Dale P Woolridge

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Scholarly Contributions

Chapters

• Bradshaw, H. R., & Woolridge, D. P. (2008). Emergency Department Analgesia: Sickle cell crisis. In In: Thomas SH, ed. Emergency Department Analgesia: An Evidence-Based Guide. Cambridge Pocket Clinicians.(pp 365-379). Cambridge University Press. doi:10.1017/CBO9780511544835.056
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  1. Bradshaw H, Woolridge D. Sickle cell crisis. In: Thomas SH, ed. Emergency Department Analgesia: An Evidence-Based Guide. Cambridge Pocket Clinicians. Cambridge University Press; 2008:365-379.

Journals/Publications

• Saidinejad, M., Duffy, S., Wallin, D., Hoffmann, J., Joseph, M., Uhlenbrock, J., Brown, K., Waseem, M., Snow, S., Andrew, M., Kuo, A., Sulton, C., Chun, T., Lee, L., Conners, G., Callahan, J., Gross, T., Mack, E., Marin, J., , Mazor, S., et al. (2023). The Management of Children and Youth With Pediatric Mental and Behavioral Health Emergencies. Pediatrics, 153(3). doi:10.1542/PEDS.2023-063256
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  Mental and behavioral health (MBH) visits of children and youth to emergency departments are increasing in the United States. Reasons for these visits range from suicidal ideation, self-harm, and eating and substance use disorders to behavioral outbursts, aggression, and psychosis. Despite the increase in prevalence of these conditions, the capacity of the health care system to screen, diagnose, and manage these patients continues to decline. Several social determinants also contribute to great disparities in child and adolescent (youth) health, which affect MBH outcomes. In addition, resources and space for emergency physicians, physician assistants, nurse practitioners, and prehospital practitioners to manage these patients remain limited and inconsistent throughout the United States, as is financial compensation and payment for such services. This technical report discusses the role of physicians, physician assistants, and nurse practitioners, and provides guidance for the management of acute MBH emergencies in children and youth. Unintentional ingestions and substance use disorder are not within the scope of this report and are not specifically discussed.
• Ackerman, A. D., Alade, K. H., Amato, C. S., Atanelov, Z., Auerbach, M., Barata, I. A., Benjamin, L. S., Berg, K. T., Brandt, C., Brown, K., Brown, K. M., Bryant, D. E., Callahan, J., Chang, C. H., Chow, J. L., Chumpitazi, C. E., Claudius, I. A., Cline, K., Conners, G. P., , Cooper, M. R., et al. (2021). Access to Optimal Emergency Care for Children.. Annals of emergency medicine, 77(5), 523-531. doi:10.1016/j.annemergmed.2021.03.034
• Baumann, G. P., Curtis, K., Edwards, C. J., Guinn, A., Jarrell, D. H., Lowry, S., Morizio, K., Robertson, W., Tolby, N., & Woolridge, D. P. (2021). The Effects of Dexamethasone on the Time to Pain Resolution in Dental Periapical Abscess.. The Journal of emergency medicine, 60(4), 506-511. doi:10.1016/j.jemermed.2020.12.002
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  Dental infections are frequently encountered in the emergency department (ED), with periapical abscesses being among the most painful. Traditional pain management strategies include local anesthetic injections, oral analgesics, and intravenous opioids..We sought to identify an alternative pain management strategy with early use of dexamethasone as adjunct to conventional therapies for inflammation and pain at the site of infection..We conducted a prospective, randomized, double-blind, placebo-controlled study comparing the analgesic effect of dexamethasone and placebo in ED patients with periapical abscess during a 2-year timeframe at two urban academic EDs. Adult patients presenting with physical examination findings consistent with a diagnosis of periapical abscess were randomized to receive oral dexamethasone or an identical placebo. Pain was assessed using the verbal numeric scale in person at discharge and via telephone at 12, 24, 48, and 72 h after discharge from the ED..Seventy-three patients were enrolled, with 37 receiving dexamethasone and 36 receiving placebo. Follow-up pain scores were obtained for 52 patients at 12, 24, 48, and 72 h. Ten patients from the dexamethasone group and 11 from placebo group were lost to follow-up. Patients who received dexamethasone reported a greater reduction in pain at 12 h compared with the placebo group (p = 0.029). Changes in pain scores from baseline and at 24, 48, and 72 h were not statistically significant. No adverse events were reported..Single-dose dexamethasone as adjunct to conventional medical management for pain caused by periapical abscess demonstrated a significant reduction in pain 12 h post treatment compared with placebo.
