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Full-Text Articles in Medicine and Health Sciences

Opioid Administration And Prescribing In Older Adults In U.S. Emergency Departments (2005-2015)., Erin M Marra, Maryann Mazer-Amirshahi, Peter Mullins, Jesse M Pines Jul 2018

Opioid Administration And Prescribing In Older Adults In U.S. Emergency Departments (2005-2015)., Erin M Marra, Maryann Mazer-Amirshahi, Peter Mullins, Jesse M Pines

Emergency Medicine Faculty Publications

Introduction: We assess trends in opioid administration and prescribing from 2005-2015 in older adults in United States (U.S.) emergency departments (ED).

Methods: We analyzed data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) survey from 2005 to 2015. ED visits for painful conditions were selected and stratified by age (18-64, 65-74, 75-84, ≥ 85 years). We analyzed trends in opioid administration in the ED and prescribing at discharge to encounters ≥ 65 and assessed predictors of use using survey-weighted chi-square tests and logistic regression. Trends in the use of five commonly prescribed opioids were also explored.

Results: Opioid administration …


A Global Health Research Checklist For Clinicians., Rasha D Sawaya, Kristen A Breslin, Eiman Abdulrahman, Jennifer I Chapman, Dafina M Good, Lili Moran, Paul C Mullan, Oluwakemi Badaki-Makun Apr 2018

A Global Health Research Checklist For Clinicians., Rasha D Sawaya, Kristen A Breslin, Eiman Abdulrahman, Jennifer I Chapman, Dafina M Good, Lili Moran, Paul C Mullan, Oluwakemi Badaki-Makun

Pediatrics Faculty Publications

Global health research has become a priority in most international medical projects. However, it is a difficult endeavor, especially for a busy clinician. Navigating the ethics, methods, and local partnerships is essential yet daunting.To date, there are no guidelines published to help clinicians initiate and complete successful global health research projects. This Global Health Research Checklist was developed to be used by clinicians or other health professionals for developing, implementing, and completing a successful research project in an international and often low-resource setting. It consists of five sections: Objective, Methodology, Institutional Review Board and Ethics, Culture and partnerships, and Logistics. …


Recurrent Episodes Of Acute Pancreatitis Present To The Ed With More Severe Disease By Ct Than First-Time Acute Pancreatitis, Maryam Boumezrag, Hamza Ijaz, Lorna Richards, Sormeh Harounzadeh, Angeline Johny, Paige Kulie, Caitlin Davis, Yan Ma, Maxine Le Saux, Andrew C. Meltzer Apr 2018

Recurrent Episodes Of Acute Pancreatitis Present To The Ed With More Severe Disease By Ct Than First-Time Acute Pancreatitis, Maryam Boumezrag, Hamza Ijaz, Lorna Richards, Sormeh Harounzadeh, Angeline Johny, Paige Kulie, Caitlin Davis, Yan Ma, Maxine Le Saux, Andrew C. Meltzer

GW Research Days 2016 - 2020

Study Objective: Approximately 30% of patients with one episode of acute pancreatitis experience a recurrent episode. The objective of this study is to compare the severity of the first-time episode versus recurrent episodes of acute pancreatitis based on CT scan.

Methods: This study was conducted as part of a retrospective chart review at a single academic urban emergency department from 2012-2016. Criteria for inclusion included clinical symptoms of pancreatitis, age greater than or equal to 18 years, ED diagnosis of acute pancreatitis, and, an abdominal CT scan within 24 hours of triage. Exclusion criteria were traumatic cause of acute pancreatitis …


A Survey Of Language Diversity And Communication In Indian Academic Emergency Departments, Rebecca S. Allen, Lalit Narayan, Jay Pandya, Zohray Talib, Katherine A. Douglass Apr 2018

A Survey Of Language Diversity And Communication In Indian Academic Emergency Departments, Rebecca S. Allen, Lalit Narayan, Jay Pandya, Zohray Talib, Katherine A. Douglass

GW Research Days 2016 - 2020

Background

Communication in the Emergency Department (ED) is particularly important given the acuity of patients and lack of prior medical history. In India, patient care is further complicated by the many spoken languages, the regional differentiation in language and the fact that medical training is primarily delivered in English. Our objective was to document language diversity among clinicians in Indian EDs linked to an international training program and explore issues related to clinician-clinician and clinician-patient communication.

Methodology

A cross-sectional survey of ED clinicians was conducted from May to July 2017. Survey participants were recruited via convenience sampling by a researcher …


Tobacco Dependence Treatment In The Emergency Department: A Randomized Trial Using The Multiphase Optimization Strategy., Steven L Bernstein, James Dziura, June Weiss, Ted Miller, Katrina A Vickerman, Lauretta E Grau, Michael V Pantalon, Lorien Abroms, Linda M Collins, Benjamin Toll Mar 2018

Tobacco Dependence Treatment In The Emergency Department: A Randomized Trial Using The Multiphase Optimization Strategy., Steven L Bernstein, James Dziura, June Weiss, Ted Miller, Katrina A Vickerman, Lauretta E Grau, Michael V Pantalon, Lorien Abroms, Linda M Collins, Benjamin Toll

Prevention and Community Health Faculty Publications

Background

Tobacco dependence remains the leading preventable cause of death in the developed world. Smokers are disproportionately from lower socioeconomic groups, and may use the hospital emergency department (ED) as an important source of care. A recent clinical trial demonstrated the efficacy of a multicomponent intervention to help smokers quit, but the independent contributions of those components is unknown.

