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Pediatric Trauma Society

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WEDNESDAY, NOVEMBER 3, 2021
2:00 pm - 5:00 pm
PTS Board Meeting
5:00 pm - 6:00 pm
Program Committee Meeting
6:00 pm - 7:00 pm
Education Committee Meeting
6:00 pm - 7:00 pm
Advanced Practice Providers Committee Meeting

THURSDAY, NOVEMBER 4, 2021
7:00 am - 8:20 am
Continental Breakfast, Visit Exhibits
6:45 am - 5:00 pm
Registration
6:45 am - 5:00 pm
Speaker Ready Room
7:00 am - 5:00 pm
Exhibit Hall
7:00 am - 5:00 pm
View Scientific Posters
7:15 am - 8:05 am
Early Risers Sessions 1A* & 1B*
*Separate registration required

Early Risers 1A*: ACS Preparing for a Virtual Site Visit

Early Risers 1B*: Writing Review Articles and Their Practical Application: Collaboration between the Research and Guidelines Committee

Moderator: Rita Burke

Objectives:
  • To describe the systematic process of creating a good question for a review article
  • To describe the different types of review articles and approaches to conducting systematic reviews
  • To understand the practical application of a review article to clinical practice
Session Description: This session is a collaboration between the Research and Guidelines Committee. The session will review the types of review articles and how to select the appropriate one based on the desired purpose and outcome. We will also review the practical application of a review article to clinical practice. Participants will leave with a greater understanding of the process of selecting and creating systematic reviews, as well as the salient application to practice.

How to Develop Questions for Systematic Reviews: The Do's and Dont's
Teresa M. Bell
University of Utah School of Medicine, Salt Lake City, UT

How to Decide What Type of Review is Right for You: An Overview of Types of Reviews and Their Methodology
Julie C. Leonard
Nationwide Children's, Columbus, OH

Developing Evidence-Based Guidelines: A Practical Example from the Guidelines Committee
Mubeen A. Jafri
Oregon Health and Science University, Portland, OR
8:15 am - 8:20 am
Welcome and Opening Remarks
Terri Elsbernd, MS, RN, CEN, CPEN, TCRN
Pediatric Trauma Society President
8:20 am - 9:20 am
Invited Speaker:
Donald H. Jenkins
UTHSCSA, San Antonio, TX
9:20 am - 10:20 am
Scientific Session1A: Addressing Mental Health Needs of the Pediatric Trauma Patient
Moderator: Dan Little

Objectives:
  • Describe prevalence of mental health conditions in injured children, current knowledge gaps in the literature, and results of PTS Membership surveys on current practices of screening, treating, and preventing mental health conditions at pediatric trauma centers.
  • Describe current need for screening for mental health conditions in pediatric trauma centers and best practices for implementing screening programs.
  • Describe current state of assessing and treating mental health conditions in pediatric trauma centers and examples of best practices.
  • Identify ways trauma centers can support mental health needs throughout post-discharge recovery and community-based programs that could be developed to address ongoing mental health needs
  • Summarize current evidence base for screening, treating, and preventing mental health conditions in injured pediatric patients and future directions for research.
Session Description: This session will provide results of PTS membership surveys on current trauma center practices and needs for 1) screening for mental health conditions, 2) treating mental health conditions in patients who need psychological care, 3) supporting mental health outcomes of all patients throughout recovery. Speakers will begin by presenting background data on prevalence of mental health conditions in pediatric patients, current gaps in knowledge, and results of PTS membership surveys conducted by the injury prevention/research committee/psychology SIG task force. For objectives 2-4, each speaker will discuss best practices to provide the audience with information to advance care at their own hospital. They will also provide implementation tips and describe resources needed to implement best practices (financial, staffing, informational). The session will conclude with a summary of the evidence-based practices provided and future directions for research on addressing mental health needs of pediatric trauma patients.

Prevalence of Mental Health Conditions in Children with a History of Traumatic Injury
Teresa Bell
University of Utah School of Medicine, Salt Lake City, UT

Screening for Mental Health Conditions in Pediatric Trauma Care
TBD

Treating Mental Health Conditions in Pediatric Trauma Care
Zack Adams

Supporting Mental Health after Pediatric Trauma through Recovery and Beyond
Brian Moore

