February 2023
University of Alberta PEAK Research Team: Pediatric Emergency: Advancing Knowledge through Leadership, Collaboration, Excellence
Welcome to the February 2023 edition of the PEAK Research Team Newsletter! This newsletter serves as an update on the activities of the Division of Pediatric Emergency Medicine at the University of Alberta and provides resources and information that may be of interest to readers.
Questions? Comments? Contact us at peakrt@ualberta.ca
PEAK Highlights
Ongoing PEAK Study: CAN-PREPARE -- Canadian Anaphylaxis Network -- Predicting Recurrence after Emergency Presentation for Allergic Reaction
Food allergy impacts 1-in-2 Canadian households, and up to 80% of severe allergic reactions in children are triggered by food. In Canada, approximately every 10 minutes, there is an Emergency Room (ER) visit for food-induced allergic reaction. In the event of an allergic reaction, treatment guidelines recommend that children be transported by an ambulance to an ER for observation, even if symptoms are mild or have stopped. The rationale behind the need for observation in the ER is that some patients are at risk of delayed reactions which can be life-threatening. Unfortunately, research data on the frequency, timing, severity, and predictors of delayed allergic reactions are very limited. As a result, many children are also admitted to the hospital or observed in the ER for long hours to increase the chance of detecting delayed reactions.
Canadian families described feelings of ambiguity about the severity of a reaction and hesitance to treat with epinephrine along with perceptions that ER visits often involve a long post-treatment wait time. The unpredictability of reactions and anticipation of ER visits can have a significant psychosocial impact on children and their caregivers. In fact, surveys of Canadian families showed that almost half of respondents described their anxiety level as 8 out of 10 or higher.
The main objective of this study is to determine which combination of risk factors identify children with allergic reactions who are at risk of developing delayed reactions. From this knowledge, we can develop guidelines so that children at high risk are monitored appropriately, whereas those at no or low risk can be discharged from the ER once they have no symptoms.
Featured PEAK Team Member: Nadia Shular
Nadia graduated from the University of Alberta with a Bachelor of Arts in 2012 and later a Bachelor of Sciences in Nursing in 2018. She has been with the team since 2011 starting at as a Research Assistant and eventually moving into her current role as as Lead Research Coordinator. Along with coordinating research studies, she is a nurse in the Pediatric Emergency Department at the University of Alberta Hospital. She loves watching each study have an impact in every day clinical practice!
PEAK Networks Updates
Solutions for Kids in Pain (SKIP)
SKIP is a national knowledge mobilization network whose mission is to improve children's pain management by mobilizing evidence-based solutions through coordination and collaboration.
We're launching our ChildKind International Certification Process!
ChildKind International is an international accreditation that demonstrates an organization's commitment to children's comfort. We will be undertaking this process at the Stollery Children's Hospital starting in 2023. Stay tuned for our progress!
You can make a difference: partnership helps to improve children's comfort at the Stollery
For National Pain Awareness Week, SKIP and WCHRI hosted an online event where panellists (both patients and caregivers) discussed how the partnership helps to improve children’s comfort at the Stollery.
Watch the event recording and learn about resources, approaches and solutions to improving children's and families' pain experiences through advocacy, policy-making and improved care.
Translating Emergency Knowledge for Kids (TREKK)
TREKK is a national knowledge mobilization network established to address critical knowledge gaps and improve emergency care for children across Canada.
