996 in participating hospitals within the county. Representatives from each hospital, including Richard Ruddy, M.D., are on the medical advisory board for this project.
Children's Hospital Medical Center of Cincinnati has taken the lead in presenting data from the pediatric aspects in the past year. This includes a summary of the pediatric data by Wendy Pomerantz, M.D. and Dr. Dowd and the finding by Maria Stephan, M.D., that poisoning is the leading etiology of admissions among 10-14 year olds in our county. Currently the data is available to interested parties who have specific community prevention projects to initiate.
In other areas of trauma care, the summary of delay diagnosis in acute trauma was presented by Dr. Connors last fall and the results of a grant to evaluate Cincinnati Children's trauma system activation were presented at the fall American Academy of Pediatrics' annual meeting. In the area of education, the Injury Prevention Team of the trauma committee has implemented an injury prevention course for residents' education under the leadership of Dr. Connors. This project was presented at the Annual Pediatric Academic Societies Meeting as a workshop for other pediatric programs to model.
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The Center for Excellence in Child Abuse and Neglect
Under the direction of Robert Shapiro, M.D., the Mayerson Center for Safe and Healthy Children, directly and through education of providers, is responsible for the identification, evaluation and reporting of alleged physical and sexual abuse. He works closely with the newly formed Mayerson Center for Safe and Healthy Children. The Child Abuse research team presented four posters and one platform presentation at the Annual PAS meeting in Boston and published a study on rib fractures in infants. The child abuse program continues to represent the expertise at regional and national meetings in the clinical and educational arena. The program has graduated the first fellow in child abuse and will have two fellows in the coming academic year.
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Health Services
In 1999 there were three faculty with advanced degrees and research commitment to Health Services and strong ties have developed at Cincinnati Children's and the University of Cincinnati, particularly with General and Academic Pediatrics and Clinical Effectiveness. Jacqueline Grupp-Phelan, M.D., M.P.H., heads the group and has developed preliminary work in the evaluation of children presenting for emergency care with psychiatric issues, particularly the impact of maternal depression. Melinda Mahabee-Gittens, M.D., M. Environmental Health, has been working on several projects, particularly the clinical issues in pneumonia and, the impact of passive smoke on lower respiratory infection. Dr. Pomerantz has been working primarily in the area of injury prevention with the epidemiology of adolescent overdoses. Mary Deffner Patterson, M.D., Gregg DiGiulio, M.D., Dr. Mahabee-Gittens, Joseph Luria, M.D., Todd Glass, M.D., M.S. Phys., and Dr. Richard Ruddy have all contributed to the Clinical Effectiveness teams guideline development, implementation and measures in the past year.
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Trauma/Resuscitation
A multidisciplinary research team coordinated within Emergency Medicine including participation of Trauma Services, several surgical specialties, Critical Care Medicine, Cincinnati Center for Developmental Disorders, Psychology and Rehabilitation have been jointly working on research projects and is chaired by Dr. Glass. From Emergency Medicine, Dr. Glass is involved in the investigation of the interactions of hypotension and shock with traumatic brain injury. He continues to conduct studies in the use of an in-vitro model of traumatic brain injury. Dr. Patterson and Dr. Glass are engaged in a project investigating the pathophysiology of traumatic shock and various resuscitation strategies in blunt trauma in conjunction with Rebeccah Brown, M.D., of Pediatric Surgery. Dr. Luria and Dr. Glass, in collaboration with Victor Garcia, M.D., from Pediatric Surgery, are evaluating novel approaches to patient monitoring and the ability to reliably predict impending shock. Dr. Luria is the American Academy of Pediatrics representative on the State Trauma Committee, which reports to the Ohio Emergency Medical Services Board on trauma systems development.
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Advocacy Program
In addition to injury prevention, advocacy has always been a core aspect of the work of the Division of Emergency Medicine. This includes serving the under-served, patient care education and prevention. An important aspect has been improving the immunization rate of our children. The Center for Disease Control Immunization Action Plan is in its eighth year. Under the direction of Charles Schubert, M.D., the program is a joint effort with the City of Cincinnati Health Department with the ongoing development of a regional database. The advocacy aspect in our program is a unique one in emergency medicine that is well recognized by our specialty around the country.
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Emergency Medical Services for Children
There are a number of targeted issues, which are important areas of clinical research within our division. Important ones include pre-hospital care, pain management and sedation and acute respiratory illness. With the recruitment of Randall Bond, M.D., a pediatric emergency physician and board certified toxicologist, the continued growth of scholarly work in the prevention and treatment of pediatric exposures, both poisonings and overdoses has been enhanced. This is in collaboration with the Cincinnati Drug and Poison Information Center and the work of Earl Siegel, Pharm. D.
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