Pediatric Emergency Care Applied Research Network (PECARN)

Article Outline

• Problem
• Purpose
• Participants
• Research
• Implications
• Copyright

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Problem 

Pediatric emergency medicine has experienced rapid growth as a specialty, and children account for ∼ 25% of all emergency department (ED) visits nationwide. However, there are many areas in the continuum of emergency medical services for children (EMSC) that suffer from lack of data to guide clinical practice. Research in pediatric emergency care is hindered by a relatively low incidence of pediatric emergency events, difficulty in obtaining representative samples, lack of generalizability from adult ED settings to pediatric hospital ED settings, informed consent issues, and a lack of funding.

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Purpose 

The Pediatric Emergency Care Applied Research Network (PECARN) was formed in 2001 to conduct high quality, high priority research in EMSC. PECARN's goal is to conduct meaningful and rigorous multi-institutional research into the prevention and management of acute illnesses and injuries in children including out-of-hospital care, patient transport, emergency and in-hospital care, and rehabilitation. PECARN is the result of Cooperative Agreement grants funded through the Health Resources and Services Administration (HRSA).

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Participants 

The PECARN network consists of a coordinating data center, four Regional Nodal Centers, and 25 Hospital ED Affiliates (HEDAs) that represent academic, community, urban, rural, general, and children's hospitals. These hospitals provide differing levels of care and services that are representative of EMSC across the country. The network sites serve ∼ 808,000 acutely ill and injured children annually.

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Research 

Data collection is ongoing for multiple projects. An annual epidemiological study of PECARN demographics and data collection is in its third year. PECARN's first randomized clinical trial aims to assess the efficacy and utility of oral dexamethasone for the treatment of acute bronchiolitis. The head injury project is a prospective study of children with minor blunt head trauma to identify risk factors for brain injury. The hypothermia project is a pilot study to examine the feasibility of a future randomized control trial of therapeutic hypothermia after cardiac arrest. The seizure project is studying lorazepam to obtain FDA approval for pediatric dosing. Other ongoing projects involve psychiatric emergencies, sepsis, and cervical spine injuries.

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Implications 

PECARN is a collaborative network dedicated to research in EMSC. ED nurses at participating centers have a unique opportunity to become actively involved in data collection for ongoing projects. ED nurses can also work with the network to initiate and conduct pediatric nursing research projects at multiple ED sites. The Emergency Nurses Association, through a HRSA award, is implementing a parallel project to assist PECARN nurses in gaining research knowledge to become active participants in the PECARN studies. All patients, nurses, physicians, and emergency departments outside the network will benefit by the findings generated by PECARN studies and the improved care of children.