Summing Up the Evidence Base and Future Directions for Research
Rita Burke
Keck School of Medicine, University of Southern California, Los Angeles, CA
9:20 am - 10:20 am
Scientific Session 1B: Abstract Presentations
(7 minute presentation, 3 minutes discussion)
1.
Early Evaluation of the Pts Clinical Pathway for Non-operative Management of High-grade Pancreatic Trauma in Children
*Bindi Naik-Mathuria1, *Robert Russell2, *Richard Falcone3, *Brendan Campbell4, *Shawn St Peter5, Bethany Slater6, *Nathaniel Kreykes7, *Mubeen Jafri8, *Tony Escobar9, *Marianne Beaudin10, *Peter Ehrlich11, *Chad Hamner12, *David Notrica13, *Elizabeth Renaud14, *Steven Teich15, *Thomas Rouse16, *Rajan Thakar17, *Bret Engbrecht18, *Barbara Gaines19, *Hari Thangarajah20, *Ankush Gosain21, *Kuojen Tsao22, *Katie Russell23, *David Gourlay24
1Texas Children's Hospital, Houston, TX;2Children's Hospital of Alabama, Birmingham, AL;3Cincinnati Children's Hospital, Cincinnati, OH;4Connecticut Children's Hospital, Hasbro, CT;5Mercy Children's Hospital, Kansas City, TX;6Comer Children's Hospital, Chicago, IL;7Minnesota Children's Hospital, Minnesota, MN;8Oregon Children's Hospital, Portlant, OR;9Marybridge Children's Hospital, Tacoma, WA;10St Justine Children's Hospital, Montreal, BC;11Michigan Children's Hospital, Michigan, MI;12Cook Children's Hospital, Dallas, TX;13Phoenix Children's Hospital, Phoenix, AZ;14Hasbro Children's Hospital, Providence, RI;15Carolina HS University Medical Center, Charlotte, NC;16Riley Children's Hospital, Indianapolis, IN;17Nationwide Children's Hospital, Columbus, OH;18Pen State Children's Hospital, Hershey, PA;19Pittsburgh Children's Hospital, Pittsburgh, PA;20Riley Children's Hospital, San Diego, CA;21Le Bonheur Children's Hospital, Memphis, TN;22Memorial Hermann Children's Hospital, Houston, TX;23Primary Children's Hospital, Salt Lake City, UT;24Children's Hospital of Wisconsin, Milwaukee, WI
2.
Outcomes and Treatment of Blunt Cerebrovascular Injury in Children: A Prospective Observational Study
*Ruth Lewit1, *Adam Alder2, *Jeremy Johnson3, Samara Lewis3, *Todd Maxson4, *Jessica Naiditch5, *David Notrica6, Carol Rangel4, Lois Sayrs6, Rachel Stottlemyre6, Sandra Grimes1, *Trey Eubanks1
1Le Bonheur Children's Hospital, University of Tennessee Health Sciences Center, Memphis, TN;2Children's Health, Dallas, TX;3Oklahoma Children's Health, Oklahoma City, OK;4Arkansas Children's Hospital, Little Rock, AR;5Dell Children's Hospital, Austin, TX;6Phoenix Children's Hospital, Phoenix, AZ
3.
Recognizing Life-Threatening Bleeding in Pediatric Trauma: A Standard for When to Activate Massive Transfusion Protocol
Katrina M Morgan1, *Barbara A Gaines2, *Ward M Richardson2, Stephen Strotmeyer2, *Christine M Leeper1
1University of Pittsburgh Medical Center, Pittsburgh, PA;2Children's Hospital of Pittsburgh, Pittsburgh, PA
4.
Pediatric Trauma Scoring Tools That Incorporate Neurological Status
Marina L Reppucci1, Emily Cooper2, Maxene Meier2, Jenny Stevens1, Ryan Phillips1, Shannon N Acker1, Steven L Moulton1, Denis Bensard1
1Children's Hospital Colorado, Aurora, CO;2University of Colorado School of Medicine, Aurora, CO
5.
Establishing National Stakeholder Priorities for Quality Improvement In Pediatric Trauma Care: Consensus Results Using a Modified Delphi Process
*Caroline G Melhado1, *Brian K Yorkgitis2, Bhavin Patel3, Katherine Remick4, Charles G. Macias5, *Michael W. Dingeldein5, *Lisa Gray4, *Aaron R Jensen1
1University of California San Francisco, Oakland, CA;2University of Florida, Jacksonville, FL;3American College of Surgeons, Chicago, IL;4Dell Medical School at the University of Texas at Austin, Austin, TX;5Case Western Reserve University, Cleveland, OH
6.
Racial Disparities in the Evaluation of Suspected Child Abuse
Modupeola Diyaolu1, Chaonan Ye1, Ryan Han1, Hannah Wild2, Lakshika Tennakoon1, Rachel Landisch1, *David A Spain1, *Stephanie D Chao1
1Stanford Medical Center, Stanford, CA;2University of Washington, Seattle, WA
10:20 am - 10:50 am
Coffee Break: Visit Exhibits and Posters
10:50 am - 11:35 am
Scientific Session 2A: Pediatric Burn Care for the Non-Burn Center
Moderators: Heidi Altamirano & Leslie Dingeldein

Objectives:
  • To provide guidance for current protocols for burn care.
  • Discuss considerations for long-term care for pediatric burn injuries.
  • Participants will recognize potential signs of abuse in pediatric burn patients
  • Discuss psychological considerations for pediatric burn patients
Session Description: Healthcare professionals working in hospitals without burn centers often have limited knowledge of current burn care practices. The presentation will provide information for providing care and preparing for pediatric burn patients. The session intends to provide burn care information to a non-burn center or rural hospitals. The presenters will provide educational information regarding dressing and other treatments for primary burn care and long-term care considerations. Children presenting with burns may be victims of abuse, and other injuries are missed due to the burns. The presentation will use case studies to apply to information for recognizing signs of abuse in the pediatric burn patient. Burns have acute and long-term psychological impact. Presenters will discuss psychological considerations. Each speaker will have 10 minutes to present.

The Evolution of Burn Care: Current Burn Care Protocols
Kristin Braun & Katherine Flynn-O'Brien
Children's Hospital of Wisconsin, Milwaukee, WI

Aftercare Involving Lasers
Brittany Ayers
Regions Hospital, St. Paul, MN

Recognizing Signs of Abuse in the Burned Child
Kim Wallenstein, MD, PhD
Upstate Medical University, Syracuse, NY

Psychological Impact of Burn Injuries
Roberta Miller
Cook Children's Medical Center, Fort Worth, TX

Pediatric Burn Case Presentations
Mark Johnston, RN, BSN
Regions Hospital, St. Paul, MN

