{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T08:55:23Z","timestamp":1790585723703,"version":"4.1.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Objective:<\/jats:title>\n To explore pediatric emergency medicine (PEM) physician perspectives on the death of a child in the emergency department (ED) to identify key lessons learned and areas for improvement in care and provider support.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We conducted a 5-year review of PEM physicians\u2019 experiences after the death of a child at a single urban pediatric ED. Qualitative thematic analysis was performed on questionnaire responses regarding the resuscitation, debrief, overall support, and opportunities for improvement.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Twenty-two PEM physicians provided questionnaire responses to 34 deaths, with no difference in the distribution of number of deaths, sex, or clinical experience between questionnaire respondents and nonrespondents. Six key themes were identified from 34 questionnaire responses: (1) Physicians expressed confidence in the medical aspects of pediatric resuscitation but acknowledged a lack of prehospital information and deliberated airway management. (2) Most physicians found it helpful to have multidisciplinary providers with diverse expertise present during the resuscitation, emphasizing clear leadership and crowd control. (3) Family involvement and communication were crucial during a child\u2019s death. (4) Legal and administrative tasks after the death of a child can be burdensome, serving as possible barriers to completing other essential duties. (5) Continued support during and after the death of a child required significant staffing and was essential for resuming ED operations. (6) Staff debriefings occurred frequently and were highly valued, yet encountered challenges in implementation.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n PEM physicians highlight that leadership, multidisciplinary collaboration, communication with families, and debriefing are vital components surrounding the death of a child in the ED. Future studies should explore insights from nonphysician health care workers and family members.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/pec.0000000000003707","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T08:00:23Z","timestamp":1790582423000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Pediatric Death in the Emergency Department"],"prefix":"10.1097","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3299-5757","authenticated-orcid":false,"given":"Ji Young","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA"},{"name":"Department of Pediatrics, Division of Pediatric Emergency Medicine, Texas Children's Hospital, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Pattee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Aspiotes","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maren M.","family":"Lunoe","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Traci M.","family":"Kazmerski","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle S.","family":"Harvey","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noel B.","family":"Spears","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen A.","family":"Noorbakhsh","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"R1-20260928","doi-asserted-by":"crossref","first-page":"e2025075319","DOI":"10.1542\/peds.2025-075319","article-title":"Pediatric readiness in the emergency department: technical report","volume":"157","author":"Remick","year":"2026","journal-title":"Pediatrics"},{"key":"R2-20260928","doi-asserted-by":"crossref","first-page":"e313","DOI":"10.1542\/peds.2014-1246","article-title":"Death of a child in the emergency department","volume":"134","author":"O\u2019Malley","year":"2014","journal-title":"Pediatrics"},{"key":"R3-20260928","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual Res Psychol"},{"key":"R4-20260928","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1080\/13814788.2017.1375090","article-title":"Series: Practical guidance to qualitative research. Part 2: context, research questions and designs","volume":"23","author":"Korstjens","year":"2017","journal-title":"Eur J Gen Pract"},{"key":"R5-20260928","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1080\/13814788.2017.1375091","article-title":"Series: Practical guidance to qualitative research. Part 3: sampling, data collection and analysis","volume":"24","author":"Moser","year":"2018","journal-title":"Eur J Gen