Published Online: December 5, 2011. doi:10.1001/archpediatrics.2011.1156
Accepted for Publication: September 23, 2011.
Author Contributions: Drs Nigrovic and Kuppermann had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Nigrovic, Dayan, Holmes, and Kuppermann. Acquisition of data: Lee, Hoyle, Stanley, Gorelick, Atabaki, Dayan, Holmes, and Kuppermann. Analysis and interpretation of data: Nigrovic, Miskin, and Kuppermann. Drafting of the manuscript: Nigrovic and Kuppermann. Critical revision of the manuscript for important intellectual content: Nigrovic, Lee, Hoyle, Stanley, Gorelick, Miskin, Atabaki, Dayan, Holmes, and Kuppermann. Statistical analysis: Nigrovic, Miskin, and Kuppermann. Obtained funding: Kuppermann. Study supervision: Kuppermann.
PECARN Group Members: Atlantic Health System/Morristown Memorial Hospital, Morristown, New Jersey (M. Gerardi); Bellevue Hospital Center, New York, New York (M. Tunik and J. Tsung); Calvert Memorial Hospital, Prince Frederick, Maryland (K. Melville); Children's Hospital–Boston, Boston, Massachusetts (L. Lee); Children's Hospital of Buffalo, Buffalo, New York (K. Lillis); Children's Hospital of Michigan, Detroit (P. Mahajan); Children's Hospital of New York–Presbyterian, New York (P. Dayan); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (F. Nadel); Children's Memorial Hospital, Chicago, Illinois (E. Powell); Children's National Medical Center, George Washington University School of Medicine, Washington, DC (S. Atabaki and K. Brown); Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (T. Glass); Helen DeVos Children's Hospital, Michigan State University School of Medicine, Grand Rapids (J. Hoyle); Harlem Hospital Center, New York (A. Cooper); Holy Cross Hospital, Silver Spring, Maryland (E. Jacobs); Howard County Medical Center, Columbia, Missouri (D. Monroe); Hurley Medical Center, Flint, Michigan (D. Borgialli); Medical College of Wisconsin/Children's Hospital of Wisconsin, Milwaukee (M. Gorelick and S. Bandyopadhyay); St Barnabas Health Care System, West Orange, New Jersey (M. Bachman and N. Schamban); SUNY–Upstate Medical University, Syracuse, New York (J. Callahan); University of California–Davis Medical Center, Davis (N. Kuppermann and J. Holmes); University of Maryland, Baltimore (R. Lichenstein); University of Michigan, Ann Arbor (R. Stanley); University of Rochester, Rochester, New York (M. Badawy and L. Babcock-Cimpello); University of Utah/Primary Children's Medical Center, Salt Lake City (J. Schunk); Washington University/St Louis Children's Hospital, St Louis, Missouri (K. Quayle and D. Jaffe).
Financial Disclosure: None reported.
Funding/Support: This work was supported by a grant from the Health Resources and Services Administration/Maternal and Child Health Bureau (HRSA/MCHB), Division of Research, Training and Education (DRTE), and the Emergency Medical Services of Children (EMSC) Program (R40MC02461). The Pediatric Emergency Care Applied Research Network (PECARN) is supported by cooperative agreements U03MC00001, U03MC00003, U03MC00006, U03MC00007, and U03MC00008 from the EMSC program of the MCHB/HRSA.
Online-Only Material: This article is featured in the Archives Journal Club. Go here to download teaching PowerPoint slides.
Additional Contributions: We acknowledge the efforts of the following individuals participating in PECARN at the time this study was initiated. PECARN Steering Committee: N. Kuppermann, Chair; E. Alpern, J. Chamberlain, J. M. Dean, M. Gerardi, J. Goepp, M. Gorelick, J. Hoyle, D. Jaffe, C. Johns, N. Levick, P. Mahajan, R. Maio, K. Melville, S. Miller (deceased), D. Monroe, R. Ruddy, R. Stanley, D. Treloar, M. Tunik, and A. Walker. MCHB/EMSC Liaisons: D. Kavanaugh, H. Park. Central Data Management and Coordinating Center (CDMCC): M. Dean, R. Holubkov, S. Knight, and A. Donaldson. Data Analysis and Management Subcommittee (DAMS): J. Chamberlain, Chair; M. Brown, H. Corneli, J. Goepp, R. Holubkov, P. Mahajan, K. Melville, E. Stremski, and M. Tunik. Grants and Publications Subcommittee (GAPS): M. Gorelick, Chair; E. Alpern, J. M. Dean, G. Foltin, J. Joseph, S. Miller (deceased), F. Moler, R. Stanley, and S. Teach. Protocol Concept Review and Development Subcommittee (PCRADS): D. Jaffe, Chair; K. Brown, A. Cooper, J. M. Dean, C. Johns, R. Maio, N. C. Mann, D. Monroe, K. Shaw, D. Teitelbaum, and D. Treloar. Quality Assurance Subcommittee (QAS): R. Stanley, Chair; D. Alexander, J. Brown, M. Gerardi, M. Gregor, R. Holubkov, K. Lillis, B. Nordberg, R. Ruddy, M. Shults, and A. Walker. Safety and Regulatory Affairs Subcommittee (SRAS): N. Levick, Chair; J. Brennan, J. Brown, J. M. Dean, J. Hoyle, R. Maio, R. Ruddy, W. Schalick, T. Singh, and J. Wright. We thank Sally Jo Zuspan, Rene Enriquez, and Li Dong at the PECARN Data Center (University of Utah) for their dedicated and diligent work; the research coordinators in PECARN, without whose dedication and hard work this study would not have been possible; and all the clinicians around the PECARN who enrolled children in this study.