Panel Discussion / Question and Answer
10:50 am - 11:35 am
Scientific Session 2B: Quick Shot Abstracts
(4 minute presentation, 2 minutes discussion)
7.
An Analysis of PTSD Screening at a Level 1 Trauma Center Follow-up Clinic
*Christine Perlick1, *Stephen Strotmeyer2, *Barbara A. Gaines1, *Ward Richardson1
1UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA;2University of Pittsburgh, Pittsburgh, PA
8.
Interfacility Helicopter Transport at a Tertiary Pediatric Trauma Center
Kelli N. Patterson1, Tariku Beyene1, Katherine Bergus2, Jordan Stafford2, LeeAnn Wurster1, *Rajan Thakkar1
1Nationwide Children's Hospital, Columbus, OH;2Ohio State University, Columbus, OH
9.
Safe Pediatric Ground Ambulance Transport: A Systematic Review
Anne R. Stoklosa1, Michelle L. Zafron1, Brittany L. Cantor1, *Denise F. Lillvis2, *Kathryn D. Bass2
1University at Buffalo, Buffalo, NY;2John R. Oishei Children's Hospital, Buffalo, NY
10.
Right Place in the First Place - An EMS PI Initiative
*Tiffany Taylor, *Joshua Dugal
SSM Health Cardinal Glennon Children's Hospital, St. Louis, MO
11.
Utility of Screen Tests to Predict Clinically Relevant Liver Injuries
*Marla Ashley Sacks1, Ethan Miles2, Emily Gunderson2, Yomara S. Mendez1, John Tan1, Laura Goodman1, Asra Hasmi3, Andrei Radulescu1, Faraz A. Khan1
1Loma Linda University Children's Hospital, Loma Linda, CA;2Loma Linda University School of Medicine, Loma Linda, CA;3Loma Linda University Medical Center, Loma Linda, CA
12.
Disparities in Isolated, Serious, Blunt Splenic Injury Outcomes for Pediatric Patients
Whitney Orji, Robert Swendiman, Nicolas Muñoz, Myron Allukian, III, *Gary Nace, *Michael Nance
University of Pennsylvania, Philadelphia, PA
13.
Load Leveling During A Covid-19 Surge: Strategic Redistribution of Prehospital Pediatric Trauma Patients to Create Capacity in Adult Hospital
*Romeo C. Ignacio, Jr.1, Candy Schonheit2, Kristi L. Koenig2, Joshua Smith2, Matthew Derkrikorian1, Brandt Sisson3, Tim Fairbanks1, Hariharan Thangarajah1, David Lazar1
1Rady Children's Hospital San Diego, San Diego, CA;2County of San Diego, Health & Human Services Agency, San Diego, CA;3Department of General Surgery, Naval Medical Center San Diego, San Diego, CA
11:35 am - 11:45 am
Research Grant Presentation
11:45 am - 12:00 pm
PTS Lifetime Achievement Award Presentation
Introduced by: Terri Elsbernd, MS, RN, CEN, CPEN, TCRN
Recipient: Kathy Haley, RN, MS
12:00 pm - 1:00 pm
Lunch Break
1:00 pm - 2:15 pm
Scientific Session 3: STN Award Presentation & Abstract Session
(7 minute presentation, 3 minutes discussion)
14.
STN Award Winner: Using the 5s Methodology to Improve Efficiency, Maintain Organization, and Analyze Cost-effectiveness of a Trauma Resuscitation
*Jency Philipose, *Jennifer Zapke, *Danielle Sargeant, Chris Boukas, *Francesca Bullaro
Cohen Children's Medical Center, New Hyde Park, NY
15.
Years of Declining Pediatric Firearm Injuries Reversed By Rise in Self-inflicted And Unintentional Injuries At Home
Adrian Camarena1, Lea Hoefer2, Kelly Twohig2, Ann Polcari2, Robert Keskey2, Danielle LaVigne2, Kenneth Wilson2, *Mark Slidell2, David Hampton2
1Duke, Durham, NC;2The University of Chicago, Chicago, IL
16.
Disparities in Rural and Urban Pediatric Trauma Outcomes: A State-wide Retrospective Cohort Study
*Caroline Q Stephens1, David P Lehrfeld2, Elizabeth Dewey3, *Nicholas A. Hamilton3, Craig Newgard3, *Sanjay Krishnaswami3
1University of California- San Francisco, San Francisco, CA;2Oregon Health Authority, Portland, OR;3Oregon Health and Science University, Portland, OR
17.
An Evaluation of Pediatric Trauma Triage Employing the Need for Trauma Intervention Metric In Comparison To the Cribari Method
Krista J Stephenson, *Deidre L Wyrick, Melvin S Dassinger, Lori A Gurien, Patrick C Bonasso, *Robert T Maxson
University of Arkansas For Medical Sciences, Little Rock, AR
18.
Compliance with Non-Accidental Trauma Bundle with Resulting Outcomes
Ameer Al-Hadidi, Kevin Dolan, Dana L Noffsinger, Berkeley L Bennett, *Rajan K Thakkar, Megan M Letson, Kristin G Crichton
Nationwide Children's Hospital, Columbus, OH
19.
Hollow Viscus Injuries in Children: Tools for Diagnosis and Timing of Intervention
Lindsay Dean1, Steven Mehl1, Lucy Hart1, Brittany Johnson2, *Adam Vogel2, *Sara Fallon2, *Bindi Naik-Mathuria2
1Baylor College of Medicine, Houston, TX;2Texas Children's Hospital, Houston, TX
20.
Application of a Thoracic Ct Decision Rule in the Evaluation of Injured Children: A Quality Improvement Initiative
*Katie Downie1, Alicia McIntire1, Joseph Tobias2, *Sanjay Krishnaswami3, *Mubeen Jafri2
1Legacy Emanuel/Randall Children's Hospital, Portland, OR;2OHSU, Portland, OR;3OSHU, Portland, OR
2:15 pm - 2:45 pm
Coffee Break: Visit Exhibits and Posters
2:45 pm - 3:45 pm
Local Case Study Session
Multiple Gunshot Wounds to the Abdomen
Isam W. Nasr
Johns Hopkins Children's Center, Baltimore, MD

Complexity at It's best
Jennifer Fritzeen
Children's National Hospital, Washington, DC
4:00 pm - 6:00 pm
Nurse Leadership Committee Meeting
4:00 pm - 5:00 pm
Injury Prevention Committee Meeting
5:00 pm - 6:00 pm
Membership Committee Meeting
6:00 pm - 7:00 pm
Guidelines Committee Meeting
6:00 pm - 7:00 pm
Research Committee Meeting

FRIDAY, NOVEMBER 5, 2021
7:00 am - 5:15 pm
Registration
7:00 am - 5:15 pm
Speaker Ready Room
7:00 am - 6:00 pm
Exhibit Hall
7:00 am - 6:00 pm
View Scientific Posters
7:00 am - 8:00 am
Continental Breakfast, Visit Exhibits
7:15 am - 8:05 am
Early Risers Sessions 2A* & 2B*
* Separate registration required

Early Riser 2A*: How to PI: The 411 on Trauma PI Process
Moderators: Kara Mitchell, MSN, RN, CPEN & Susan Ziegfeld, MSN, PNP-BC, CCRN

Objectives:
  • The learner will be able to recognize opportunities for improvement
  • The learner will be able to identify the key stakeholders required to navigate the PI process
  • The learner will be able to identify action items to address opportunities for improvement identified
  • The learner will be able to develop a plan for PI loop closure
  • The learner will be able to recognize the importance of evaluating trends overtime
Session Description: This early riser session is designed for the new trauma program manager and/or trauma coordinator who are interested in learning more about navigating the PI process. This interactive session focuses on a deep dive into a pediatric trauma case for the learner to identify, develop and evaluate the PI issues. The learners will be able to navigate the PI process through interactive discussion with peers and the expert panel. Interactive case discussion will allow the learners to navigate the pros and cons of the trauma PI process and discuss how then trauma leadership team can address and ensure loop closure.

