Urinary catheter reminders and stop orders appear to reduce the rate of CAUTI and should be strongly considered to enhance the safety of hospitalized patients.

Objective To compare hesitancy toward a future COVID-19 vaccine for children of various sociodemographic groups in a major metropolitan area, and to understand how parents obtain information about COVID-19. Methods Cross-sectional online survey of parents with children < 18 years old in Chicago and Cook County, Illinois, in June 2020. We used logistic regression to determine the odds of parental COVID-19 vaccine hesitancy (VH) for racial/ethnic and socioeconomic groups, controlling for sociodemographic factors and the sources where parents obtain information regarding COVID-19. Results Surveys were received from 1702 parents and 1425 were included in analyses. Overall, 33% of parents reported VH for their child. COVID-19 VH was higher among non-Hispanic Black parents compared with non-Hispanic White parents (Odds Ratio (OR) 2.65, 95% Confidence Interval (CI): (1.99–3.53), parents of publicly insured children compared with privately insured (OR 1.93, (1.53–2.42)) and among lower income groups. Parents receive information about COVID-19 from a variety of sources, and those who report using family, internet and health care providers as information sources (compared to those who don’t use each respective source) had lower odds of COVID-19 VH for their children. Conclusions The highest rates of hesitancy toward a future COVID-19 vaccine were found in demographic groups that have been the most severely affected by the pandemic. These groups may require targeted outreach efforts from trusted sources of information in order to promote equitable uptake of a future COVID-19 vaccine.

BACKGROUND Little is known about emergency department (ED) use among pediatric patients with cancer. We explored reasons prompting emergency department (ED) visits and factors associated with hospital admission. PROCEDURE A retrospective cohort analysis of pediatric ED visits from 2006-2010 using the Nationwide Emergency Department Sample, the largest all-payer database of United States ED visits. Pediatric patients with cancer (ages ≤19 years) were identified using Clinical Classification Software. Proportion of visits and disposition for the top ten-ranking non-cancer diagnoses were determined. Weighted multivariate logistic regression was performed to analyze factors associated with admission versus discharge. RESULTS There were 294,289 ED visits by pediatric patients with cancer in the US over the study period. Fever and fever with neutropenia (FN) were the two most common diagnoses, accounting for almost 20% of visits. Forty-four percent of pediatric patients with cancer were admitted to the same hospital, with admission rates up to 82% for FN. Risk factors for admission were: FN (odds ratio (OR) 8.58; 95% confidence interval (CI) 5.97-12.34); neutropenia alone (OR 7.28; 95% CI 5.08-10.43), ages 0-4 years compared with 15-19 years (OR 1.19; 95% CI 1.08-1.31) and highest median household income ZIP code (OR 1.27; 95% CI 1.08-1.49) compared with lowest. “Self-pay” visits had lower odds of admission (OR 0.42; 95% CI 0.35-0.51) compared with public payer. CONCLUSION FN was the most common reason for ED visits among pediatric patients with cancer and is the condition most strongly associated with admission. Socioeconomic factors appear to influence ED disposition for this population.

It is estimated that 166 200 out-of-hospital cardiac events occur each year in the United States, with approximately 60% of these events treated by emergency medical services (EMS). 1 Reported rates of survival following outof-hospital cardiac arrest (OHCA) vary widely, from 0.2% (Detroit [2007]) 2 to 23% (London, England [2005]). 3 Nationwide, the median reported survival rate is 6.4%. 4 The vast majority of patients who survive OHCA are resuscitated at the scene of the cardiac arrest and subsequently transported to the hospital for definitive care. 5,6 Nevertheless, the practice of EMS systems in cases of refractory OHCA vary widely from agency to agency. Although most systems generally follow the basic life support (BLS) and advanced life support(ALS)generalresuscitationguidelines outlined by the American Heart Association, 7 there is widespread variability in their application. In one study, adherence to American Heart Association guidelines for the out-of-hospital care of cardiac arrest was only 40%. 8 During the past 30 years, several research teams have sought to define objective clinical criteria to identify patients who likely will not benefit from rapid transport to the hospital for further resuscitative efforts. 9-18 Despite this research, many EMS systems still urgently transport patients with refractory cardiac arrest to the hospital for continued resuscitative efforts. 19-21 Rapid transport with lights and siren may pose hazards for EMS personnel and the public and should occur only when the risks of high-speed trans-See also pp 1423 and 1462.