Researchers in the Division of Pediatric Emergency Medicine are working on a number of multi-center studies coordinated by the National Pediatric Emergency Medicine Clinical Research Network involving infectious diseases in young infants. The division has additional important research focus areas, including:

• Education
• Injury prevention (research followed by advocacy/interventions)
• Pain management in the Emergency Department (ED)
• Quality improvement (QI)

Christine Campbell, M.D., has ongoing QI projects that include:

• Evaluation of DKA Pathway at Children’s of Alabama
• Disparities in care of febrile neonates (PEMCRC)
• Improving time to pain medicine for sickle cell patients (with Shaundra Blakemore, M.D.)
• Improving time to antibiotics for high-risk patients with fever
• Improving resident reporting of safety events
• Standardizing Management of Febrile Neonate in ED
• Better Antibiotic Selection in Children (BASiC)

Christina Cochran, M.D., is part of a multi-center high powered magnet study. The first manuscript was accepted by Pediatrics, and a second manuscript is in progress.

Kara Huls, M.D., received external funding supporting her sheltered time devoted to her focus in human trafficking.

Michele Nichols, M.D., is the lead on projects, including a retrospective study on dog bites in children with Kathy Monroe, M.D., and a clonidine ingestion study with a pediatric emergency medicine fellow.

Valerie Davis, M.D., MPH, is a part of the Children’s Hospital Association Pediatric Surviving Sepsis Collaborative and the American Academy of Pediatrics (AAP) Value in Inpatient Pediatrics (VIP) QI project, Preventing High-Flow Overuse in Bronchiolitis project.

Fellow projects with faculty mentors:

1. Clinical pathway for the febrile neonate (quality improvement project)
2. Socioeconomic and rurality disparities of pediatric firearm injuries in Alabama
3. Trends and Outcomes of Pediatric Firearm Injuries Involving the Upper Extremities
4. Trends and demographics of pediatric firearm injuries from 2000–2019
5. Identifying risks and preventing injuries in the pediatric emergency department
6. How COVID-19 changed bronchiolitis
7. ATV injury awareness
8. Utility of tadpole sign in distinction of abusive and accidental head trauma
9. AAP QI antibiotic stewardship project
10. Spanish interpreter study:

Trends in Pediatric Emergency Department Acuity and Trauma during the COVID-19 Pandemic
This project was led by Shea Duerring, M.D., with participation of Isabella Masler, M.D., a pediatric resident, and Nipam Shah, Ph.D., and Kathy Monroe, M.D. This study has been submitted to Injury Epidemiology and accepted for presentation at EMS conference and Injury Free Coalition for Kids. The purpose of this study was to evaluate the effect on both volume and acuity that occurred in the pediatric population and to assist in the planning of staffing of the emergency department. The findings are seen below and have implications for staffing numbers and types of staff needed during a pandemic.

Community Partnership Approaches for Safe Sleep (CPASS)
We are one of five sites across the country to be awarded funding from the American Academy of Pediatrics. The PI for this project is Jennifer McCain, M.D., and she will be working with the Birmingham Healthy Start Plus organization and the Children’s of Alabama Foundation to provide safe sleep education to families with infants in our area. This project is much needed, as historically Alabama has one of the highest infant mortality rates in the country. This funding also provides a safe sleep environment (pack and play, sheets and safe infant sleepwear) for the families. We are particularly excited about this project, as it reaches our most vulnerable patients and provides both education and equipment to reduce one of the deadliest injuries in infants in our state.

Teen Driving Retrospective
Authors of this study published in Injury Epidemiology include Drs. Monroe and Nichols. This was an observational study of high school students ages 14 to 19 years old that compared recent self-reported risky driving behaviors to those reported in a prior study. The purpose was to assess changes in behavior and will guide interventions in the community.

Table 2. Comparison of Participant Responses from 2018 Compared to Responses in 2009

Share Our Stories: An Exploration of the Healthcare Experiences of Child Sex Trafficking Survivor Study
Carmelle Wallace, M.D., is first author on this qualitative study utilizing semi-structured interviews to explore the health care interactions of child sex trafficking survivors. Homeless youth currently aged 18–21 who were sex trafficked before age 18 were interviewed using semi-structured interview techniques.