Nurse Leader Mentor
Lisa Nichols MBA, BSN, RN, CCRN-K
Wolfson Children's Hospital, Jacksonville, FL

Nurse Leader Mentee
Alita Lanoux, MSN, RN, CPN
Our Lady of the Lake Children's Hospital, Baton Rouge, LA

QI SIG Chair
Trey Babino, BSN, RN, CEN
Texas Children's Hospital, Houston, TX

Clinical Data Abstractor
Patsy Williamson, DNP, RN, CPN
Wolfson Children's Hospital, Jacksonville, FL

Trauma Medical Director
Mark B. Slidell, MD, MPH
The University of Chicago, Chicago, IL

Panel Discussion
Early Risers 2B*: Initiating Screening Programs for Mental Health Conditions in Pediatric Trauma Centers
Moderator: Dan Little

Objectives:
  • Describe prevalence of mental health conditions in injured children and need to increase screening around various mental health conditions, including PTSD
  • Describe how to develop protocols for conducting screenings that address who perform screenings, when they are conducted, what format they are conducted in (in-person, virtually), how results are recorded and communicated.
  • Provide a summary of the appropriate screening tools to use for each mental health condition and patient age group.
  • Identify best practices for providing referrals or treatment for patients that screen positive for a mental health condition.
  • Identify best practices for providing referrals or treatment for patients that screen positive for a mental health condition.
Session Description: This session will provide the audience with information to begin developing a mental health screening program at their trauma center. It will cover protocol development, screening tool choice, best practices for referring patients to mental health services, and strategies for implementing screening protocols. It will also address resource needs and ways to adapt protocols in hospitals with greater financial constraints.

Prevalence of Mental Health Conditions in Children with a History of Traumatic Injury and Need to Increase Surveillance
Teresa Bell
University of Utah School of Medicine, Salt Lake City, UT

Developing a Screening Program Protocol
Sarah A. Ostrowski-Delahanty, PhD, MBA
Akron Children’s Hospital, Akron, OH

Trauma Informed Care and Violence Recovery Programs (7 minute presentation)
Mark B. Slidell, MD, MPH
The University of Chicago, Chicago, IL

Current State of Screening for Post Traumatic Mental Health Disorders in Children – Results of National PTS Survey
Carisa Parrish
Johns Hopkins School of Medicine, Baltimore, MD

Best Practices for Referring Patients to Mental Health Services
Gina Berg
Wesley Medical Center, Wichita, KS
8:15 am - 9:15 am
Scientific Session 4A: Beyond the Trauma Bay: Exploring the Role of the Trauma APP
Moderators: Brandi Farrel & Elizabeth Waibel
Session Description: The panel will be discussing the Role of the APP in Pediatric Trauma Care. We will have two APPs, a Trauma Program Manager, and a Trauma Medical Director (MD) to address the following objectives.

Objectives:
  • Define and review the evolving role of the APP in pediatric trauma team, specifically roles other than direct patient care such as: education, quality improvement, research, etc.
  • Discuss how a trauma APP can prove their effectiveness and improve care provided to pediatric trauma patients.
  • Summarize the value of the APP in the trauma team and how to justify the financial costs of these professionals (budgeting for the APP).
  • Identify the leadership opportunities for APPs in the pediatric trauma role.
Panelists: Kathryn D. Bass, MD, MBA
SUNY at Buffalo, Buffalo, NY

Jen Fritzeen, MSN
Children's National Medical Center, Washington, DC

Maria Bautista Durand, MSN, FNP-C, PNP
Children's Hospital Los Angeles, Los Angeles, CA

Richele Koehler, PA-C
Children's Hospital Colorado, Aurora, CO

Panel Discussion
8:15 am - 9:15 am
Scientific Session 4B: Injury Prevention and Outreach during the COVID-19 Era
Moderator: Kelly L. Wiseman, MSBS, PA-C

Objectives:
  • Attendees will understand baseline pediatric injury trends and changes to these trends in the COVID-19 era.
  • Attendees will reflect on COVID-19 era injury trends and consider new modalities for outreach and injury prevention.
  • Attendees will discuss changes to injury prevention due to social distancing and the COVID-19 pandemic.
  • Attendees will learn the benefit of using social media for injury prevention, how to incorporate social media into their home program, and review creative examples of injury prevention during the COVID-19 pandemic.
Session Description: The COVID-19 Pandemic started in early 2020. In addition to the challenge of understanding, diagnosing, and treating a novel disease, there was a sudden renewed focus on public health policy. Social distancing, closures of businesses, and transitions to virtual education changed our way of life in the United States and abroad. Throughout the COVID-19 pandemic we have seen changes to typical pediatric injury trends. Current literature suggests that some injury patterns such as fractures, sports injuries, and motor vehicle accidents are decreasing. Some changes may be related to lack of typical childhood activities, such as organized sports and recess, while evaluation of changes to incidence of abusive pediatric trauma may be more complicated. It is important for pediatric caregivers to be aware of the changes in common injury types, as well as potential differences by region, community, or trauma program. The COVID-19 pandemic has also changed the way in which we provide education and outreach, both internally within medical facilities and in outreach to our communities. Pediatric trauma centers have been challenged with enhancing injury prevention while maintaining the principles of social distancing. Previous activities such as bike safety gatherings and personal in-vehicle car seat checks have been replaced with virtual events and small group opportunities. We will discuss novel and creative injury prevention programming during the pandemic, with special emphasis on the benefits and challenges of developing a social media campaign. Many of the "forced” lesions learned during the pandemic will continue to be valuable tools for child injury prevention even after we return to a new societal normal.

