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Related Concept Videos

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

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Related Experiment Video

Updated: Jul 3, 2026

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
11:27

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn

Published on: April 7, 2023

Variation in Emergency Department Experience With Pediatric Critical Illness.

Allan M Joseph1, Kenneth A Michelson2, Maya L Dewan1

  • 1Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.

Annals of Emergency Medicine
|July 2, 2026
PubMed
Summary

Most emergency departments (EDs) rarely treat critically ill children. A small percentage of these pediatric critical illness cases in low-volume EDs could potentially be diverted to nearby high-volume EDs.

Keywords:
Critical careEpidemiologyPediatricsReadiness

Related Experiment Videos

Last Updated: Jul 3, 2026

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
11:27

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn

Published on: April 7, 2023

Area of Science:

  • Pediatric Emergency Medicine
  • Healthcare Systems Analysis
  • Critical Care

Background:

  • Emergency departments (EDs) vary significantly in their management of pediatric critical illness.
  • Understanding the distribution of these critical cases is crucial for optimizing care access.

Purpose of the Study:

  • To analyze the variation in pediatric critical illness encounters across different ED volumes.
  • To evaluate the geographic proximity of low-volume EDs to high-volume EDs for potential patient diversion.

Main Methods:

  • Retrospective cohort study using Healthcare Cost and Utilization Project databases (5 states, 2018-2022).
  • Defined critical illness by specific outcomes (death, CPR, intubation) or critical care billing.
  • Categorized EDs as low- or high-volume based on the 75th percentile and assessed proximity within a 15-minute drive.

Main Results:

  • 0.3% (40,483 of 14,313,896) of pediatric ED encounters were critical.
  • Median EDs managed 5 critical cases annually; 31.8% of EDs had no pediatric critical illness in a given year.
  • 16.8% of critically ill children in low-volume EDs were within a 15-minute drive of a high-volume ED.

Conclusions:

  • The majority of EDs infrequently encounter critically ill children.
  • Diversion to high-volume EDs is a limited strategy for improving access to critical pediatric emergency care.
  • Direct transport to high-volume centers is not a universally applicable solution.