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erlenmyer-research
Research group/lab  |  P.I. Prof. Henriëtte A. Moll

General Pediatric Emergency Care

Focus on research questions arising from the clinical care at the pediatric emergency department.

About our research group/lab

Our research

Background information

To meet the needs of the many children who need emergency care worldwide, the field of pediatric emergency medicine (PEM) requires the availability of up-to-date trained healthcare professionals in well-designed and equipped healthcare facilities.

In the post-vaccination era with low-prevalence of serious bacterial infections, healthcare professionals, as well as parents and caretakers of (young) children need to be aware and educated on early recognition of these nowadays rare but serious infections.

A number of good quality guidelines exist, however several of them are not appropriately validated ór implemented ór used. We are aware of new developed biomarkers to identify children at risk for serious infections, but they need to be evaluated in routine practice. As uncertainty on diagnosis or disease course remain in  number of patients after an ED visit, patients at risk in need for a revisit need to be identified and discharge instructions need to be improved in order to empower (parents of) patients in adequate at home management and initiate adequate return visits.

Given the nature of triage systems (experts opinion based) validity studies may contribute to improvements of the triage systems adapted to settings and specific patient populations.

Overall aim

The general aim of this research group is to improve the recognition of serious illness in children attending emergency care. For children are admitted for a large variety of reasons and with many different manifestations.

We focus on children with fever, children at risk for serious infections, and triage at the  emergency department.

We address the following topics:

  • Decision making.
  • Diagnostic evaluation.
  • Diversity in pediatric emergency care.
  • Validity aspects of the Manchester Triage System.

Research focus areas

We focus on clinical epidemiologic studies.

Our projects

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Emergency Department - PEWS: a new early warning score for the ED

The Paediatric Early Warning Score (PEWS) is a simple score, combining several physiological parameters, that can improve the prioritization of children in the emergency department.

PERFORM

PERFORM - Personalised Risk assessment in Febrile illness to Optimise Real-life Management across the European Union

This study aims to improve the diagnosis and management of febrile children through the development of simple diagnostic tests to discriminate bacterial and viral infection.

Safetynetting project

Safetynetting for febrile children and improving parental information on serious illness

To optimize information for parents on serious childhood illness and to improve parents’ ability to recognize alarming signs for serious illness in their child.

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SHIVER

The SHIVER group is part of the REPEM (Research European Pediatric Emergency Medicine) network and focuses on variability of care in children with fever.

To reduce antibiotic prescription

To reduce antibiotic prescription in children suspected of pneumonia (STRAP)

This is a study using a prediction rule for children with fever that estimates the risk of pneumonia and/or bacterial infections, to guide decisions upon antibiotic prescription.

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To study diagnostic accuracy of (low) blood pressure

We study the diagnostic accuracy of (low) blood pressure and its relation with other circulatory parameters in children receiving emergency. We also define 'abnormal vital signs in a population receiving routine emergency care.

Triage

Triage

Triage identifies the most urgent patients in emergency departments and ensures that patients who need immediate medical attention are timely treated.

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Vital signs and triage in low- and middle-income countries (VITALS)

The VITALS project is an international collaboration aiming to improve the recognition of serious illness in children in low- and middle-income countries (LMICs).

Key Publications

General

Methodology

Decision making

Safetynetting

Triage

Collaborations

Collaborations within Erasmus MC

  • Department of Medical Informatics: Prof. J. (Johan) van der Lei.
  • Department of Public Health and Clinical Decision Making: D. (Daan) Nieboer MSc, Dr S. (Suzanne) Polinder, Prof. E.W. (Ewout) Steyerberg.

National network of pediatricians

Collaborations outside Erasmus MC

Within the REPEM group (Research European Pediatric Emergency Medicine)

  • Children’s hospital, University Hospitals of Geneva. Geneva, Switzerland ( Prof. A. Gervaix)
  • Pediatric Emergency Department, University Hospital. Bilbao.
  • University of the Basque Country, Cruces, Spain: Dr S. Mintegi
  • St. Mary’s Hospital, London, United Kingdom: Dr I. Maconochie, Hôpital Necker-Enfants Malades, Paris, France: Dr F. Angoulvant.

PERFORM

TriAge: 

  • Maasstad Ziekenhuis, Rotterdam: Frank Smit,
  • Vienna General Hospital, Vienna: Prof. Susanne Greber-Platzer,
  • St. Mary’s Hospital, London: Ian Maconochie,
  • Hospital Prof. Doutor Fernando Fonseca, Lissabon:Claudio Alves.