Shifts in Pediatric Injury Trends during the COVID-19 Pandemic

Changes in Regional Injury Trends from Multiple Institutions
Kelly L. Wiseman, MSBS, PA-C
Akron Children's Hospital, OH

Cindy Colson, MSN, RN
Children's National, Washington DC

Kayla Cehand MSN, RN, NEA-BC, CPN, CPST
McLane Children's Medical Center / Baylor Scott and White, Temple, TX

Heidi Altamirano, RN, MS
Region's Hospital, Saint Paul MN

Pivoting Injury Prevention Efforts during a Pandemic
Tanya Charyk Stewart, MSc
London Health Sciences Centre, Ontario, Canada

Enhancing Injury Prevention and Outreach with Social Media
Cindy Colson, MSN, RN
Children's National, Washington DC

Panel Discussion / Question and Answer
9:15 am - 9:45 am
Coffee Break: Visit Exhibits and Posters
9:45 am - 10:45 am
Scientific Session 5: Joseph Tepas Paper Competition - Part 1
(7 minute presentation, 3 minutes discussion)
21.
Venous Thromboembolic Screening In Pediatric Trauma: A Prospective Cohort Study Of Risk-stratified Ultrasonography Reveals Significant Hidden Morbidity
Joseph Tobias, Aaron Cunningham, Alexandra Dixon, Daniel F. Labuz, Lori Moss, Elizabeth Dewey, Kristina Haley, Erin Burns, Martin Schreiber, Rachel Wilson, *Nicholas A. Hamilton, *Mubeen A. Jafri
Oregon Health & Science University, Portland, OR
22.
Pediatric Shock Index Outperforms SIPA in Predicting Mortality, PICU Admission, and Need for Transfusion
Nathan Georgette1, Robert Keskey2, David Hampton2, Emily Alberto3, Nikunj Chokshi1, Tanya Zakrison2, Kenneth Wilson2, Alisa McQueen1, *Randall Burd3, *Mark Slidell1
1Comer Children's Hospital at the University of Chicago, Chicago, IL;2University of Chicago Medical Center, Chicago, IL;3Children's National Hospital, Washington, D.C., DC
23.
Pediatric Damage Control Resuscitation: Are They Really Small Adults?
Omar Obaid, Adam Nelson, *Marion Henry, Molly Douglas, Lourdes Castanon, Letitia Bible, Michael Ditillo, Lynn Gries, Andrew Tang, Bellal Joseph
University of Arizona, Tucson, AZ
24.
Clinical And Radiographic Predictors Of The Need For Facial Ct In Pediatric Blunt Trauma: A Multi-institutional Study
Brittany Nguyen1, *Mary J Edwards1, Shachi Srivatsa1, *Derek Wakeman2, Brittany Cantor3, Thais Calderon2, *Abdularouf Lamoshi4, *Kim Wallenstein5, Mitchell Chess2, Tiffany Fabiano6, Richard Thomas6, *Kathryn Bass6
1Albany Medical Center, Albany, NY;2University of Rochester Medical Center, Rochester, NY;3John R Oishei Children's Hospital, Bufflao, NY;4Cohen Children's Medical Center, Queen's, NY;5SUNY Upstate Medical Center, Syracuse, NY;6John R. Oishei Children's Hospital, Buffalo, NY
25.
Failure-to-rescue After Emergent Trauma Laparotomy: Does It Apply to Children?
Omar Obaid, Letitia Bible, *Marion Henry, Tanya Anand, Michael Ditillo, Lynn Gries, Adam Nelson, Molly Douglas, Lourdes Castanon, Bellal Joseph
University of Arizona, Tucson, AZ
10:45 am - 12:00 pm
Scientific Session 6A: Nurse Leadership: Everything is Better in Hindsight
Moderators: Susan Ziegfeld, MSN, PNP-BC, CCRN & Kara Mitchell, MSN, RN, CPEN

Objectives:
  • Identify an opportunity for improvement occurring with a trauma patient that will impact the care of future pediatric trauma patients
  • Explain the development and implementation of the action plan leading to loop closure
  • Discuss challenges and opportunities encountered in the loop closure process
Session Description: This break out session is designed for clinicians who are interested in using the performance improvement process to identify, develop and evaluate issues affecting patient care. This interactive session will walk the participant through the PI process of two unique cases. Each case will include recognition of an opportunity for improvement, evaluation of the issue, and implementation of an action plan leading to change. A panel of trauma program managers, from novice to expert, will lead the discussion of the presented cases challenging the audience to identify barriers they may face in their trauma centers, provide additional interventions that may work better at different trauma center, and share strategies for successful loop closure.

Airway Stabilization in Pediatric Trauma Patients
Carly Farner-Cordell
Sanford USD Medical Center, Sioux Falls, SD