• Baumann, G., Robertson, W., Guinn, A., Curtis, K., Morizio, K., Jarrell, D., Edwards, C., Lowry, S., Woolridge, D., & Tolby, N. (2021). The Effects of Dexamethasone on the Time to Pain Resolution in Dental Periapical Abscess. Journal of Emergency Medicine, 60(4). doi:10.1016/j.jemermed.2020.12.002
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  Background: Dental infections are frequently encountered in the emergency department (ED), with periapical abscesses being among the most painful. Traditional pain management strategies include local anesthetic injections, oral analgesics, and intravenous opioids. Objectives: We sought to identify an alternative pain management strategy with early use of dexamethasone as adjunct to conventional therapies for inflammation and pain at the site of infection. Methods: We conducted a prospective, randomized, double-blind, placebo-controlled study comparing the analgesic effect of dexamethasone and placebo in ED patients with periapical abscess during a 2-year timeframe at two urban academic EDs. Adult patients presenting with physical examination findings consistent with a diagnosis of periapical abscess were randomized to receive oral dexamethasone or an identical placebo. Pain was assessed using the verbal numeric scale in person at discharge and via telephone at 12, 24, 48, and 72 h after discharge from the ED. Results: Seventy-three patients were enrolled, with 37 receiving dexamethasone and 36 receiving placebo. Follow-up pain scores were obtained for 52 patients at 12, 24, 48, and 72 h. Ten patients from the dexamethasone group and 11 from placebo group were lost to follow-up. Patients who received dexamethasone reported a greater reduction in pain at 12 h compared with the placebo group (p = 0.029). Changes in pain scores from baseline and at 24, 48, and 72 h were not statistically significant. No adverse events were reported. Conclusions: Single-dose dexamethasone as adjunct to conventional medical management for pain caused by periapical abscess demonstrated a significant reduction in pain 12 h post treatment compared with placebo.
• Brown, K., Ackerman, A., Ruttan, T., Snow, S., Conners, G., Callahan, J., Gross, T., Joseph, M., Lee, L., Mack, E., Marin, J., Mazor, S., Paul, R., Timm, N., Dietrich, A., Alade, K., Amato, C., Atanelov, Z., Auerbach, M., , Barata, I., et al. (2021). Access to Optimal Emergency Care for Children. Annals of Emergency Medicine, 77(5). doi:10.1016/j.annemergmed.2021.03.034
• Amato, C. S., Baldwin, S., Friesen, P., Goodloe, J. M., Homme, J. J., Ishimine, P., Joseph, M. M., Pauze, D. R., Perina, D. G., Rose, E., Saidinejad, M., Valente, J., & Woolridge, D. P. (2020). Optimizing the workforce: a proposal to improve regionalization of care and emergency preparedness by broader integration of pediatric emergency physicians certified by the American Board of Pediatrics.. Journal of the American College of Emergency Physicians open, 1(6), 1520-1526. doi:10.1002/emp2.12114
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  Emergency care in the United States faces notable challenges with regard to children. In some jurisdictions, available resources are not sufficient to meet local needs. Physicians with specialty training in pediatric emergency care are largely concentrated in children's medical centers within larger urban areas. Rural emergency facilities, which are more likely to face ongoing staffing shortages in all specialties, are particularly deficient in pediatric emergency medicine (PEM) physicians. This paper addresses challenges in distribution of pediatric emergency care specialists into suburban and rural health care facilities, and proposes potential local and regional solutions to improve pediatric emergency care capabilities as well as to enhance disaster response in children..The American College of Emergency Physicians (ACEP) committee on PEM generated the objective to study and explore methods and strategies to address current challenges and shortcomings in the distribution of pediatric emergency physicians and to develop recommendations to improve access to emergency pediatric expertise in all care settings. A sub-committee was formed to generate a written report followed by full committee input. The content was reviewed by the ACEP Board of Directors..Pediatric emergency physicians are certified either by the American Board of Emergency Medicine or the American Board of Pediatrics (ABP) depending on whether their training occurred through the emergency medicine or a pediatric residency program. ABP-certified PEM that account for the majority of PEM physicians, remain largely concentrated in urban tertiary pediatric care centers, primarily children's hospitals. By contrast to the resources, the majority of pediatric patients receive emergency care in emergency departments (EDs) outside this setting. The goal of our recommendations is to help regionalize PEM expertise, allowing sharing of such resources with facilities that have traditionally not had access to PEM expertise. Financial or low number of pediatric cases likely contributed to lack of PEM resources in suburban and rural EDs, although a significant factor for lack of access to ABP-certified PEM physicians may be local privilege and practice restrictions. Expanding the scope of practice for ABP-certified PEM physicians beyond traditionally assigned arbitrary age limits to include selective adult patients has the potential to alleviate credentialing barriers and offset the financial and volume concerns while enhancing preparedness efforts, resource utilization, and access to specialized pediatric emergency care..Recognition that the training of ABP-certified PEM physicians allows for these individuals to safely care for selective adult patients with common disease patterns that extend beyond traditionally assigned arbitrary pediatric age limits has the potential to improve resource dissemination and utilization, allowing for greater access to pediatric emergency physicians in currently underserved settings.