These themes illustrate the experiences of sex trafficked youth experiencing homelessness and provide pediatric practitioners the opportunity to become more informed and equipped to recognize them.

Outpatient Pain Clinic and Intranasal Fentanyl to Improve Sickle Cell Disease Outcomes
Shaundra Blakemore, M.D., was a co-investigator on this study that has been published in Pediatric Blood Cancer. The study attempted to improve pain outcomes using an outpatient pain clinic and intranasal fentanyl in the ED pain for sickle cell order set.

TABLE 1. Comparison of outcomes for individual patient seeking care in both the pain clinic and emergency department

Abbreviations: ED, emergency department; SD, standard deviation.

a P-value obtained using chi-square, remaining P-values obtained using matched-pair analysis.

The use of intranasal fentanyl reduced the time to first opioid administration in the ED.

Effectiveness of a Central Line Associated Blood Stream Infection Protocol in a Pediatric Population
Dr. Monroe was a co-author on this study that was published in the American Journal of Surgery. The study focused on patients with central lines and intestinal failure (IF) who are at increased risk of bacteremia and sepsis. This was a collaborative, multidiscipline-supported protocol for the care of patients with IF presenting to the ED to enhance efficiency of antibiotic ordering/administration, as well as reduce the number of unplanned floor-ICU transfers.

Using a Resident-Led School Outreach Program to Improve Knowledge of All-Terrain Vehicle Safety
Drs. Nichols and Monroe were co-authors on this study published in Southern Med Journal. This study made use of surveillance data from the Children’s of Alabama hospital electronic medical record database. Several Alabama counties near Birmingham were identified as having an increased number of children with ATV-related injuries in 2016. The Safety Tips for ATV Riders (STARs) Program, developed in Iowa, was provided to middle school students in these counties by pediatric residents.

Acad Pediatr. 2021 Aug 10;S1876-2859(21)00424-1. Current fellowship funding limitations and their threat to the pediatric subspecialty workforce. Pnina Weiss, Angela L Myers, Kathleen A McGann, Jennifer C Kesselheim, Christine Barron, Ann Klasner, Melvin B Heyman, Doria L Weiss, Elizabeth Mauer, Katherine E Mason, Linda M Gerber, Erika L Abramson.

Academic Pediatrics. 2021 Volume 21, Issue 7, September–October, Pages 1104-1107. Social Media Changes in Pediatric Residency Programs During COVID-19 Pandemic. J Clay Pruett, Kristin Deneen, Harrison Turner, Thomas Kozar, Nikhi P Singh, Timothy W King, Michele H Nichols.

Adv Simul (Lond). 2021 Apr 29;6(1):16. Building impactful systems-focused simulations: integrating change and project management frameworks into the pre-work phase. Dubé M, Posner G, Stone K, White M, Kaba A, Bajaj K, Cheng A, Grant V, Huang S, Reid J.

American Journal of Surgery. Volume 222, Issue 4, October 2021, Pages 867-873. Effectiveness of a central line associated blood stream infection protocol in a pediatric population. M Shroyer, SA Anderson, C Hutto, K Monroe.

Cochrane Database of Systematic Reviews. Feb 2021. Belimumab for systemic lupus erythematosus. JA Singh, NP Shah, AS Mudano.

Clinical Simulation in Nursing. 2021, March. 52(C), 9-16. Interprofessional simulation for understanding poverty. Hitchcock, L. I., Timmons McKenzie, C., Shipman, S., Varley, A., Pollio, W., Peterson, D. T., King, D. M., & White, M.L.

Health Commun. 2021 Jul 12;1-9. Why We Want Our Students to Learn about Poverty and Health Care: Sharing Our Own Experiences from Poverty Simulations. Michelle Brown, Laurel Iverson Hitchcock, Dawn Taylor Peterson, Carly Timmons McKenzie, Shilpa Register, R. Lynn Holt & Marjorie Lee White.

