Fran Balamuth, MD, PhD

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Fran Balamuth, MD, PhD, is an attending physician and the Director of Research in the Emergency Department, Co-Director of the Center for Sepsis Excellence, and a faculty member in the Center for Pediatric Clinical Effectiveness at Children’s Hospital of Philadelphia.

Locations: Main Hospital
Appointments and Referrals: 1-800-TRY-CHOP (1-800-879-2467)

Background

Fran Balamuth MD, PhD, MSCE is Associate Professor of Pediatrics at the University of Pennsylvania, and an attending physician in the emergency department at the Children’s Hospital of Philadelphia. Dr. Balamuth’s research interests focus on pediatric sepsis recognition using both epidemiologic and translational approaches, for which she has received both NIH and foundational funding. She is the co-PI of the PROMPT BOLUS trial, a multinational pragmatic trial which compares saline vs balanced fluids in pediatric sepsis, and will be the largest acute care pediatric trial in history. In addition, she co-leads the CHOP Pediatric Sepsis Program, which supports and promotes local clinical, research, educational, and quality improvement initiatives around sepsis. She is an internationally recognized sepsis leader, and has been invited to serve on the national steering committee for the Improving Pediatric Sepsis Outcomes quality collaborative through the US Children’s Hospital Association, and 2 international task forces focused on defining pediatric sepsis through the US Centers for Disease Control and Prevention and the Society of Critical Care Medicine.

Education and Training

Medical School

MD - Yale University School of Medicine, New Haven, CT

Residency

Pediatrics - Children's Hospital of Philadelphia, Philadelphia, PA

Fellowship

Postdoctoral Fellow - Yale University School of Medicine, New Haven, CT
Pediatric Emergency Medicine - Children's Hospital of Philadelphia, Philadelphia, PA

Board Certification

Pediatric Emergency Medicine – American Board of Pediatrics
Pediatrics – American Board of Pediatrics

Graduate Degree

PhD in Immunobiology - Yale University School of Medicine, New Haven, CT
MSCE - University of Pennsylvania School of Medicine, Philadelphia, PA

Titles and Academic Titles

Attending Physician

Director of Research, Division of Emergency Medicine

Co-Director, Pediatric Sepsis Program

Associate Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania

Departments and Services

Selected Publications

Publications

Books

Chapters

2017

Anna Weiss and Fran Balamuth: Triage of the Acutely Ill Child. Nelson's Textbook of Pediatrics, 21st Edition. Robert C. Tasker (eds.). ELSEVIER, in press 2017.

2016

Balamuth F, Alpern ER.: Protocol-based, septic-shock care may reduce acute kidney injury. Journal of Pediatrics 172: 224-227, May 2016.

Balamuth F, Fitzgerald J, and Weiss S: Shock. Textbook of Pediatric Emergency Medicine. Fleischer and Ludwig (eds.). Lippincott, Williams, and Wilkins, Page: 55-68, 2016.

Fran Balamuth, Fred Henretig, and Elizabeth Alpern: Fever. Textbook of Pediatric Emergency Medicine. Fleischer and Ludwig (eds.). Lippincott, Williams, and Wilkins, Page: 176-186, 2016.

2013

Balamuth F and Alpern ER: Fever. Schwartz's Clinical Handbook of Pediatric, 5th Edition. Elizabeth R. Alpern (eds.). Lippincott Williams & Wilkins, 2013.

Balamuth F, Henretic F, and Nadel F: Caustic Ingestions. Step Up to Pediatrics. Shah S, Averson B, and Ronan J (eds.). Lippincott Williams and Wilkins, Page: 494- 495, 2013.

Balamuth F, Henretig F, and Nadel F: Lead Poisoning. Step Up to Pediatrics. Shah S, Averson B, Ronan J (eds.). Lippincott Williams and Wilkins, 2013.

Balamuth F, Henretig F, and Nadel F: Acetaminophen Poisoning. Step Up to Pediatrics. Shah S., Averson B, and Ronan J (eds.). Lippincott Williams and Wilkins, 2013.