• Goldberg, L. C., Pacheco, G. S., & Woolridge, D. P. (2019). Comprehensive Overview of Pediatric Airway Management. Family Medicine. doi:10.2310/tywc.4402
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  Pediatric endotracheal intubation is a procedure that can be stress provoking to the emergency physician. Although the need for this core skill is rare, when confronted with this situation, the emergency physician must have knowledge of the anatomic, physiologic, and pathologic components unique to the pediatric airway to optimize success. Furthermore, the emergency physician should be well versed in the various equipment and adjuncts as well as techniques developed to effectively manage the pediatric airway. This review covers the pathophysiology and practice of endotracheal intubation. Figures show a gum elastic bougie; the Mallampati classification; appropriate oropharyngeal, laryngeal, and tracheal axes; advancing the laryngoscope to lift the epiglottis; endotracheal tube position in neonates; and synchronized intermittent mandatory ventilation pressure-regulated volume control mechanical ventilation. Tables list endotracheal tube sizes, neonatal endotracheal tube sizes, pediatric laryngeal mask airway sizes, commonly used induction agents, and endotracheal tube insertion depth guidelines. This review contains 6 figures, 8 tables, and 77 references. Key words: emergent tracheal intubation; endotracheal tube; laryngoscopy; pediatric airway; pediatric airway management; pediatric endotracheal intubation; pediatric laryngeal mask; video laryngoscopy
• Remick, K., Gausche-Hill, M., Joseph, M., Brown, K., Snow, S., Wright, J., Adirim, T., Agus, M., Callahan, J., Gross, T., Lane, N., Lee, L., Mazor, S., Mahajan, P., Timm, N., Alade, K., Amato, C., Avarello, J., Baldwin, S., , Barata, I., et al. (2019). Pediatric Readiness in the Emergency Department. Journal of Emergency Nursing, 45(1). doi:10.1016/j.jen.2018.10.003
• Saidinejad, M., Paul, A., Gausche-Hill, M., Woolridge, D., Heins, A., Scott, W. R., Friesen, P., Rayburn, D., Conners, G., Petrack, E., Horeczko, T., Stoner, M., Edgerton, E., & Joseph, M. (2019). Consensus Statement on Urgent Care Centers and Retail Clinics in Acute Care of Children. Pediatric emergency care, 35(2), 138-142.
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  This article provides recommendations for pediatric readiness, scope of services, competencies, staffing, emergency preparedness, and transfer of care coordination for urgent care centers (UCCs) and retail clinics that provide pediatric care. It also provides general recommendations for the use of telemedicine in these establishments. With continuing increases in wait times and overcrowding in the nation's emergency departments and the mounting challenges in obtaining timely access to primary care providers, a new trend is gaining momentum for the treatment of minor illness and injuries in the form of UCCs and retail clinics. As pediatric visits to these establishments increase, considerations should be made for the type of injury or illnesses that can be safely treated, the required level training and credentials of personnel needed, the proper equipment and resources to specifically care for children, and procedures for safe transfer to a higher level of care, when needed. When used appropriately, UCCs and retail clinics can be valuable and convenient patient care resources.
• Abdy, N. A., Martinez, R., Chea, I., Boczar, B., Nuño, T., & Woolridge, D. (2018). A pilot study demonstrating the efficacy of transcutaneous bilirubin meters to quantitatively differentiate contusions from Congenital Dermal Melanocytosis. Child abuse & neglect, 80, 108-112.
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  Congenital Dermal Melanocytosis (CDM) can be difficult to differentiate from contusions. The need for a prompt and accurate diagnosis is best illustrated in cases where child abuse and maltreatment is of concern. Transcutaneous bilirubin (TCB) spectrophotometry has been well established to measure bilirubin under the skin for jaundice in infants. The use of TCB spectrometry has not been used to identify or differentiate contusions from CDM. We hypothesized that bilirubin, a degradation product of hemoglobin, would be elevated in contusions but not in CDM thus demonstrating the efficacy of a novel diagnostic technique to compliment or improve on physical assessment alone.