Methods

This is a full-factorial (16-arm) randomized trial in a busy hospital ED of 4 tobacco dependence interventions: brief motivational interviewing, nicotine replacement therapy, referral to a telephone quitline, and a texting program. The trial utilizes the Multiphase Optimization …


Identifying Gaps And Launching Resident Wellness Initiatives: The 2017 Resident Wellness Consensus Summit., Fareen Zaver, Nicole Battaglioli, William Denq, Anne Messman, Arlene Chung, Michelle Lin, Emberlynn L Liu Mar 2018

Identifying Gaps And Launching Resident Wellness Initiatives: The 2017 Resident Wellness Consensus Summit., Fareen Zaver, Nicole Battaglioli, William Denq, Anne Messman, Arlene Chung, Michelle Lin, Emberlynn L Liu

Emergency Medicine Faculty Publications

Introduction: Burnout, depression, and suicidality among residents of all specialties have become a critical focus for the medical education community, especially among learners in graduate medical education. In 2017 the Accreditation Council for Graduate Medical Education (ACGME) updated the Common Program Requirements to focus more on resident wellbeing. To address this issue, one working group from the 2017 Resident Wellness Consensus Summit (RWCS) focused on wellness program innovations and initiatives in emergency medicine (EM) residency programs.

Methods: Over a seven-month period leading up to the RWCS event, the Programmatic Initiatives workgroup convened virtually in the Wellness Think Tank, an online, …


Acute Cardiac Air Embolism, Leslie Billello, Brian Gacioch, James P. Phillips Jan 2018

Acute Cardiac Air Embolism, Leslie Billello, Brian Gacioch, James P. Phillips

Emergency Medicine Faculty Publications

No abstract provided.


Optimal Implementation Of Prescription Drug Monitoring Programs In The Emergency Department, Joshua Elder, Garrett Depalma, Jesse M. Pines Jan 2018

Optimal Implementation Of Prescription Drug Monitoring Programs In The Emergency Department, Joshua Elder, Garrett Depalma, Jesse M. Pines

Emergency Medicine Faculty Publications

The opioid epidemic is the most significant modern-day, public health crisis. Physicians and lawmakers have developed methods and practices to curb opioid use. This article describes one method, prescription drug monitoring programs (PDMP), through the lens of how to optimize use for emergency departments (ED). EDs have rapidly become a central location to combat opioid abuse and drug diversion. PDMPs can provide emergency physicians with comprehensive prescribing information to improve clinical decisions around opioids. However, PDMPs vary tremendously in their accessibility and usability in the ED, which limits their effectiveness at the point of care. Problems are complicated by varying …


The Accuracy Of Point-Of-Care Ultrasound In Detecting Small Bowel Obstruction In Emergency Department, Ali Pourmand, Ubah Dimbil, A. Drake, Hamid A. Shokoohi Jan 2018

The Accuracy Of Point-Of-Care Ultrasound In Detecting Small Bowel Obstruction In Emergency Department, Ali Pourmand, Ubah Dimbil, A. Drake, Hamid A. Shokoohi

Emergency Medicine Faculty Publications

Radiological imaging plays an essential role in the evaluation of a patient with suspected small bowel obstruction (SBO). In a few studies, point-of-care ultrasound (POCUS) has been utilized as a primary imaging modality in patients with suspected SBO. POCUS has been shown to be an accurate tool in the diagnosis of SBO with multiple research studies noting a consistent high sensitivity with a range of 94–100% and specificity of 81–100%. Specific sonographic findings that increase the likelihood of SBO include dilatation of small bowel loops > 25 mm, altered intestinal peristalsis, increased thickness of the bowel wall, and intraperitoneal fluid accumulation. …


Simulation-Based Training In Ebola Personal Protective Equipment For Healthcare Workers: Experience From King Abdulaziz University Hospital In Saudi Arabia, Jameel Abualenain, M. Al-Alawi Jan 2018

Simulation-Based Training In Ebola Personal Protective Equipment For Healthcare Workers: Experience From King Abdulaziz University Hospital In Saudi Arabia, Jameel Abualenain, M. Al-Alawi

Emergency Medicine Faculty Publications

Background: Millions of Muslims from across the world gather annually to perform pilgrimage. This can import unusual communicable diseases such as Ebola. Communicable diseases with a high risk of mortality necessitate special training to master the required competency to avert transmission of infections. The efficacy of simulation-based training (SBT) has been shown in such circumstances. Objective: We sought to develop an SBT program in Ebola Personal Protective Equipment (PPE) for all healthcare workers (HCWs). Methods: We conducted a quasi-experimental study at the clinical skills and simulation center at the King Abdulaziz University. An interdisciplinary committee was formed to develop this …


International Scope Of Emergency Ultrasound: Barriers In Applying Ultrasound To Guide Central Line Placement By Providers In Nairobi, Kenya, Fareen Zaver, Keith S. Boniface Jan 2018

International Scope Of Emergency Ultrasound: Barriers In Applying Ultrasound To Guide Central Line Placement By Providers In Nairobi, Kenya, Fareen Zaver, Keith S. Boniface

Emergency Medicine Faculty Publications

Background

While ultrasound (US) use for internal jugular central venous catheter (CVC) placement is standard of care in North America, most developing countries have not adopted this practice. Previous surveys of North American physicians have identified lack of training and equipment availability as the most important barriers to the use of US. Go to:

Objective

We sought to identify perceived barriers to the use of US to guide CVC insertion in a resource-constrained environment. Go to:

Methods

Prior to an US-guided CVC placement training course conducted at the Aga Khan University Hospital in Nairobi, Kenya, physicians were asked to complete …