Balamuth F, Henretig F, and Nadel F: Oral Hypoglycemic Poisoning. Step Up to Pediatrics. Shah S, Averson B, and Ronan J (eds.). Lippincott Williams and Wilkins, 2013.

Balamuth F, Henretig F, and Nadel F: Methemoglobinemia. Step Up to Pediatrics. Shah S, Averson B, Ronan J (eds.). Lippincott Williams and Wilkins, 2013.

Balamuth F, Henretig F, and Nadel F: Organophosphate Poisoning. Step Up to Pediatrics. Shah S, Averson B, Ronan J (eds.). Lippincott Williams and Wilkins, Page: 497-498, 2013.

Balamuth F, Henretig F, and Nadel F: Calcium Channel Blocker Poisoning. Step Up to Pediatrics. Shah S, Averson B, and Ronan J (eds.). Lippincott Williams and Wilkins, Page: 495-496, 2013.

Balamuth F, Henretig F, and Nadel F: Iron Poisoning. Step Up to Pediatrics. Shah S, Averson B, Ronan J (eds.). Lippincott Williams and Wilkins, Page: 496-497, 2013.

2012

Fran Balamuth and Cynthia Mollen: Heroin Intoxication. The 5 Minute Pediatric Clinical Consult. M. William Schwartz, MD (eds.). Wolters Kluwer, Lippincott William Wilkins, publisher, 2012.

Posters and Presentations

2019

Sarah Nutman, Katie Hayes, Fran Balamuth: Predictors of Invasive Testing and Treatment of Fever Without A Source in Children 57 Days to 36 Months in the Emergency Department. Pediatric Academic Societies Annual Meeting, Baltimore, MD, poster presentation April 2019.

Raina Paul, Charles Macias, M Neider, R Brilli, Ruth Riggs, Troy Richardson, Gloria Lukasiewicz, Fran Balamuth, Halden Scott, M Schafer, Holly Depinet, Jeffrey Auletta: Variable and Metric Development for the Improving Pediatric Sepsis Outcomes Collaborative Pediatric Academic Societies Annual Meeting, Baltimore, MD, poster presentation April 2019.

Halden Scott, Raina Paul, R Brilli, Charles Macias, M Niedner, Holly Depinet, Troy Richardson, Ruth Riggs, Heidi Gruhler, Fran Balamuth: Defining Pediatric Sepsis for Large-Scale Electronic Health Record Case Identification in Multicenter Quality Improvement. Pediatric Academic Societies Annual Meeting, Baltimore, MD, platform presentation April 2019.

Fran Balamuth, Nicole Vestal, Marlena Kittick, Peter McBride, Charlie Casper, Melissa Metheney, Jill Baren, Mike Dean, Nate Kuppermann, Ashley Woodford, Scott Weiss: Pragmatic Pediatric Trial of Balanced versus Normal Saline Fluid in Sepsis: PRoMPT BOLUS Pilot Feasibility Study. Pediatric Academic Societies Annual Meeting, Baltimore, MD, poster presentation April 2019.

Desiree Neville, Jonathan Bennett, Fran Balamuth, Aris Garro, David Lewander, Mark Alexander, Lise Nigrovic, M Levas: The clinical impact of an electrocardiogram in children undergoing evaluation for Lyme disease in the emergency department. Pediatric Academic Societies Annual Meeting, Baltimore, MD, poster presentation April 2019.

2018

Sanya Desai, Sahar Rooholomani, Marie Want, Lise Nigrovic, Mark Neuman, Fran Balamuth, Samir Shah, Lura Sartori, Derek Williams, Rianna Leader, Richard Marble, Christine Mitchell, Christ Pruitt, Adrienne DePorre, and Paul Aronson: Duration of Parenteral Antibiotic Therapy in Young Infants with Bacteremic Urinary Tract Infections. Platform Presentation at Pediatric Academic Societies Meeting. Toronto, CA May  2018.