Pract"},{"key":"R6-20260928","doi-asserted-by":"crossref","first-page":"16094069231205789","DOI":"10.1177\/16094069231205789","article-title":"A step-by-step process of thematic analysis to develop a conceptual model in qualitative research","volume":"22","author":"Naeem","year":"2023","journal-title":"Int J Qual Methods"},{"key":"R7-20260928","doi-asserted-by":"crossref","first-page":"100174","DOI":"10.1016\/j.ijnsa.2024.100174","article-title":"Saturation in qualitative research: an evolutionary concept analysis","volume":"6","author":"Rahimi","year":"2024","journal-title":"Int J Nurs Stud Adv"},{"key":"R8-20260928","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"Tong","year":"2007","journal-title":"Int J Qual Health Care J Int Soc Qual Health Care"},{"key":"R9-20260928","doi-asserted-by":"crossref","first-page":"e10709","DOI":"10.1002\/aet2.10709","article-title":"Evolution of clinical event debriefs in a quaternary pediatric emergency department after implementation of a debriefing tool","volume":"5","author":"Chu","year":"2021","journal-title":"AEM Educ Train"},{"key":"R10-20260928","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.jsurg.2017.06.025","article-title":"Closed-loop communication improves task completion in pediatric trauma resuscitation","volume":"75","author":"El-Shafy","year":"2018","journal-title":"J Surg Educ"},{"key":"R11-20260928","doi-asserted-by":"crossref","first-page":"549","DOI":"10.5811\/westjem.2016.7.29812","article-title":"Leadership and teamwork in trauma and resuscitation","volume":"17","author":"Ford","year":"2016","journal-title":"West J Emerg Med"},{"key":"R12-20260928","doi-asserted-by":"crossref","first-page":"116058","DOI":"10.1016\/j.amjsurg.2024.116058","article-title":"Less is more: overlapping communication in trauma resuscitation","volume":"239","author":"Wooder","year":"2025","journal-title":"Am J Surg"},{"key":"R13-20260928","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1111\/anae.15939","article-title":"Cognitive aids in the management of clinical emergencies: a systematic review","volume":"78","author":"Greig","year":"2023","journal-title":"Anaesthesia"},{"issue":"16_suppl_2","key":"R14-20260928","doi-asserted-by":"crossref","first-page":"S719","DOI":"10.1161\/CIR.0000000000001374","article-title":"Part 12: Resuscitation Education Science: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care","volume":"152","author":"Donoghue","year":"2025","journal-title":"Circulation"},{"key":"R15-20260928","doi-asserted-by":"crossref","first-page":"e2024067876","DOI":"10.1542\/peds.2024-067876","article-title":"\u201cDeath is not a dirty word:\u201d a qualitative study of emergency clinician end-of-life communication","volume":"154","author":"Kotler","year":"2024","journal-title":"Pediatrics"},{"key":"R16-20260928","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/S0736-4679(97)00119-4","article-title":"Pediatric death: managing the aftermath in the emergency department","volume":"15","author":"Ahrens","year":"1997","journal-title":"J Emerg Med"},{"key":"R17-20260928","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1056\/NEJMoa1203366","article-title":"Family presence during cardiopulmonary resuscitation","volume":"368","author":"Jabre","year":"2013","journal-title":"N Engl J Med"},{"issue":"16_suppl_2","key":"R18-20260928","doi-asserted-by":"crossref","first-page":"S323","DOI":"10.1161\/CIR.0000000000001371","article-title":"Part 3: Ethics: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care","volume":"152","author":"Elmer","year":"2025","journal-title":"Circulation"},{"key":"R19-20260928","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1177\/10497323231197534","article-title":"Physicians\u2019 lived experience of breaking bad news in clinical practice: five essentials of a relational process","volume":"33","author":"Tranberg","year":"2023","journal-title":"Qual Health Res"},{"key":"R20-20260928","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1136\/archdischild-2019-318398","article-title":"Breaking bad news: what parents would like you to know","volume":"106","author":"Brouwer","year":"2021","journal-title":"Arch Dis Child"},{"key":"R21-20260928","doi-asserted-by":"crossref","first-page":"e1173","DOI":"10.1097\/PEC.0000000000001950","article-title":"Impact of a Pediatric-Focused Communication Course on Patient\/Caregiver-Perceived Physician Communication Skills in a Pediatric Emergency Department","volume":"37","author":"Leaming-Van Zandt","year":"2021","journal-title":"Pediatr Emerg