• Amini, R., Baker, N., Woolridge, D. P., Echeverria, A. B., Amini, A., & Adhikari, S. (2018). Emergency department diagnosis of an ovarian inguinal hernia in an 11-year-old female using point-of-care ultrasound. World journal of emergency medicine, 9(4), 291-293.
• Benjamin, L., Frush, K., Shaw, K., Shook, J., Snow, S., Wright, J., Adirim, T., Agus, M., Callahan, J., Gross, T., Lane, N., Lee, L., Mazor, S., Mahajan, P., Timm, N., Joseph, M., Alade, K., Amato, C., Avarello, J., , Baldwin, S., et al. (2018). Pediatric Medication Safety in the Emergency Department. Annals of Emergency Medicine, 71(3). doi:10.1016/j.annemergmed.2017.12.013
• Fox, S. M., & Woolridge, D. P. (2018). Pediatric Emergencies: The Common and the Critical. Emergency medicine clinics of North America, 36(2), xvii-xviii.
• Higa, K., Irving, S., Cervantes, R. J., Pangilinan, J., Slykhouse, L. R., Woolridge, D. P., & Amini, R. (2017). The Case of an Obstructed Stone at the Distal Urethra. Cureus, 9(12), e1974.
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  This report highlights a presentation of urinary calculus impacted at the urethral meatus and bedside extraction after evaluation with point-of-care ultrasound (POCUS). Visualization of a stone at the urethral meatus prompted a point-of-care ultrasound of the penile shaft and glans. The ultrasound ruled out anatomic variations such as urethral diverticula and as a result bedside removal was expedited. The stone was successfully removed with traction and intraurethral lidocaine gel without urethral lesions or injury to the meatus. Bedside ultrasound is readily available in the emergency department and can be used to characterize urethral foreign bodies, evaluate urethral anatomy, and assess the likelihood of bedside removal.
• Pacheco, G. S., Woolridge, D. P., & Siacunco, E. A. (2017). Obstructed Infradiaphragmatic Total Anomalous Pulmonary Venous Return in a 13 Day Old Infant Presenting Acutely to the Emergency Department: A Case Report. Journal of Emergency Medicine.
• Rice, A., Dudek, J., Gross, T., St Mars, T., & Woolridge, D. (2017). The Impact of a Pediatric Emergency Department Facility Verification System on Pediatric Mortality Rates in Arizona. The Journal of emergency medicine, 52(6), 894-901.
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  The Emergency Medical Services for Children State Partnership Program, as well as the Institute of Medicine report on pediatric emergency care, encourages recognition of emergency departments (EDs) through categorization and verification systems. Although pediatric verification programs are associated with greater pediatric readiness, clinical outcome data have been lacking to track the effects and patient-centered outcomes by implementing such programs.
• Siacunco, E. A., Pacheco, G. S., & Woolridge, D. P. (2017). Obstructed Infradiaphragmatic Total Anomalous Pulmonary Venous Return in a 13-Day-Old Infant Presenting Acutely to the Emergency Department: A Case Report. The Journal of emergency medicine, 52(6), e239-e243.
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  Total anomalous pulmonary venous return (TAPVR) is an uncommon congenital heart defect. Obstructed forms are more severe, and typically present earlier in life, usually in the immediate newborn period, with symptoms of severe cyanosis and respiratory failure.
• Woolridge, D. (2017). Childhood Appendicitis: Is Time Really of the Essence?. Journal of Emergency Medicine, 52(3). doi:10.1016/j.jemermed.2016.11.019
• Woolridge, D. P. (2017). Childhood Appendicitis: Is Time Really of the Essence?. The Journal of emergency medicine, 52(3), 364-365. doi:10.1016/j.jemermed.2016.11.019
• Chun, T., Mace, S., Katz, E., Shook, J., Callahan, J., Conners, G., Conway, E., Dudley, N., Gross, T., Lane, N., Macias, C., Timm, N., Bullock, K., Edgerton, E., Haro, T., Joseph, M., Mickalide, A., Moore, B., Remick, K., , Snow, S., et al. (2016). Evaluation and management of children and adolescents with acute mental health or behavioral problems. Part I: Common clinical challenges of patients with mental health and/or behavioral emergencies. Pediatrics, 138(3). doi:10.1542/peds.2016-1570
• Goldberg, L. C., Prior, J., & Woolridge, D. (2016). Appendicitis in the Infant Population: A Case Report and Review of a Four-Month Old With Appendicitis. The Journal of emergency medicine.