Lise Nigrovic, Jonathan Bennett, Fran Balamuth, Michael Levas, Desiree Neville, Alexandra Maulden, Rachel Chenard, John Branda, and Aris Garro: C6 enzyme immunoassay for the initial management of children presenting to the emergency department with acute arthritis. Platform Presentation at the Pediatric Academic Societies Meeting. Toronto, CA May  2018.

Ellie Souganidis, Mary Kate Abbadessa, Christian Minich, Jane Lavelle, Joseph Zorc, Fran Balamuth: Analysis of Missed Sepsis Patients in an ED with an Electronic Sepsis Alert Session Title: Emergency Medicine - Sepsis Poster presentation at the Pediatric Academic Societies Meeting. Toronto, CA May  2018.

Christopher Woll, Mark Neuman, Chris Pruitt, Marie Wang, Eugene Shapiro, Samir Shah, Russel McCullough, Lise Nigrovic, Sanya Desai, Adrienne DePorre, Rianna Leader, Richard Marble, Fran Balamuth, Elana Feldman, Laura Sartori, Whitney Browning, and Paul Aronson: Epidemiology of Invasive Bacterial Infection in Infants u880460 Days Treated in Emergency Departments. Poster presentation at the Pediatric Academic Societies Meeting. Toronto, CA May  2018.

Chris Pruitt, Sarah Shin, Sanya Desai, Rianna Leazer, Marie Wang, Laura Sartori, Richard Marble, Veronika Shabanova, Christopher Toll, Sahar Rooholamini, Catherine Lumb, Fran Balamuth, and Paul Aronson: Factors Associated with Adverse Outcomes Among Infants u880460 Days Old with Invasive Bacterial Infections. Platform Presentation at Pediatric Academic Societies Meeting. Toronto, CA May  2018.

Aronson PL, Wang ME, Nigrovic LE, Shah SS, Desai S, Pruitt CM, Balamuth F, Sartori L, Marble RD, Rooholamini SN, Leazer RC, Woll C, DePorre AG, Neuman MI; for the Febrile Young Infant Research Collaborative: Time to Pathogen Detection for Infants u880460 Days Old with Invasive Bacterial Infections Session Title: Hospital Medicine: febrile neonate Poster presentation at the Pediatric Academic Societies Meeting. Toronto, CA May  2018.

Jenny Raman, Tiffani Johnson, Katie Hayes, Fran Balamuth:  Racial Differences in Pediatric Sepsis Alert Performance in a Children's Hospital Emergency Department. Platform Presentation at Pediatric Academic Societies Meeting. Toronto, CA May  2018.

2017

Sarah Fesnak, Katie Hayes, Marianne Chilutti, Joe Zorc, MaryKate Abbadessa, Jane Lavelle, Fran Balamuth: Sepsis in complex patients in the Emergency Department: Time to recognition and therapy in patients with high risk conditions. Poster Presentation at the Pediatric Academic Societies Annual Meeting, San Francisco, CA May  2017.

Phoebe Hollyer1,2, Nancy Kassam-Adams PhD3,4, Cynthia Mollen MD MSCE3,4, Fran Balamuth MD, PhD, MSCE3,4: Parental Opinions on the Timing of Informed Consent in Pediatric Sepsis Research Poster Presentation at the Pediatric Academic Societies Annual Meeting, San Francisco, CA May 2017.

Lise Nigrovic1, Jonathan Bennett3, Frances Balamuth2, Michael Levas5,Aris Garro4: Accuracy of clinician suspicion for identifying Lyme disease in children presenting to emergency departments in Lyme disease endemic areas. Poster presentation at the Pediatric Academic Societies Annual Meeting, San Francisco, CA May 2017.

Fran Balamuth, Elizabeth Alpern, Katie Hayes, Ebbing Lautenbach, Blanca Himes: Gene Expression Profiles Differentiate Bacterial vs Viral Source Pathogen in Children with Suspected Sepsis. Poster Presentation at the Pediatric Academic Societies Annual Meeting, San Francisco, CA May  2017.