Care"},{"key":"R22-20260928","doi-asserted-by":"crossref","first-page":"e377","DOI":"10.1542\/hpeds.2023-007174","article-title":"PedsTalk: a pilot communication skills education course for pediatric residents","volume":"13","author":"Kase","year":"2023","journal-title":"Hosp Pediatr"},{"key":"R23-20260928","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1111\/acem.14901","article-title":"Not a crime scene: the need to examine the impact of police in the pediatric emergency department","volume":"31","author":"Abrams","year":"2024","journal-title":"Acad Emerg Med Off J Soc Acad Emerg Med"},{"key":"R24-20260928","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1097\/PEC.0000000000002908","article-title":"Interactions with police in the emergency care of children: ethical and legal considerations","volume":"39","author":"Schultz","year":"2023","journal-title":"Pediatr Emerg Care"},{"key":"R25-20260928","doi-asserted-by":"crossref","first-page":"101997","DOI":"10.1016\/j.jflm.2020.101997","article-title":"A prospective study about the discrepancy between postmortem inspections conducted by emergency physicians and forensic pathologists","volume":"73","author":"Lim","year":"2020","journal-title":"J Forensic Leg Med"},{"key":"R26-20260928","doi-asserted-by":"crossref","first-page":"e367","DOI":"10.1097\/PEC.0000000000002476","article-title":"Discrepancies in physician and coroner findings in cases of fatal suspected physical child abuse","volume":"37","author":"Arnold","year":"2021","journal-title":"Pediatr Emerg Care"},{"key":"R27-20260928","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1007\/s12024-015-9680-x","article-title":"An evidence-based guide to the investigation of sudden unexpected death in infancy","volume":"11","author":"Garstang","year":"2015","journal-title":"Forensic Sci Med Pathol"},{"key":"R28-20260928","doi-asserted-by":"crossref","first-page":"e20192076.","DOI":"10.1542\/peds.2019-2076","article-title":"Identifying child abuse fatalities during infancy","volume":"144","author":"Palusci","year":"2019","journal-title":"Pediatrics"},{"key":"R29-20260928","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1002\/aet2.10031","article-title":"Pediatric critical event debriefing in emergency medicine training: an opportunity for educational improvement","volume":"1","author":"Nocera","year":"2017","journal-title":"AEM Educ Train"},{"key":"R30-20260928","doi-asserted-by":"crossref","first-page":"146","DOI":"10.5811\/westjem.2016.10.31467","article-title":"Characteristics of real-time, non-critical incident debriefing practices in the emergency department","volume":"18","author":"Nadir","year":"2017","journal-title":"West J Emerg Med"},{"key":"R31-20260928","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1016\/j.resuscitation.2012.12.005","article-title":"Implementation of an in situ qualitative debriefing tool for resuscitations","volume":"84","author":"Mullan","year":"2013","journal-title":"Resuscitation"},{"key":"R32-20260928","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1097\/PEC.0000000000001898","article-title":"Implementation of an Innovative, Multiunit, Postevent Debriefing Program in a Children\u2019s Hospital","volume":"36","author":"Zinns","year":"2020","journal-title":"Pediatr Emerg Care"},{"issue":"3","key":"R33-20260928","doi-asserted-by":"crossref","first-page":"696","DOI":"10.5811\/westjem.2020.49180","article-title":"Help us help you: engaging emergency physicians to identify organizational strategies to reduce burnout","volume":"22","author":"Baugh","year":"2021","journal-title":"West J Emerg Med"},{"key":"R34-20260928","doi-asserted-by":"crossref","first-page":"167","DOI":"10.2147\/OAEM.S418935","article-title":"Compassion fatigue in emergency medicine: current perspectives","volume":"16","author":"Jeanmonod","year":"2024","journal-title":"Open Access Emerg Med OAEM"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/PEC.0000000000003707","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T08:00:28Z","timestamp":1790582428000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/PEC.0000000000003707"}},"subtitle":["Qualitative Insights From Physicians\u2019 Experiences"],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":34,"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000003707","relation":{},"ISSN":["0749-5161","1535-1815"],"issn-type":[{"value":"0749-5161","type":"print"},{"value":"1535-1815","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,28]]},"assertion":[{"value":"2026-04-21","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-31","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}