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  Appendicitis is uncommon in children
• Smith, N., St Mars, T., & Woolridge, D. (2016). Arizona's Emergency Medical Services for Children Pediatric Designation System for Emergency Departments. The Journal of emergency medicine, 51(2), 194-200.
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  In 2012, a voluntary certification program called Pediatric Prepared Emergency Care (PPEC) was established in Arizona as a system for pediatric emergency preparedness. Emergency medicine and pediatric specialists generated basic, intermediate, and advanced designation criteria. Dedicated medical management by a pediatric emergency specialist is required for advanced centers. Designation follows a site visit, review, and approval by the subcommittee and the Arizona Chapter of the American Academy of Pediatrics.
• Strobel, A. M., Chasm, R. M., & Woolridge, D. P. (2016). A Survey of Graduates of Combined Emergency Medicine-Pediatrics Residency Programs: An Update. The Journal of emergency medicine, 51(4), 418-425.
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  In 1998, emergency medicine-pediatrics (EM-PEDS) graduates were no longer eligible for the pediatric emergency medicine (PEM) sub-board certification examination. There is a paucity of guidance regarding the various training options for medical students who are interested in PEM.
• Woolridge, D. P. (2016). Childhood Appendicitis: Is Time Really of the Essence?. The Journal of emergency medicine.
• Abo, A. M., Ackerman, A. D., Alade, K., Arms, J., Avarello, J. T., Baldwin, S., Barata, I. A., Benjamin, L. S., Bird, S. B., Blomkalns, A. L., Brown, K., Cantor, R. M., Carmody, K., Chun, T. H., Clem, K. J., Cohen, A., Conners, G. P., Courtney, D. M., Diercks, D. B., , Dietrich, A. M., et al. (2015). Point-of-care ultrasonography by pediatric emergency physicians. Policy statement.. Annals of emergency medicine, 65(4), 472-8. doi:10.1016/j.annemergmed.2015.01.028
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  Point-of-care ultrasonography is increasingly being used to facilitate accurate and timely diagnoses and to guide procedures. It is important for pediatric emergency physicians caring for patients in the emergency department to receive adequate and continued point-of-care ultrasonography training for those indications used in their practice setting. Emergency departments should have credentialing and quality assurance programs. Pediatric emergency medicine fellowships should provide appropriate training to physician trainees. Hospitals should provide privileges to physicians who demonstrate competency in point-of-care ultrasonography. Ongoing research will provide the necessary measures to define the optimal training and competency assessment standards. Requirements for credentialing and hospital privileges will vary and will be specific to individual departments and hospitals. As more physicians are trained and more research is completed, there should be one national standard for credentialing and privileging in point-of-care ultrasonography for pediatric emergency physicians.
• Barata, I., Brown, K., Fitzmaurice, L., Griffin, E., Snow, S., Shook, J., Ackerman, A., Chun, T., Conners, G., Dudley, N., Fuchs, S., Gorelick, M., Lane, N., Moore, B., Wright, J., Benjamin, L., Alade, K., Arms, J., Avarello, J., , Baldwin, S., et al. (2015). Best practices for improving flow and care of pediatric patients in the emergency department. Pediatrics, 135(1). doi:10.1542/peds.2014-3425
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  This report provides a summary of best practices for improving flow, reducing waiting times, and improving the quality of care of pediatric patients in the emergency department.
• Leetch, A. N., Leipsic, J., & Woolridge, D. P. (2015). Evaluation of child maltreatment in the emergency department setting: an overview for behavioral health providers. Child and adolescent psychiatric clinics of North America, 24(1), 41-64.
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  Emergency providers are confronted with medical, social, and legal dilemmas with each case of possible child maltreatment. Keeping a high clinical suspicion is key to diagnosing latent abuse. Child abuse, especially sexual abuse, is best handled by a multidisciplinary team including emergency providers, nurses, social workers, and law enforcement trained in caring for victims and handling forensic evidence. The role of the emergency provider in such cases is to identify abuse, facilitate a thorough investigation, treat medical needs, protect the patient, provide an unbiased medical consultation to law enforcement, and provide an ethical testimony if called to court.
• Leetch, A. N., Woolridge, D. P., & Glasser, J. A. (2019). A Roadmap for the Student Pursuing a Career in Pediatric Emergency Medicine. Western Journal of Emergency Medicine.
