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Pulse rhythm01:30

Pulse rhythm

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Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
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Preventive healthcare services keep people healthy via frequent check-ups, screening, and counseling. They primarily aid in disease prevention rather than treating an acute or chronic illness. Preventive treatment also keeps individuals productive and energetic, allowing them to work well into their retirement years. Examples of preventive care services include:
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Pulse assessment sites are crucial in evaluating a patient's cardiovascular health. By assessing the pulsations of arteries at specific anatomical locations, healthcare professionals can gather valuable information about blood flow, heart rate, and peripheral circulation. Understanding these pulse assessment sites is essential for conducting comprehensive cardiovascular evaluations and monitoring patients' overall health. These sites are strategically chosen due to the accessibility and...
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Implementing Sudden Cardiac Death Risk Screening Within a Pediatric Primary Care Network.

Naveed Rabbani1, Margaret Fry2, Louis Vernacchio3

  • 1Pediatric Physicians' Organization at Children's (N Rabbani, M Fry, L Vernacchio, ET Correa, and J Hatoun), Wellesley, Mass; Department of Pediatrics (N Rabbani, L Vernacchio, J Hatoun, M Day, and ME Alexander), Harvard Medical School, Boston, Mass; Computational Health Informatics Program (N Rabbani), Boston Children's Hospital, Boston, Mass.

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|May 21, 2025
PubMed
Summary
This summary is machine-generated.

Universal cardiac risk screening in pediatrics identified an 8.4% positive rate, but adoption and follow-up remain challenges, disproportionately affecting disadvantaged groups.

Keywords:
cardiologyclinical decision supportimplementationpopulation healthprimary caresudden cardiac death

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Area of Science:

  • Pediatric Cardiology
  • Preventive Medicine
  • Public Health

Background:

  • The American Academy of Pediatrics (AAP) updated recommendations in 2021 for universal, history-based sudden cardiac death risk screening in children.
  • This expanded screening aims to identify more at-risk individuals compared to previous history- and exam-based methods.
  • Understanding implementation workflows and system effects is crucial for widespread adoption in pediatric primary care.

Purpose of the Study:

  • To evaluate the implementation of universal cardiac risk screening in a large pediatric primary care network.
  • To assess screening positivity rates and identify optimal workflow designs.
  • To examine potential system-based effects and disparities in screening rates.

Main Methods:

  • Adapted AAP guidelines into a three-question screener integrated into the electronic health record (EHR) via patient portal.
  • Established a paper-based backup workflow for patients without portal access.
  • Utilized non-interruptive alerts for clinical decision support and measured screening and follow-up rates; analyzed demographic associations with screening.

Main Results:

  • Of 72,037 eligible patients, 41,433 (58%) completed screening between March 2024 and February 2025.
  • A clinically actionable positive screen was identified in 3,463 patients (8.4%).
  • Follow-up evaluations were ordered in only 31% of positive cases; lower screening rates were linked to inactive portal status, older age, unknown race, and public insurance.

Conclusions:

  • Universal history-based screening yielded an 8.4% positivity rate, indicating a significant potential need for cardiology referrals.
  • Screening adoption and adherence to follow-up protocols were suboptimal, with over half of eligible patients not screened and a minority of positive screens leading to evaluation.
  • Implementation highlighted disparities, with lower screening rates observed in specific disadvantaged populations.