Aris C. GarroAssociate Professor of Emergency Medicine, Associate Professor of Pediatrics
Dr. Garro is a researcher affiliated with the Warren Alpert Medical School of Brown University and Rhode Island Hospital. His clinical affiliation is as an attending in the Hasbro Children's Hospital Emergency Department. His research expertise includes interventions to improve disease management in children presenting to the emergency department with asthma, biomarkers of cerebral injury, and clinical management of Lyme meningitis.
Garro AC, Chun T. Trauma Emergencies, Book Chapter in Practical Guide to the Care of the Pediatric Patient. Alario A - author, Elsevier - 2007
Garro AC, Linakis J. Umbilical Vessel Catheterization Book Chapter in Textbook of Pediatric Emergency Procedures, King & Henritig - editors, Lippincott Williams & Wilkins – 2007
Garro AC. Lyme Disease. First Consult online reference. Updated February 2012.
Garro AC. “Management of asthma exacerbations in the home: Analysis of current guidelines, barriers to implementation and potential solutions”. Thesis May 2007; Submitted in partial fulfillment of the requirements for the degree of Master of Public Health in the division of Biology and Medicine at Brown University
Dr. Garro's is a clinical researcher in the Hasbro Children's Hospital emergency department. He is a clinical trialist who focuses on two disease processes; asthma and Lyme disease. His work in asthma includes point-of-care interventions at an ED visit for children with asthma to improve disease management. Dr. Garro was a co-founder of Pedi Lyme Net, a consortium of pediatric hospitals developing novel diagnostics and treatment for children with Lyme disease. In addition, Dr. Garro is the site investigator at Hasbro Children's Hospital for the PECARN Fluid Therapy in DKA study, and is performing ancillary work on biomarkers of cerebral injury in DKA.
Dr. Garro's research focuses on preventive interventions after an ED visit for children with asthma to improve disease management, and Lyme meningitis. He is currently funded on several research grants, notably as the principal investigator on an NIH sponsored grant (NICHD R21HD082621 ), which is a clinical trial of a novel computer-based intervention to improve adherence with asthma medications in a setting where children often have low medication adherence. Dr. Garro is also a member of the Children's Asthma Research Program (CARP), a multi-disciplinary group of researchers at Brown.
Dr. Garro is a co-founder of Pedi Lyme Net and has published studies on Lyme meningitis, focusing on decision-making to identify children with undifferentiated aseptic meningitis vs. children with Lyme meningitis. "Prospective Validation of a Clinical Prediction Model for Lyme Meningitis in Children" validated the clinical prediction rule derived by Avery, et al., and also resulted in the rule of 7's.
Recently Dr. Garro is currently is the lead investigator planning a trial of oral doxycycline for the treatment of Lyme meningitis in children.
1. Diagnosing Asthma in Young Children: Parents' Perceptions of Barriers. University Emergency Medicine Foundation Junior Faculty Research Development Grant (PI Garro), $31,478 FY 2009, role: Principal Investigator
Grant description: The goal of this study was to identify the expectations that caregivers have during the diagnostic process, and provide guidance to clinicians on how to incorporate these expectations in caregiver education. We addressed these research goals using thematic analysis of caregiver focus groups that occurred within one year of a child's asthma diagnosis.
2. Rhode Island Department of Health Asthma Control Program: Addressing Asthma from a Public Health Perspective, Rhode Island Department of Health CAP Contract: Emergency Department Diversion Project (PI: Klein / McQuaid) 2011 to present, $70,000 FY 2011, role: Sub-contracted Investigator
Grant description: The CDC is funding the health department in Rhode Island to conduct asthma surveillance, maintain and expand partnerships, implement statewide comprehensive asthma plans, implement interventions to reduce the burden of asthma, and develop and implement an evaluation plan.
3. Improving Pediatric Resuscitation: A Simulation Program for the Community ED. Agency for Health Research and Quality R18 (PI Brown), 2011 to present, $243,101 (all years), role: Consultant on Qualitative Methods
Grant description: This study proposes to utilize high-fidelity in situ medical simulation to assess Rhode Island's community emergency departments' ability to perform pediatric resuscitations. The study also aims to develop a simulation-enhanced educational intervention to assist Rhode Island's community emergency departments and staff members in improving their skills and optimizing the systems required to effectively perform pediatric resuscitations
4. Optimizing Use of Inhaled Corticosteroids after Emergency Department Visits for Children with Uncontrolled Asthma. American Lung Association / Chest Foundation Grants Program (PI Garro) 2012-2014, $76,980 (all years), role: Principal Investigator
Grant description: The objectives of the project are to develop a systematized method to prescribe inhaled corticosteroids to children with uncontrolled asthma after an emergency department visit, and to identify factors associated with medication adherence to develop an educational component to accompany prescriptions.
5. New England Asthma Innovations Collaborative. Center for Medicaid & Medicare Services / Health Resources in Action, Health Care Initiative Challenge Award (PI: Chacker), 2012 to 2015, $4,040,657 (all years), role Sub-contracted Investigator
Grant description: This program is a multi-state, multi-sector partnership that includes health care providers, payers, and policy makers aimed at creating an innovative Asthma Marketplace in New England that will increase the supply and demand for high-quality, cost-effective health care services. Over the three year funding period, services will be delivered to over 1400 children ages 2-17 with persistent asthma to lower costs of asthma care by delivering cost-effective prevention oriented care in clinics and at home to reduce preventable pediatric-related emergency visits and hospital admissions with estimated savings of over $4 million.
6. Fluid Therapy and Cerebral Injury in Pediatric Diabetic Ketoacidosis. NICHD U01HD062417 (PIs: Kupperman/Glaser), 2011 to 2016, $600,784 FY 2012, Role: Clinical Center Investigator
Grant description: This is a multi-center factorial-design randomized controlled trial comparing four ﬂuid treatment protocols for pediatric DKA to determine the optimal fluid therapy for reducing the incidence of cerebral injury in pediatric diabetic ketoacidosis.
7. Vital Signs: A Quality Improvement Project to Improve Patient Outcomes and Reduce Return Visits in the Pediatric ED. Lifespan Risk Management Grant (PI: Jacobs), 2012, $17,893 FY 2012, role: Co-investigator.
Grant description: The objectives of this 12 month project are to gather data regarding baseline documentation of and response to vital signs in the pediatric emergency department, to describe behaviors of clinicians regarding potential barriers to documentation and follow-up of abnormal vital signs, to identify strategies for educational and system-based interventions to improve documentation and recognition of and response to abnormal vital signs, and to institute interventions, through PDSA cycles, to achieve improved documentation of vital signs in the Pediatric ED.
2006 - Present Rhode Island Public Health Association
2008 - Present Society for Academic Emergency Medicine, Section of Pediatrics
2008 - Present Academic Pediatric Association
2008 - Present Rhode Island Medical Society
2010 - Present Project HARP (Home Asthma Response Plan) steering committee member. This collaboraton between the Centers for Disease Control, Rhode Island Department of Health, and Hasbro Children's Hospital uses home-based interventions to improve disease management after children visit the emergency department for an asthma exacerbation.
2011 - Present The Pediatric Emergency Care Applied Research Network site investigator for the Fluid Therapy and Cerebral Injury in Pediatric Diabetic Ketoacidosis.
2015 - Present Co-founder of Pedi Lyme Net, a consortium of pediatric hospitals studying novel diagnostics and treatment for children with Lyme disease
Clinical teaching occurs in the Hasbro Children's Hospital Emergency Department, where he is an instructor for emergency medicine, pediatric, and family practice residents as well as medical students during his clinical shifts.