DVT Prohpylaxis
Krista Easley
BSW - McLane Children's Medical Center, Temple, TX

10:45 am - 12:00 pm
Scientific Session 6B: Quick Shot Abstracts
(4 minute presentation, 2 minutes discussion)
26.
Novel Technique for High-tension Repair of Complex Traumatic Sternal Fractures: Zip for a Fix
Katrina M Morgan1, Kathryn T Anderson2, *Barbara A Gaines2, *Stefan Scholz2
1UPMC, Pittsburgh, PA;2Children's Hospital of Pittsburgh, Pittsburgh, PA
27.
Investigating The Presence Of A Radial Bubble As A Cast Index To Predict Redisplacement Following Closed Reduction Of Distal Forearm Fractures In Children
Bryn Gornick1, Jonathan Semaan2, Matthew Weber3, John Schlechter4
1CHOC Children's Hospital, Orange, CA;2Western University of Health Sciences, Pomona, CA;3Riverside University Health System, Riverside, CA;4Pediatric Orthopedic Specialists of Orange County, Orange, CA
28.
Comparison of Whole Body Computed Tomography (WBCT) Utilization between Pediatric and Adult Trained Providers In Adolescent Trauma Activations
Bergthor Jonsson, Tyler W Ellis, *Denise B Klinkner, Aidan F Mulllan, James L Homme
Mayo Clinic, Rochester, MN
29.
Relationships between Socioeconomic Deprivation and Pediatric Firearm related Injury at the Neighborhood Level
*Meera Kotagal, Cole Brokamp, Andrew Vancil, Dawne Gardner, *Suzanne Moody, Carley Riley, Rashmi Sahay, Nicole Sofer, Andrew F. Beck, *Richard A. Falcone, Jr.
Cincinnati Children's Hospital Medical Center, Cincinnati, OH
30.
Low Titer Group O Whole Blood Utilization in Pediatric Trauma Resuscitation: A National Survey
Dana Meshkin1, Mark Yazer1, Nancy Dunbar2, Philip Spinella3, *Christine M Leeper4
1University of Pittsburgh, Pittsburgh, PA;2Dartmouth-Hitchcock, Lebanon, NH;3Washington University in St Louis, St Louis, MO;4Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA
31.
Assessing the Variability of Antibiotic Management in Patients with Open Hand Fractures Presenting To the Pediatric Emergency Department
Sophia Gorgens, Deepa Patel, Kaitlin Keenan, Joanna Fishbein, *Francesca Bullaro
Northwell Health, New Hyde Park, NY
32.
Screening for Child Abuse in Children with Isolated Skull Fractures
Stephanie Y Chen1, Leland Gao2, Karen K Imagawa1, Eric R Roseman1, Cathy E Shin1, Eugene S Kim1, Ryan Spurrier1
1Children's Hospital Los Angeles, Los Angeles, CA;2Keck School of Medicine of the University of Southern California, Los Angeles, CA
33.
An Innovative Individual-level Socioeconomic Measure Identifies Disparities among Injured Children at a Level 1 Trauma Center
Rebecca Zhu, Yu Shi, Chung Il Wi, Amy Glasgow, Young Juhn, *Stephanie Polites
Mayo Clinic, Rochester, MN
34.
Population Density and Triage of Pediatric Firearm Injuries in a Predominantly Rural State Trauma System
*Taylor Shaw, Hannah Cockrell, Kristen Carter, David Sawaya, Michael Morris, *Matthew Kutcher, Barry Berch
University of Mississippi Medical Center, Jackson, MS
35.
Patterns of Bicycle Rider Injury Defined by Latent Class Analysis
*Joseph Piatt
A I Dupont Hospital for Children, Wilmington, DE
36.
Impact Of Simulation-based Clinical Systems Testing on Transition to an Independent Pediatric Trauma Center
Sacha Williams, Jennifer Arnold, Katie Fitzpatrick, *Christopher Snyder
Johns Hopkins All Children's Hospital, St Petersburg, FL
37.
Association of Individual and Neighborhood Social Determinants of Health with Non-accidental Trauma
Steven C. Mehl, Hannah Todd, Tim Singer, Abiodun Oluyomi, Omar Rosales, *David E. Wesson, *Adam M. Vogel, Trey Babino, Chris Greeley, *Bindi Naik-Mathuria
Baylor College of Medicine, Houston, TX
38.
Inaccuracies in Registry Data Regarding Shooting Intent for Pediatric Firearm Injuries
*Bindi Naik-Mathuria1, Elisa Benavides2, Marie Kasbaum2, *Trey Babino1, Aden Feustel2, Rosemary Demet2, Lisa Pompeii2
1Texas Children's Hospital, Houston, TX;2Baylor College of Medicine, Houston, TX
12:00 pm - 1:00 pm
Lunch Break
1:00 pm - 1:15 pm
Introduction of the President
Jill M. Hunchis, APRN, CNP
Mayo Clinic, Rochester, MN

Lee Ann Wurster, RN
Nationwide Children's Hospital, Columbus, OH
1:15 pm - 2:00 pm
Presidential Address
Pathway To Success
Not Easy But Worth the Fight

Terri Elsbernd, MS, RN, CEN, CPEN, TCRN Mayo Clinic Hospital, Rochester, MN
2:00 pm - 3:00 pm
Scientific Session 7: Joseph Tepas Paper Competition - Part 2
(7 minute presentation, 3 minutes discussion)
39.
Relationship between Posttraumatic Stress Symptoms, Risk For Posttraumatic Stress Symptoms, And Pain in Children after Unintentional Injury
*Anna Monica Agoston, Amina Bhatia, John Bleacher, Karen Hill, Maia Routly
Children's Healthcare of Atlanta, Atlanta, GA
40.
Characterizing Physical Trauma in Children and Youth with Special Health Care Needs
*Denise F. Lillvis1, Karen M. Sheehan2, Jihnhee Yu3, Katia Noyes3, *Kathryn D. Bass1, Dennis Z. Kuo3
1John R. Oishei Children's Hospital, Buffalo, NY;2Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL;3University at Buffalo, Buffalo, NY
41.
Prehospital Analgesia for Children with Long Bone Fractures: Should We Be Doing More?
*Garrett D. Hall1, Remle P. Crowe1, Antonio R. Fernandez1, Scott S. Bourn1, *Bindi Naik-Mathuria2, Sally K. Snow3, Katherine Remick4, J. Brent Myers1
1ESO, Austin, TX;2Baylor College of Medicine / Texas Children's Hospital, Houston, TX;3Independent Pediatric Emergency and Trauma Nursing Consultant, Graham, TX;4University of Texas Dell Medical School, Austin, TX
42.
Mental Health Screening and Follow Up In Pediatric Trauma Centers: A National Survey of 82 Centers and Mixed Methods Evaluation
*Leigh E. Ridings1, Hannah C Espeleta1, Olivia Bravoco1, Tatiana Davidson1, Nicole Litvitsky1, *Nancy Kassam-Adams2, *Christian Streck1, Kenneth Ruggiero1
1Medical University of South Carolina, Charleston, SC;2Children's Hospital of Philadelphia, Philadelphia, PA
43.
It Takes Two: Child Passenger Safety Technicians (CPSTs) and Pediatric Rehabilitation Clinicians Unite To Address Challenges Associated With Proper Car Seat Restraint in Children with Special Needs
*Michelle Price, *Angela Campos, Stephanie Lyons, Melissa Tally, Patrick Edmunds, *Meera Kotagal, *Richard A Falcone, *Rebeccah L Brown
Cincinnati Children's Hospital Medical Center, Cincinnati, OH
3:00 pm - 3:30 pm
Coffee Break: Visit Exhibits and Posters
3:30 pm - 4:30 pm
Scientific Session 8A: Predicting and Enhancing Outcomes in Traumatic Brain Injury
Moderators:

Objectives:
  • Describe the tools available to predict outcomes from a traumatic brain injury (TBI)
  • Recognize the heterogeneity of traumatic brain injuries and the associated difficulty with early prognostication.
  • List the therapies available to enhance functional recovery.
Session Description: Traumatic brain injury (TBI) present new changes in function at the onset of trauma. Providers, patients and caregivers are often faced with the difficulty of attempting to project functional outcomes despite either limited or vague data available to do so. These questions most commonly occur in the acute phase of care, when prognostication is difficult yet often quite valuable for making care decisions. The evidence base behind prognostication in acute TBI will be discussed, along with cases to illustrate these scenarios. The topic of provider message delivery will also be discussed, as there is a host of qualitative literature in brain injury regarding how families would like to have a prognosis presented to them. We will then discuss the resolution of the cases (including videos of outcomes) and how the models were utilized to predict these outcomes. Lastly, time will be spent discussing optimization of outcomes under the angle that majority of outcome optimization occurs within the first week of trauma care. Time will be left for discussion and Q&A, with a planned speaking time of 50-55 minutes.

