Dale P Woolridge

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Journals/Publications

• 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.
• 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.
• 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.
• 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., Mendelson, J., Gaspers, M., & Pacheco, G. S. (2017). Pediatric Ventilator Management in the Emergency Department. Emergency Medicine Clinics of North America.
• 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.
• 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.
• 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.

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.