Pediatric Emergency Care. October 2021 - Volume 37 - Issue 10 - p 498-501. Unintentional Opioid Ingestions Presenting to a Pediatric Emergency Department. Pallavi Ghosh, Christopher Pruitt, Nipam Shah, Abhay Kulkarni, Ann Slattery, Michele Nichols.

Pediatrics. 2021;147(1):e20200772. A survivor-derived approach to addressing trafficking in the pediatric ED. Carmelle Wallace, Yvette Schein, Gina Carabelli, Heta Patel, Needhi Mehta, Nadia Dowshen, Nancy Kassam-Adams, Kenneth Ginsburg, Cynthia Mollen.

Pediatrics. 2021; 148 (4). Half Century Since SIDS: A Reappraisal of Terminology. Hirsch M, B Johnston, S Kendi, LK Lee, K Monroe.

Pediatrics. Volume 147, Issue 3 March 2021. Neonatal Mastitis and Omphalitis: Presentation, Outcomes, and Concurrent Serious Bacterial Infection. Ron L Kaplan, Andrea T Cruz, Kenneth A Michelson, Constance McAneney, Mercedes M Blackstone, Christopher M Pruitt, Nipam Shah, Kathleen A Noorbakhsh, Thomas J Abramo, Richard D Marble, Leah Middelberg, Kathleen Smith, Nirupama Kannikeswaran, David Schnadower, Geetanjali Srivastava, Amy D Thompson, Roni D Lane, Julia F Freeman, Kelly R Bergmann, Oihane Morientes, James Gerard, Oluwakemi Badaki-Makun, Usha Avva, Pradip P Chaudhari, Stephen B Freedman, Margaret Samuels-Kalow, Elizabeth Haines, Jonathan Strutt, Kajal Khanna, Cheryl Vance, Lalit Bajaj.

Simul Healthc. 2021 April. An Investigation on the Perceptions of Practicing Interdisciplinary Health Professionals on Rapid Cycle Deliberate Practice Simulation. Roszczynialski KN, Register SJ, Bergman L, White ML.

Southern Medical Journal. 114.5 (2021): 266-270. Descriptive epidemiology of pediatric drowning patients presenting to a large southern US children's hospital. B Foxworthy, B Hinten, N Shah, KW Monroe, M Nichols.

Southern Medical Journal. 01 Jul 2021, 114(7):380-383. Storage of Medications: A Survey of Families in the Pediatric Emergency Department. SM Mohr, AI Atkins, AC Webb, KW Monroe, M Nichols.

Southern Medical Journal. 01 Feb 2021, 114(2):106-110. Using a Resident-Led School Outreach Program to Improve Knowledge of All-Terrain Vehicle Safety. K. Jeffries, A. Burks, M Nichols, K Monroe.

Southern Medical Journal. 2021 Jan;114(1):13-16. Examining Pediatric Residency Voting Practices. C Smola, N Shah, K Monroe.

Book Chapters

1. White ML, Ambardekar A. Overview of Simulation in Healthcare. In: Deutsch E, Perry S, Gurnaney H Comprehensive Healthcare Simulation: Improving Healthcare Systems. New York, NY: Springer, June 2021.
2. Sawyer, Bergman, White. Simulation for Procedural Skills Teaching and Learning. In Nestel D, Reedy G, McKenna L, Gough S Clinical Education for the Health Professions. Springer, November, 2021.

Steve Baldwin, M.D.

• Dr. Baldwin is an elected member of the board of the Alabama chapter of American College of Emergency Physicians.

Mark Baker, M.D.

• Dr. Baker is a medical officer with the National Disaster Medical System in the US Department of Health and Human Services. (COVID-19 deployment this year to Travis Air Force base in California in February and Yuma, Arizona, in June).

Jud Barber, M.D.

• Dr. Barber is a founding board member of the Society for Pediatric Sedation.

Terri Coco, M.D.

• Dr. Coco is a member of the national American Academy of Pediatrics Urgent Care Committee and the subcommittee responsible for writing a fellowship curriculum.