Early Intervention of TBI
Jennifer Smid
Wake Forest Baptist Medical Center, Winston Salem, NC

Predicting Outcomes in TBI
Nathan Rosenberg
Nationwide Children's Hospital, Columbus, OH

Guideline Based Operative and Medical Intervention in TBI
Eric Sribnick
Nationwide Children's Hospital, Columbus, OH
3:30 pm - 4:30 pm
Scientific Session 8B: Quick Shot Abstracts
(4 minute presentation, 2 minutes discussion)
44.
Sledding Behind Motorized Vehicles Associates with More Severe and Lethal Injuries
David N. Hanna, Zaid Haddadin, Caroline Godfrey, Brittney Aiello, Amber L. Greeno, *Harold N. Lovvorn, III
Vanderbilt University Medical Center, Nashville, TN
45.
Epidemiology of Pediatric Trauma at A National Kenyan Referral Hospital
Manisha B. Bhatia1, Helen Li1, Eunice Chepkimoi2, Emmy Jepkurui Rutto2, Kyle Carpenter1, Jessica Hogan3, Connie Keung1, Joshua Kisorio2
1Indiana University, Indianapolis, IN;2Moi Teaching and Referral Hospital, Eldoret, Kenya3University of Alberta, Edmonton, AB, Canada
46.
Psychological Screening Rates of Pediatric Burn Patients across 5 Pediatric Burn Centers
*Carisa Parrish1, Sarah VerLee2
1Johns Hopkins School of Medicine, Baltimore, MD;2Nationwide Children's Hospital, Columbus, OH
47.
Rural Vs Urban Mechanism of Injury in Pediatric Trauma Fatalities
Samara L. Lewis
Oklahoma Children's Hospital, Oklahoma City, OK
48.
The Health Equity Network: Using Quality Improvement Methodology in a Learning Network to Improve Equity in the Care of Trauma Patients
*Meera Kotagal, *Allison Bailey, *Erin Butt, Nora Buzek, Dawne Gardner, Robert Kahn, Dimitrios Makrozahopoulos, *Suzanne Moody, Carley Riley, *Kaaren Shebesta, Ndidi Unaka, *Richard A. Falcone, Jr., Andrew F. Beck
Cincinnati Children's Hospital Medical Center, Cincinnati, OH
49.
A Quality Improvement Project Using Simulation to Improve Nursing Confidence and Skills and Promote Teamwork during High Acuity, Low Occurrence Clinical Events In The Pediatric Intensive Care Unit
Kimberly Torrey-White1, Laura Gary1, Amber Bergson1, Jennette Flynn1, Mindi Driehorst1, Russ Siekman1, Frances Prekker1, *Tina Slusher1, Kelly Maynard1, Glenn Paetow1, V.N. Vimal Rao2, Lori Hendrickx3, *Ashley Bjorklund1
1Hennepin County Medical Center, Minneapolis, MN;2University of Minnesota, Minneapolis, MN;3South Dakota State University, Brookings, SD
50.
Stopping the Bleed on the Streets: Teaching Hemorrhage Control at the Source of Violence
*Steve Weinman, *Tracy Evans
St. Joseph's University Medical Center, Paterson, NJ
51.
Clearance of the Cervical Spine In Obtunded Pediatric Blunt Trauma Patients: Quality Assessment of an Existing Clearance Pathway
Rachel Kalthoff1, Elizabeth Boudiab2, Diane Studzinski2, Nathan Novotny3, Pavan Brahmamdam3, *Begum Akay3
1Oakland University William Beaumont School of Medicine, Rochester, MI;2Beaumont Health, Royal Oak, MI;3Beaumont Children's, Royal Oak, MI
52.
Big Kids: Application of a Modified Brain Injury Guideline in a Pediatric Trauma Center
Allison G McNickle1, *Stephanie A Jones1, Mais Yacoub2, Stephanie M Streit1, Dina Bailey2, Judith Ben Ari2, Douglas R Fraser1
1Kirk Kerkorian School of Medicine at Unlv, Las Vegas, NV;2University Medical Center of Southern Nevada, Las Vegas, NV
53.
Children Caught in the Crossfire: A Decade of Firearm Injuries
Anne Sescleifer1, Emily Onufer2, *Jose Greenspon1, *Martin Keller2
1Saint Louis University School of Medicine, St. Louis, MO;2Washington University in St. Louis School of Medicine, St. Louis, MO
4:30 pm - 5:15 pm
Scientific Session 9A: Pediatric Disaster Management: Now is the Time Partnerships
Moderators: Rita Burke, PhD & Christopher Newton, MD

Objectives:
  • To identify and understand key terms, concepts, definitions, facilitators and barriers in establishing a coordinated pediatric disaster response.
  • To identify strategies for implementing a coordinated regional pediatric disaster response.
  • To provide cutting edge best practices resources, tools and training for pediatric disaster preparedness that have emerged as a result of the effort.
Session Description: In 2019, the Assistant Secretary for Preparedness and Response funded two pilot sites to create centers of excellence for comprehensive regional pediatric disaster management: Eastern Great Lakes Pediatric Consortium for Disaster Response led by University Hospitals Rainbow Babies and Children's Hospital of Cleveland and the Western Region Alliance for Pediatric Emergency Management led by University of California, San Francisco (UCSF) Health System and UCSF Children's Hospitals. The focus of both sites quickly changed in early 2020 as SARS-CoV-2 spread in the US and grant partners had to pivot in the response. Since then, many strengths and opportunities for improvement have begun to emerge as part of our national and regional preparedness and response efforts.

One advantage of establishing the regional centers of excellence has been the inclusion and integration of the multiple different efforts nationally from numerous organizations. This session will attempt to highlight at the PTS annual meeting the programs and plans for the coming year from federal agencies, partner societies (the AAP), and other funded national programs. The intent will be not only to educate our membership, but to expand PTS scope to serve as the hub for idea exchanges, integration and collaboration in this focus area.