• Woolridge, D. P., Woolridge, D. P., Mendelson, J., Mendelson, J., Gaspers, M., Gaspers, M., Pacheco, G. S., & Pacheco, G. S. (2017). Pediatric Ventilator Management in the Emergency Department. Emergency Medicine Clinics of North America.
• Ackerman, A. D., Alade, K., Arms, J., Avarello, J. T., Baldwin, S., Barata, I. A., Benjamin, L. S., Brown, K., Cadwell, S. M., Cantor, R. M., Chun, T. H., Cohen, A., Conners, G. P., Dietrich, A. M., Dudley, N. C., Eakin, P. J., Frankenberger, W. D., Fuchs, S. M., Gausche-hill, M., , Gerardi, M., et al. (2014). Death of a child in the emergency department.. Annals of emergency medicine, 64(1), 102-5. doi:10.1016/j.annemergmed.2014.05.010
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  The American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nurses Association have collaborated to identify practices and principles to guide the care of children, families, and staff in the challenging and uncommon event of the death of a child in the emergency department in this policy statement and in an accompanying technical report.
• Fallat, M. E., Ackerman, A. D., Adelson, P. D., Alade, K., Arms, J., Avarello, J. T., Baldwin, S., Barata, I. A., Benjamin, L. S., Brown, K., Bulgar, E., Cantor, R. M., Chun, T. H., Cohen, A., Conners, G. P., Cooper, A., Dietrich, A. M., Dudley, N. C., Eakin, P. J., , Fuchs, S. M., et al. (2014). Withholding or termination of resuscitation in pediatric out-of-hospital traumatic cardiopulmonary arrest.. Pediatrics, 133(4), e1104-16. doi:10.1542/peds.2014-0176
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  This multiorganizational literature review was undertaken to provide an evidence base for determining whether recommendations for out-of-hospital termination of resuscitation could be made for children who are victims of traumatic cardiopulmonary arrest. Although there is increasing acceptance of out-of-hospital termination of resuscitation for adult traumatic cardiopulmonary arrest when there is no expectation of a good outcome, children are routinely excluded from state termination-of-resuscitation protocols. The decision to withhold resuscitative efforts in a child under specific circumstances (decapitation or dependent lividity, rigor mortis, etc) is reasonable. If there is any doubt as to the circumstances or timing of the traumatic cardiopulmonary arrest, under the current status of limiting termination of resuscitation in the field to persons older than 18 years in most states, resuscitation should be initiated and continued until arrival to the appropriate facility. If the patient has arrested, resuscitation has already exceeded 30 minutes, and the nearest facility is more than 30 minutes away, involvement of parents and family of these children in the decision-making process with assistance and guidance from medical professionals should be considered as part of an emphasis on family-centered care because the evidence suggests that either death or a poor outcome is inevitable.
• O'Malley, P., Barata, I., Snow, S., Shook, J., Ackerman, A., Chun, T., Conners, G., Dudley, N., Fuchs, S., Gorelick, M., Lane, N., Moore, B., Wright, J., Benjamin, L., Bullock, K., Robbins, E., Gross, T., Edgerton, E., Haro, T., , Mickalide, A., et al. (2014). Death of a child in the emergency department. Pediatrics, 134(1). doi:10.1542/peds.2014-1245
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  The American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nurses Association have collaborated to identify practices and principles to guide the care of children, families, and staff in the challenging and uncommon event of the death of a child in the emergency department in this policy statement and in an accompanying technical report. Copyright © 2014 by the American Academy of Pediatrics.
• Baker, N., & Woolridge, D. (2013). Emerging concepts in pediatric emergency radiology. Pediatric clinics of North America, 60(5), 1139-51.
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  Radiologic studies are a vital component in the workup and diagnosis of disease. An appropriate radiographic study will accurately rule in or rule out disease with the least possible harm. Special considerations are necessary for the imaging of children. Current trends in pediatric imaging support the increased use of ultrasound and magnetic resonance imaging to decrease radiation exposure. In this review, we highlight some of the emerging concepts in the radiographic workup of pediatric disease, with a focus on decreasing ionizing radiation, increasing ultrasound use, and using clinical decision rules to identify children who do not need imaging.
• Leetch, A. N., & Woolridge, D. (2013). Emergency department evaluation of child abuse. Emergency medicine clinics of North America, 31(3), 853-73.