Featured PEAK Team Publications
Ali AZ, Wright B, Curran JA, et al. Review: Patient engagement in child, adolescent, and youth mental health care research - a scoping review. Child Adolesc Ment Health. 2022 Dec 9. Epub ahead of print. doi: 10.1111/camh.12615
Ali S, Drendel AL. Responsible and safe use of opioids in children and adolescents in the emergency department. Pediatr Emerg Med Pract. 2023 Jan;20(1):1-24. Epub 2023 Jan 2. PMID: 36592388
Alqurashi W, Shaker M, Wells GA ... Dixon A, et al. Canadian Anaphylaxis Network-Predicting Recurrence after Emergency Presentation for Allergic REaction (CAN-PREPARE): a prospective, cohort study protocol. BMJ Open 2022;12:e061976. do: 10.1136/bmjopen-2022-061976
Cairncross M, Yeates KO, Tang K ... Craig W, et al. Early Postinjury Screen Time and Concussion Recovery. Pediatrics. 2022 Nov 1;150(5):e2022056835. doi: 10.1542/peds.2022-056835
Charide R, Stallwood L, Munan M ... Hartling L, et al. Knowledge mobilization activities to support decision-making by youth, parents, and adults using a systematic and living map of evidence and recommendations on COVID-19: protocol for three randomized controlled trials and qualitative user-experience studies. Trials. 2023 Jan 14;24(1):27. doi: 10.1186/s13063-023-07067-9
Doan Q, Chadwick L, Tang K ... Craig W, et al. A Prospective Cohort Study of the Association Between Preinjury Psychosocial Function and Postconcussive Symptoms in Pediatric Mild Traumatic Brain Injury: An A-CAP Study. J Head Trauma Rehab. 2022 Dec. Epub ahead of print. doi: 10.1097/htr.0000000000000853
Kammerer E, Eszczuk J, Caldwell K ... Ali S. A Qualitative Study of the Pain Experiences of Children and Their Parents at a Canadian Children’s Hospital. Children. 2022; 9(12):1796. doi: 10.3390/children9121796
La PL, Joyce JM, Bell TK ... Craig W, et al. Brain metabolites measured with magnetic resonance spectroscopy in pediatric concussion and orthopedic injury: An Advancing Concussion Assessment in Pediatrics (A-CAP) study. Hum Brain Mapp. 2023 Feb 10. Epub ahead of print. doi: 10.1002/hbm.26226
Lamoureux E, Ishikawa T, Yeates KO ... Craig W, et al. Convergent Validity of Myheartsmap: A Pediatric Psychosocial Health Screening Tool. Child Psychiatry Hum Dev. 2023 Feb;54(1):66-75. doi: 10.1007/s10578-021-01221-7
Ma K, Ali S, Xie J, Maki C, et al. Characterizing the Pain Experience of Children With Acute Gastroenteritis Based on Identified Pathogens. J Pediatr Gastroenterol Nutr. 2023; 76(2):160-5. doi: 10.1097/MPG.0000000000003671
Meckler, GD, Alqurashi, W, Eltorki, M ... Curtis SJ ... Wright B, et al. Epinephrine metered-dose inhaler for pediatric croup. Acad Emerg Med. 2023; 30: 144-6. doi: 10.1111/acem.14616
Pillay J, Rahman S, Guitard S ... Hartling L. Risk factors and preventive interventions for post Covid-19 condition: systematic review. Emerg Microbes Infect 2022;11(1): 2762-80. doi: 10.1111/acem.14616
Poonai N, Teefy J, Van Aarsen K ... Ali S. Provision of immobilization or ice by paramedics in Southwestern Ontario. CJEM. 2023 Jan;25(1):74-80. doi: 10.1007/s43678-022-00394-x
Sader N, Gobbi D, Goodyear B ... Craig WR, et al. Can quantitative susceptibility mapping help diagnose and predict recovery of concussion in children? An A-CAP study. J Neurol Neurosurg Psychiatry. 2023 Mar;94(3):227-235. doi: 10.1136/jnnp-2022-329487
Simone L, Zemek R, Roland D ... Curtis SJ, et al. International practice patterns of IV magnesium in paediatric acute asthma. Emerg Med J. Published Online First: 07 November 2022. doi: 10.1136/emermed-2022-212642
Trottier ED, Ali S, Doré-Bergeron MJ, et al. Best practices in pain assessment and management for children. Paediatr Child Health. 2022 Dec 9;27(7):429-448. doi: 10.1093/pch/pxac048
Trottier ED, Ali S, Doré-Bergeron MJ, et al. Les pratiques exemplaires pour l'évaluation et le traitement de la douleur chez les enfants. Paediatr Child Health. 2022 Dec 9;27(7):429-448. doi: 10.1093/pch/pxac049
Vaughan CG, Ledoux A, Sady MD, ... Craig W, et al. Association Between Early Return to School Following Acute Concussion and Symptom Burden at 2 Weeks Postinjury. JAMA Netw Open. 2023;6(1):e2251839. doi: 10.1001/jamanetworkopen.2022.51839
Zello A, Kirschner D. Diagnosis of a rare pediatric case of small-bowel obstruction secondary to a phytobezoar in a Meckel's diverticulum aided by point-of-care ultrasound. CJEM. 2023 Feb 7. Epub ahead of print. doi: 10.1007/s43678-023-00463-9