MSC and EIIC Project Updates and Plans for the Coming Year
Charles G. MacIas
Texas Children's Hospital, Houston, TX

The AAP Committee on Children and Disasters: Evolution of the Group and Plans for the Future
Steve Krug

Federal Programs for Pediatric Disaster Management and the National Advisory Council on Children in Disasters
Andy Garrett

Perspectives and Programs from the ACS-COT and the AAST
Deb Kuhls
4:30 pm - 5:15 pm
Scientific Session 9B: Quick Shots
(4 minute presentation, 2 minutes discussion)
54.
A Novel Rapid Fluid Infusion Device for Pediatric Trauma
*Mark Piehl1, Lisa C Wanda2, Elaine N. James1, Jianyong Wu3, Valerie J De Maio2
1WakeMed, Raleigh, NC;2University of North Carolina, Chapel Hill, NC;3Data Explorer LLC, Chapel Hill, NC
55.
Implementation of Universal Screening for Food Insecurity At a Level One Pediatric Trauma Center: A Novel Initiative
Matthew Krock, Edward Barksdale, Jr.
University Hospitals Rainbow babies & Children's Hospital, Cleveland, OH
56.
To Ct or Not to Ct: A Level2 Pediatric Trauma Center's Aim to Reduce Ionizing Radiation in Pediatrics and Adolescents
*Aaron Isaiah Worthley, Heather Rhodes, Nasser Mohammad, Stephanie Howerton, Jennifer Morse, Alison Burns, Laura Strickland, Antonio Pepe, Robert Horton, Summer Rabon, Christina Catlla
Grand Strand Medical Center, Myrtle Beach, SC
57.
Community Grand Rounds: Enhancing Pediatric Education and Care Practices Across the Spectrum of Care
*Lana Martin, *John Bealer
Children's Hospital Colorado - Colorado Springs, Colorado Springs, CO
58.
Factors of Survival for Pediatric Patients <15 with Gunshot Wounds
Teresa Evans, Keren Guiab, Faran Bokhari
Cook County Hospital, Chicago, IL
59.
Development of a Clinical Pathway for Management of Mild Traumatic Brain Injury at a Level IV Pediatric Trauma Center
Krista Stephenson, Heather Kimbro, *Marcene McVay-Gillam
University of Arkansas For Medical Sciences, Little Rock, AR
60.
Time to Definitive Surgery in Pediatric Patients <18 years with Gunshot Wounds.
Teresa Evans, Keren Guiab, Faran Bokhari
Cook County Hospital, Chicago, IL
5:15 pm - 6:15 pm
Reception and Scientific Poster Competition

SATURDAY, NOVEMBER 6, 2021
7:30 am - 12:00 pm
Registration
7:30 am - 12:00 pm
Speaker Ready Room
7:30 am - 8:00 am
Continental Breakfast
8:00 am - 9:00 am
PTS Membership Meeting (Members Only)
9:00 am - 9:15 am
Tepas Award Presentations
STN Award Presentations
Poster Award Presentation

Michael Nance, MD
Pediatric Trauma Society President-Elect
9:15 am - 9:25 am
Introduction of Keynote Speaker
Terri Elsbernd, MS, RN, CEN, CPEN, TCRN
Pediatric Trauma Society President

Kathy Haley, RN, MS
Nationwide Children's Hospital, Columbus, OH
9:25 am - 10:15 am
Keynote Address
David P. Mooney, MD, MPH
Boston Children's Hospital, Boston, MA
10:15 am - 11:15 am
Scientific Session 10: Papers That Should Change Your Practice: Current Trauma Literature: A Year in Review of Pediatric Trauma
11:15 am - 12:00 pm
Scientific Session 11: Quick Shots
(4 minute presentation, 2 minutes discussion)
61.
Pediatric Foregut Trauma: A National Trauma Data Bank Overview
Niloufar Hafezi1, *Jodi L Raymond2, *Matthew P Landman1
1Indiana University School of Medicine, Indianapolis, IN;2Riley Trauma Program at Indiana University Health, Indianapolis, IN
63.
Ethnoracial and Socioeconomic Disparities in Pediatric Burn Care in Southern Connecticut
Nensi Melissa Ruzgar1, Griffin Coghill2, *Patricia Morrell3, Alisa Savetamal3, *Emily Christison-Lagay3
1Yale School of Medicine, New Haven, CT;2New York Medical College, Valhalla, NY;3Department of Surgery, Yale School of Medicine, New Haven, CT
64.
Neurologic Outcomes for Pediatric Trauma Patients Who Require Cardiopulmonary Resuscitation In The Trauma Bay
Ryan Eaton1, Sarah Durisek1, *Lee Ann Wurster2, *Morgan Wurtz2, *Eric A Sribnick2
1The Ohio State University, Columbus, OH;2Nationwide Children's Hospital, Columbus, OH
65.
Improving Educator Recognition of Abuse and Neglect in the Virtual Classroom Setting
Jerica Ramos, John Kinnison, *Shannon Castle
Valley Children's Hospital, Madera, CA
66.
Pediatric Trauma Epidemiology During The Covid-19 Pandemic And Sociopolitical Unrest Of 2020: A Multi-institutional Study
Amelia T. Collings1, Manzur Farazi2, Thomas Sato2, *Mary E. Fallat3, Peter C. Minneci4, Kyle Van Arendonk2, K. Elizabeth Speck5, Rashmi Kabre6, *Katherine Flynn-O'Brien2
1Department of Surgery, Indiana University School of Medicine, Indianapolis, IN;2Children's Hospital of Wisconsin, Milwaukee, WI;3Hiram C. Polk, Jr Department of Surgery, University of Louisville and Norton Children's Hospital, Louisville, KY;4Center for Surgical Outcomes Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine and Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH;5Division of Pediatric Surgery, Mott Children's Hospital, Ann Arbor, MI;6Division of Pediatric Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL
67.
Impact Of Health Disparities And Literacy In Pediatric Disasters: A Qualitative Approach
Irene Navis1, Almaas Shaikh2, David McCarthy3, Evette Perez4, Milissa Chanice3, *Chris Newton5, *Rita V Burke2
1Western Regional Alliance for Pediatric Emergency Management, Clark County, CA;2University of Southern California, Los Angeles, CA;3Western Regional Alliance for Pediatric Emergency Management, Phoenix, AZ;4Western Regional Alliance for Pediatric Emergency Management, Oakland, CA;5University of California, San Francisco, Oakland, CA
12:00 pm
Adjourn