Courtney Nelson, Svetlana Ostapenko, Joseph Zorc, and Fran Balamuth: Treatment of Non-Urgent Fever in a Pediatric Emergency Department. Poster Presentation at the Pediatric Academic Societies Annual Meeting, San Francisco, CA May  2017.

2016

Allison Ballantine, MD, MEd, Susan DiTaranto, RN, MHA, CPON ,Kathryn Roberts, RN, MSN, CNS, CCRN, CCNS, Frances Balamuth, MD, PhD, MSCE, Scott Weiss, MD, MSCE, Julie Fitzgerald, MD, PhD Sarah Hadley, RN, CPHQ, Christian Minich, BS, Valerie Rigby, RN, Ron Keren, MD, MPH: Improving Response to Suspected Sepsis: Results of a hospital-wide quality improvement initiative. Poster presentation at the American Academy of Pediatrics Annual Meeting.  San Francisco, CA October  2016.

Paul L. Aronson, MD,Russell J. McCulloh, MD, Joel S. Tieder, MD, MPH, Lise E. Nigrovic, MD, MPH,Rianna C. Leazer, MD, Elizabeth R. Alpern, MD, MSCE, Elana A. Feldman, BA,Fran Balamuth, MD, PhD, MSCE, Whitney L. Browning, MD, and Mark I. Neuman, MD, MPH, for the Febrile Young Infant Research Collaborative: Application of Rochester Criteria to Identify Young Infants with Invasive Bacterial Infection. Poster presentation at the Pediatric Academic Society Annual Meeting, Baltimore, MD May  2016.

Lyons T, Cruz A, Freedman S, Neuman M, Balamuth F, Aronson P, Thomson J, Pruitt C, Shah S, Nigrovic L, for the PEM-CRC HSV Study Group: Cerebrospinal fluid WBC correction in infants with traumatic lumbar punctures. Platform Presentation at the Pediatric Academic Societies Annual Meeting, Baltimore, MD May  2016.

Feldman E; McCulloh R; Meyers A; Aronson P; Neuman M; Bradford, M; Williams D; Alpern E; Balamuth F; Blackstone MM; Browning W; Hayes K; Korman R; Leazer R; Nigrovic L; Marble R; Roben, E; Tieder JS: Epidemiology and Antimicrobial Susceptibility in Infants with Bacterial Infections Across US Children's Hospitals  Poster presentation at the Pediatric Academic Society Annual Meeting, Baltimore, MD May  2016.

Cruz A, Freedman S, Kulik D, Fleming A, Thomson J, Schnadower D, Garro A, Pruitt C, Balamuth F, Aronson P, Uspal N, Lyons T, Ishimine P, Bradin S, Grether-Jones K, Miller A, Louie L, Shah S, Nigrovic L: HSV in infants <= 60 days presenting for emergency department evaluation. Platform Presentation at the Pediatric Academic Societies Annual Meeting, Baltimore, MD May  2016.

Courtney E Nelson, MD; Fran Balamuth, MD, PhD; Stephanie Ng, APN; Lisa McAndrew, MD; Khoon-Yen Tay, MD; Aaron Chen, MD: Management of Skin and Soft Tissue Infections Before and After Clinical Pathway Implementation. Poster Presentation at the Pediatric Academic Societies Annual Meeting, Baltimore, MD May  2016.

Moonjoo Han, MD, Julie C. Fitzgerald, MD, PhD, Fran Balamuth, MD, PhD, MSCE, Luke Keele, PhD, Elizabeth R. Alpern, MD, MSCE, Jane Lavelle, MD, Marianne Chilutti, MS,5 Robert Grundmeier, MD,5,6 Vinay M. Nadkarni, MD, MS,1 Neal J. Thomas, MD, MSc,7 Scott L. Weiss, MD, MSCE1: Effects of Delayed Antimicrobial Therapy on Long-term Mortality After Pediatric Sepsis Poster Presentation at the Society for Critical Care Medicine Annual Meeting, Orlando, FL February 2016.