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  Child abuse presents commonly to emergency departments. Emergency providers are confronted with medical, social, and legal dilemmas with each case. A solid understanding of the definitions and risk factors of victims and perpetrators aids in identifying abuse cases. Forensic examination should be performed only after the child is medically stable. Emergency providers are mandatory reporters of a reasonable suspicion of abuse. The role of the emergency provider is to identify abuse, facilitate a thorough investigation, treat medical needs, protect the patient, provide an unbiased medical consultation to law enforcement, and to provide an ethical testimony if called to court.
• Lu, L. e., Woolridge, D., & Dietrich, A. M. (2013). Pediatric emergency medicine. Preface. Emergency medicine clinics of North America, 31(3), xvii-xviii.
• Pacheco, G. S., Viscusi, C., Hays, D. P., & Woolridge, D. P. (2012). The effects of resident level of training on the rate of pediatric prescription errors in an academic emergency department. The Journal of emergency medicine, 43(5), e343-8.
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  Medication errors are a leading cause of increased cost and iatrogenic injury in the pediatric population. In the academic setting, studies have suggested that these increased error rates are related primarily to resident inexperience, thus advocating a higher level of supervision.
• Hays, D. P., Pacheco, G. S., & Woolridge, D. P. (2010). 309: The Effects of Resident Matriculation and Level of Training on the Rate of Pediatric Prescription Errors In the Emergency Department. Annals of Emergency Medicine, 56(3), S101. doi:10.1016/j.annemergmed.2010.06.359
• Kiefer, C. S., Colletti, J. E., Bellolio, M. F., Hess, E. P., Woolridge, D. P., Thomas, K. B., & Sadosty, A. T. (2010). The "good" dean's letter. Academic medicine : journal of the Association of American Medical Colleges, 85(11), 1705-8.
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  To determine whether a correlation exists between the term "good" on the summative, comparative assessment of a student's Medical Student Performance Evaluation (MSPE) and his or her actual performance in medical school.
• Bellolio, M., Colletti, J. E., Kiefer, C. S., Thomas, K. B., & Woolridge, D. P. (2009). 26: When “Good” Is Below Average. Annals of Emergency Medicine, 54(3), S9. doi:10.1016/j.annemergmed.2009.06.046
• Murray, M. L., Woolridge, D. P., & Colletti, J. E. (2009). Pediatric emergency medicine fellowships: faculty and resident training profiles. The Journal of emergency medicine, 37(4), 425-9.
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  The objective of this study was to evaluate the faculty and graduate training profiles of Pediatric Emergency Medicine (PEM) fellowship training programs. An electronic 10-point questionnaire was sent to 57 PEM fellowship directors, with a 70% response rate. Analysis of the individual certification of faculty members in PEM training programs demonstrated that the largest represented training types were general pediatricians and pediatricians with PEM sub-certification (29% and 62% representation, respectively). The remaining faculty types consistently showed < 5% overall involvement. Reported estimates on faculty delivery of clinical training, didactic training, and procedural skills demonstrated that pediatricians sub-board certified in PEM consistently administered the highest percentage of these skill sets (74%, 68%, and 68%, respectively). Emergency Medicine-trained physicians showed a relative increase of involvement in fellowship programs administered by Emergency Medicine departments and in those programs located within adult hospitals. Yet, this involvement still remained substantially lower than that of the pediatric-type faculty. Program directors of fellowships within pediatric hospitals and those administered by Pediatric programs demonstrated a preference for general pediatricians with sub-board certification in PEM to improve their faculty pools. Program directors of fellowship programs located in adult hospitals and those administered by departments of EM demonstrated no preference in training type. Lastly, program directors report that 95% of past graduates received their primary board certification through Pediatrics and only 5% received their primary board certification through Emergency Medicine. There are currently many more pediatric-trained physicians among PEM fellowship faculty and graduates. This survey has demonstrated that there has been a decline in EM-trained physicians involved in PEM fellowships since 2000.
• Lowe, M. C., & Woolridge, D. P. (2007). The normal newborn exam, or is it?. Emergency medicine clinics of North America, 25(4), 921-46, v.
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  Despite the broad technologic advancements of medicine, screening for illness in infants is highly reliant on a complete physical exam. For this reason it is critical that the examining physician not only have a thorough understanding of abnormal findings but also the normal findings and their variants. The vast majority of infants are healthy and findings predictive of future health problems are subtle and infrequent. Yet, outcomes can be devastating. Therefore it is critical the physician remain diligent when screening for these. It is our hope that this article will assist you in this task and allow for more accurate and timely diagnosis that prevents or minimizes long-term health problems in children.