Shea Duerring, M.D.

• Dr. Duerring was named the assistant state EMS medical director, tasked with directing the Alabama Pediatric EMS system. This position is funded by the state. He is involved locally, regionally and nationally focusing on the pediatric education of prehospital providers.
• He was named to the American College of Emergency Physicians Board of Directors for the state.
• He is the president of the Alabama Chapter of the National Association of EMS Physicians.

Jennifer McCain, M.D.

• Dr. McCain was awarded 2021 District Award by Alabama Chapter of the AAP.

Kathy Monroe, M.D.

• Dr. Monroe is an elected member of the Executive Council for Injury, Violence and Poison Prevention for the American Academy of Pediatrics nationally.
• She is presently the education chair for the Council on Injury, Violence and Poison Prevention (COIVPP) Program.
• In addition, she is a board member and program chair for Injury Free Coalition for Kids.

Michele Nichols, M.D.

• Dr. Nichols is on the Business Model Committee of the National Association of Program Directors.
• She has been a board member of the Injury Free Coalition for Kids since 2003.

Annalise Sorrentino, M.D.

• Dr. Sorrentino is an elected member of the national American College of Emergency Physicians (ACEP) Steering Committee.
• She is the education chair of the Alabama Chapter of American College of Emergency Physicians and the medical director of an annual nine-state regional conference sponsored by ACEP.

Carmelle Wallace, M.D.

• Dr. Wallace is the assistant district representative for District X (AL, GA, FL, Puerto Rico) of the AAP Section on Early Career Physicians.

Marjorie Lee White, M.D.

• Dr. White is active in the international simulation community. She serves on the executive committee of the International Simulation Data Registry.
• She is the program chair and executive committee member for the American Academy of Pediatrics Section on Simulation and Innovative Learning Methods.
• She is on a board subcommittee of the International Pediatric Simulation Society.
• She was also to be a standing member of the Healthcare Systems & Value Research Study Section (HSVR) of the Agency for Healthcare Research and Quality. Dr. White will serve a four-year term.
• Dr. White is also the vice chair of the Safety II and Resilience Engineering Affinity Group, Society for Simulation in Healthcare.

The UAB Pediatric Emergency Medicine Fellowship Program has been in existence for more than 30 years. We are the only Level 1 pediatric trauma center in the state and the fifth-busiest pediatric emergency department in the country. This exposes our fellows to a wide range of patient experiences and provides them with the necessary skills to become excellent emergency medicine physicians. Our fellows have an intensive didactic educational conference curriculum that includes research, quality improvement, journal club, evidence-based medicine, patient safety, radiology and interesting cases. We offer various electives and a significant amount of protected research time throughout the training program. Our research program includes online courses in epidemiology and biostatistics, lectures and mentorship with a scholarly project to be completed during fellowship.

2021–2022 Fellows

Lauren Nelson, M.D.
First-Year Fellow
Residency: St. Christopher’s Hospital for Children

Alexis Ricci, M.D.
First-Year Fellow
Residency: University of Alabama at Birmingham

Jeremy Ruhlmann, M.D.
First-Year Fellow
Combined Critical Care & Emergency Medicine
Residency: University of Alabama at Birmingham

Austin Wheeler, M.D.
First-Year Fellow
Residency: University of Alabama at Birmingham

Reid Burks, M.D.
Second-Year Fellow
Residency: University of Alabama at Birmingham

Kevin Gutermuth, M.D.
Second-Year Fellow
Residency: University of Alabama at Birmingham

Mickinzie Morgan, M.D.
Second-Year Fellow
Residency: Texas Tech Health Science Center

Eric Jorge, M.D.
Third-Year Fellow
Residency: University of Alabama at Birmingham

Emily Skoog, M.D.
Third-Year Fellow
Residency: Baylor Scott & White

Alicia Webb, M.D.
Third-Year Fellow
Residency: University of Alabama at Birmingham

Program Directors

Terri Coco, M.D.
Program Director

Christina Cochran, M.D.
Assistant Program Director

Program Coordinator

Aaliyah Williams