Jessica Signoff, MD; Julie Fitzgerald, MD; David Teachey, MD; Fran Balamuth, MD; Scott L Weiss, MD MSCE: Hypofibrinogenemia is associated with poor outcome and secondary HLH in pediatric severe sepsis. Poster Presentation at Society for Critical Care Medicine Annual Meeting, Orlando, FL February 2016.

Invited Lectures

2021

Fran Balamuth, MD. “Improving Recognition of Pediatric Sepsis by Digital Support Systems", World Sepsis Congress, Virtual Conference. Apr, 2021.

Fran Balamuth, MD. "Sepsis Screening", Grand Rounds, Nationwide Children's Hospital, Columbus, OH (virtual presentation), Nov 2021

Fran Balamuth, MD. "Improving Pediatric Sepsis Recognition", Advocare Children's Hospital, Chicago, IL (virtual presentation), Sept 2021.

2020

Fran Balamuth, MD. "Definitions of Sepsis in Children and Adolescents". Society for Healthcare Epidemiology of America Decennial Conference. Atlanta, GA, Mar, 2020.

Fran Balamuth, MD. "Implementing an Electronic Sepsis Alert in a Community Pediatric Emergency Department", Pediatric Academic Societies (PAS) 2020 Meeting, Philadelphia PA (Meeting cancelled due to COVID-19), May, 2020.

Fran Balamuth, MD. "The Champage Tap: Time to Pop the Cork?", Pediatric Academic Societies (PAS) 2020 Meeting, Philadelphia PA (Meeting cancelled due to COVID-19), May, 2020.

Fran Balamuth, MD. "Association between clinician suspicion and empiric antibiotics for children undergoing emergency department evaluation for potential Lyme disease", Pediatric Academic Societies (PAS) 2020 Meeting, Philadelphia PA (Meeting cancelled due to COVID-19), May, 2020.

Fran Balamuth, MD. "Sexual Abuse Response Team (SART): A Decade in Review", Pediatric Academic Societies (PAS) 2020 Meeting, Philadelphia PA (Meeting cancelled due to COVID-19), May, 2020.

Fran Balamuth, MD. "Characteristics of afebrile infants u880460 days of age with invasive bacterial infections", Pediatric Academic Societies (PAS) 2020 Meeting, Philadelphia PA (Meeting cancelled due to COVID-19), May, 2020.

Fran Balamuth, MD. "Agreement Between Quality Improvement-based Suspected Sepsis and Surveillance-based Confirmed Sepsis in Children", Pediatric Academic Societies (PAS) 2020 Meeting, Philadelphia PA (Meeting cancelled due to COVID-19), May, 2020.

Fran Balamuth, MD. "The Impact of a National Multicenter QI Collaborative on Pediatric Sepsis Care", Pediatric Academic Societies (PAS) 2020 Meeting, Philadelphia PA (Meeting cancelled due to COVID-19), May, 2020.

Fran Balamuth, MD. "Validation of a Prediction Rule for Serious Bacterial Infections (SBIs) in Febrile Infants u8804 60 Days in a Multicenter Network", Pediatric Academic Societies (PAS) 2020 Meeting, Philadelphia PA (Meeting cancelled due to COVID-19), May, 2020.

Fran Balamuth, MD. "Prevalence of bacteremia and meningitis in febrile infants u8804 60 days with positive urinalyses in a multicenter network", Pediatric Academic Societies (PAS) 2020 Meeting, Philadelphia PA (Meeting cancelled due to COVID-19), May, 2020.

Fran Balamuth, MD. "Prospective Validation of the Lyme Meningitis Rule of 7's for identifying children with Lyme Meningitis", Pediatric Academic Societies (PAS) 2020 Meeting, Philadelphia PA (Meeting cancelled due to COVID-19), May, 2020.

Fran Balamuth, MD. "Early Recognition Of Pediatric Sepsis In Community Emergency Departments", Pediatric Academic Societies (PAS) 2020 Meeting, Philadelphia PA (Meeting cancelled due to COVID-19), May, 2020.