• Woolridge, D. P., & Lichenstein, R. (2007). A survey on the graduates from the combined emergency medicine/pediatric residency programs. The Journal of emergency medicine, 32(2), 137-40.
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  The guidelines for dual training in Emergency Medicine (EM) and Pediatrics over a 5-year program have long existed. Many have questioned the benefit of such training in relation to either specialty and in relation to Pediatric Emergency Medicine (PEM) sub-specialty training. We report on the professional outcome, career focus, and job satisfaction of these graduates. Surveys were returned from 91% (n = 29) of graduates, all of whom reported completing either of the two combined training programs. All respondents reported practicing in an emergency medicine setting either with or without an additional pediatric emphasis. Fifty-nine percent reported an academic EM affiliation. Almost all (96.5%) would choose to repeat combined training and all reported they would recommend the combined program to medical students interested in Pediatrics and EM. Combined graduates report a high level of satisfaction with their training and overwhelmingly would recommend such training to medical students. Combined graduates seem to universally work in an ED setting, although a number maintain their pediatric involvement. Over half of the graduates participate in academic EM.
• Carson, S., Woolridge, D. P., Colletti, J., & Kilgore, K. (2006). Pediatric upper extremity injuries. Pediatric clinics of North America, 53(1), 41-67, v.
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  The pediatric musculoskeletal system differs greatly from that of an adult. Although these differences diminish with age, they present unique injury patterns and challenges in the diagnosis and treatment of pediatric orthopedic problems.
• Thiessen, M. L., & Woolridge, D. P. (2006). Pediatric minor closed head injury. Pediatric clinics of North America, 53(1), 1-26, v.
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  Many studies have found conflicting evidence over the use of clinical indicators to predict intracranial injury in pediatric mild head injury. Although altered mental status, loss of consciousness, and abnormal neurologic examination have all been found to be more prevalent among head-injured children, studies have observed inconsistent results over their specificity and predictive value. Children older than 2 years have been evaluated, managed, and studied differently than those less than 2 years old. Evidence strongly supports a lower threshold to perform a CT scan in younger children because they have a higher risk of significant brain injury after blunt head trauma.
• Woolridge, D., Martinez, J., Stringer, D., & Gerner, E. (1999). Characterization of a novel spermidine/spermine acetyltransferase, BltD, from Bacillus subtilis. Biochemical Journal, 340(3). doi:10.1042/0264-6021:3400753
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  Overexpression of the BltD gene in Bacillus subtilis causes acetylation of the polyamines spermidine and spermine. BltD is co-regulated with another gene, Blt, which encodes a multidrug export protein whose overexpression facilitates spermidine export. Here we show that BltD acetylates both spermidine and spermine at primary propyl amine moieties, with spermine being the preferred substrate. In the presence of saturating concentrations of acetyl CoA, BltD rapidly acetylates spermine at both the N1 and N12 positions. The K(m) (app) values for spermine, spermidine and N1-acetylspermine are ≤ 67, 200 and 1200 μM, respectively. Diamines ranging from 1,3-diaminopropane to 1,12-diaminododecane, monoacetylputrescine and N8-acetylspermidine were not substrates for BltD. Putrescine (1,4-diaminobutane) and N8-acetylspermidine were competitive inhibitors of spermidine acetylation by BltD, with K(i) values of 0.25 and 5.76 mM, respectively. CoA competitively inhibited both spermidine and acetyl-CoA interactions with BltD. These data and other results indicate that the mechanism of spermidine and spermine acetylation by BltD is a random-order mechanism of bi-molecular kinetics.
• Gerner, E. W., Gannett, D. E., Hamilton, A. J., Stea, B., & Woolridge, D. P. (1995). 123 Hypusine as a potential prognostic marker in glial derived brain tumors. International Journal of Radiation Oncology Biology Physics, 32, 202. doi:10.1016/0360-3016(95)97786-z

Proceedings Publications

• Gaither, J. B., M, U., V, C., R, B., J, D. J., C, K., Rice, A., Denninghoff, K. R., Bobrow, B. J., Spaite, D. W., & Woolridge, D. P. (2019, May). Use of Supplemental Fields to Identify Additional Cases of Potential Abusive Head Trauma. In 22nd Annual Meeting of the Western Society for Academic Emergency Medicine.

Presentations

• Friedman, L., Woolridge, D. P., Friedman, L., & Woolridge, D. P. (2007, July). Polyamines and Their Acetyl Derivatives as Biomarkers for Urinary Tract Infections. NIH/University of Arizona Medical Student Research Program (MSRP) Institute. Tucson, AZ.