2019

Fran Balamuth, MD. The PROMPT BOLUS Trial," Co-lecture with Scott Weiss at the Pediatric Emergency Research, Canada Conference, Banff, Alberta, CA, Feb, 2019.

Fran Balamuth, MD. "Pro/Con Debate: Controversies in Pediatric Sepsis," Invited Science Session at Pediatric Academic Societies Annual Meeting, Baltimore, MD, Apr, 2019.

Fran Balamuth, MD. "Validation of the Pediatric Sequential Organ Failure Assessment Score and Evaluation of Sepsis-3 Definitions in the Pediatric Emergency Department," Platform presentation at Pediatric Academic Societies Annual Meeting, Baltimore, MD, Aug, 2019

Fran Balamuth, MD. "pSOFA in the Emergency Department," Improving Pediatric Sepsis Outcomes Collaborative Conference.  Dallas, TX, Jun, 2019.

Fran Balamuth, MD. "Pediatric Sepsis Screening in the Community Setting". Hospital Association of Pennsylvania Sepsis Conference.  Lancaster, PA, Sept, 2019.

Fran Balamuth, MD. "Saline vs. LR for Sepsis Fluid Resuscitation" Improving Pediatric Sepsis Outcomes Collaborative Conference.  Dallas, TX, Dec, 2019.

Awards and Honors

2016, CHOP Resident Faculty Honor Roll

2014, Outstanding Research Poster, CHOP Research Poster Day

2012, Best Abstract, Patient Quality and Safety Day, Children's Hospital of Philadelphia

2005, Alpha Omega Alpha, Yale University School of Medicine

Editorial and Academic Positions

Editorial positions

2012-present, Peer Reviewer, Academic Emergency Medicine
2012-present, Peer Reviewer, Annals of Emergency Medicine
2009-Present, Peer Reviewer, Archives of Pediatrics and Adolescent Medicine
2009-Present, Peer Reviewer, Pediatric Emergency Care
2012-Present, Peer Reviewer, Annals of Emergency Medicine
2012-Present, Peer Reviewer, Academic Emergency Medicine

Academic positions

2015-present, Co-chair, research committee. Improving Sepsis Outcomes Quality Collaborative Executive Committee
2015-present, Improving Pediatric Sepsis Outcomes (IPSO) National Expert Advisory Committee
2015-present, Grant writing and Publications Committee for the Pediatric Emergency Care Applied Research Network (PECARN)
2012-present, Sepsis Governance Committee, Children's Hospital of Philadelphia
2011-present, Leader, Emergency Department sepsis working group, Children's Hospital of Philadelphia
2009-Present, Education Improvement Committee, Division of Emergency Medicine, Children's Hospital of Philadelphia
2009-Present, Research Committee, Division of Emergency Medicine, Children's Hospital of Philadelphia
2009-Present, Scientific Review Committee, Division of Emergency Medicine, Children's Hospital of Philadelphia
2011-Present, Leader, Emergency Department sepsis working group, Children's Hospital of Philadelphia
2012-Present, Member, Sepsis Governance Committee, Children's Hospital of Philadelphia
2012-Present, Steering Committee Member, American Academy of Pediatrics Septic Shock Collaborative
2014-Present, Member, Society of Critical Care Medicine International Septic Shock Guideline Committee
2015-present, Member, Grant writing and Publications Committee for the Pediatric Emergency Care Applied Research Network (PECARN)
2015-Present, Member, Improving Pediatric Sepsis Outcomes (IPSO) National Expert Advisory Committee

Leadership and Memberships

Memberships in Professional Organizations

National

CHOP Clinical Trials Research Affinity Group, Advisory committee member

2013-present, Shock Society

2012-present, American Academy of Pediatrics Septic Shock Collaborative

2012-present, Society of Critical Care Medicine

 - 2014-present, International Septic Shock Guideline Committee

2010-present, Society for Academic Emergency Medicine

2009-present, Pediatric Academic Societies

2009-present, American Academy of Pediatrics

 - 2012-present, Septic Shock Collaborative Steering Committee