Emergency Medicine Commons^™

The Perils Of Recreational Marijuana Use: Relationships With Mental Health Among Emergency Department Patients, Catherine A. Marco, John Paul Detherage Iii, Ashley Lafountain, Megan Hanna, Justin Anderson, Rachel Rhee, Jacqueline Ziegman, Dennis Mann

Emergency Medicine Faculty Publications

Abstract Introduction Marijuana is a commonly used drug in the United States. Many states have legalized the recreational use of marijuana. The effects of marijuana on mental health are unknown. Methods In this prospective survey study, eligible participants included ED patients age 18 and older, who had ever used recreational marijuana. A survey instrument was developed, piloted, and revised. Data collected included reasons for marijuana use, marijuana's perceived effectiveness, and history of mental health conditions, including depression, anxiety, and suicidal thoughts. Results Among 303 participants (86% response rate), the median age of first marijuana use was 16 ([IQR 14, 19], …

Predictors Of New-Onset Atrial Fibrillation In Geriatric Trauma Patients, Catherine A. Marco, Jennifer Lynde, Blake Nelson, Joshua Madden, Adam Schaefer, Claire Hardman, Mary Mccarthy

Emergency Medicine Faculty Publications

Geriatric patients (age >65) comprise a growing segment of the trauma population. New-onset atrial fibrillation may occur after injury, complicating clinical management and resulting in significant morbidity and mortality. This study was undertaken to identify clinical and demographic factors associated with new-onset atrial fibrillation among geriatric trauma patients . Methods: In this case control study, eligible participants included admitted trauma patients age 65 and older who developed new-onset atrial fibrillation during the hospitalization. Controls were admitted trauma patients who were matched for age and injury severity score, who did not develop atrial fibrillation. We evaluated the associations between new-onset atrial …

Mandatory And Permissive Reporting Laws: Obligations, Challenges, Moral Dilemmas, And Opportunities, Joel M. Geiderman, Catherine A. Marco

Emergency Medicine Faculty Publications

The duty to report certain conditions to public health or law enforcement authorities is one that falls on all physicians and other health care workers as part of their duty to protect the public from harm. In an open society, others, such as teachers, clergy, police officers, or simply neighbors, share the responsibility of protecting individuals at risk, often by reporting them to authorities. The emergency physician and others in the emergency department are uniquely positioned to identify people at risk or who pose a risk, and to report them as required or allowed under the law. In some circumstances, …

The 2016 Model Of The Clinical Practice Of Emergency Medicine, Francis L. Counselman, Kavita Babu, Mary Ann Edens, Diane L. Gorgas, Cherri Hobgood, Catherine A. Marco, Eric Katz, Kevin Rodgers, Leonard A. Stallings, Michael C. Wadman

Emergency Medicine Faculty Publications

Emergency medicine (EM) has a scientifically derived and commonly accepted description of the domain of its clinical practice. That document, “The Model of the Clinical Practice of Emergency Medicine” (EM Model), was developed through the collaboration of six organizations: the American Board of Emergency Medicine (ABEM), the administrative organization for the project, the American College of Emergency Physicians (ACEP), the Council of Emergency Medicine Residency Directors (CORD), the Emergency Medicine Residents' Association (EMRA), the Residency Review Committee for Emergency Medicine (RRC-EM), and the Society for Academic Emergency Medicine (SAEM). Development of the EM Model was based on an extensive practice …

Emergency Department Length Of Stay: Accuracy Of Patient Estimates, Brendan T. Parker, Catherine A. Marco

Emergency Medicine Faculty Publications

Introduction

Managing a patient’s expectations in the emergency department (ED) environment is challenging. Previous studies have identified several factors associated with ED patient satisfaction. Lengthy wait times have shown to be associated with dissatisfaction with ED care. Understanding that patients are inaccurate at their estimation of wait time, which could lead to lower satisfaction, provides administrators possible points of intervention to help improve accuracy of estimation and possibly satisfaction with the ED. This study was undertaken to examine the accuracy of patient estimates of time periods in an ED and identify factors associated with accuracy.

Method

In this prospective convenience …

Pain Scores Among Ed Patients: Correlation With Desire For Pain Medication, Catherine A. Marco, Megan Mcgervey, Joan Gekonde, Caitlin Martin

Emergency Medicine Faculty Publications

Introduction: Pain has been identified as the most common reason for Emergency Department (ED) visits. The verbal numeric rating pain scale (VNRS) is commonly used to assess pain in the ED. This study was undertaken to determine whether VNRS pain scores correlate with desire for pain medication among ED patients.

Methods: In this prospective survey study, eligible patients included Emergency Department patients over 18 with painful conditions. The primary outcome measures included self-reported VNRS, ED diagnosis, number of ED visits and number of ED admissions within the past year, and the self-reported desire for pain medication.

Results: Among 482 participants …

End-Of-Life Issues In The Acute And Critically Ill Patient, Eric A. Savory, Catherine A. Marco

Emergency Medicine Faculty Publications

The challenges of end-of-life care require emergency physicians to utilize a multifaceted and dynamic skill set. Such skills include medical therapies to relieve pain and other symptoms near the end-of-life. Physicians must also demonstrate aptitude in comfort care, communication, cultural competency, and ethical principles. It is imperative that emergency physicians demonstrate a fundamental understanding of end-of-life issues in order to employ the versatile, multidisciplinary approach required to provide the highest quality end-of-life care for patients and their families.

Informed Consent For Medical Research: Case Studies, Catherine A. Marco

Emergency Medicine Faculty Publications

Informed consent for medical research is an essential, but challenging, process to assure the protection of the rights of potential research subjects. Numerous barriers to the informed consent process exist among patients, including impaired decisional capacity, impaired cognition, language barriers, illiteracy, insufficient time and communication, and numerous others. Because of the inherent vulnerability of patients, particular attention should be paid to addressing barriers to adequate informed consent, and steps should be taken to ensure adequate delivery of information, understanding of the study and its risks and benefits, and voluntariness of the informed consent.

Decisions At The End Of Life, Catherine A. Marco

Emergency Medicine Faculty Publications

As members of the Church, we believe that our Heavenly Father, in His divine judgment, chooses the appropriate time of death, the essential step and passageway to the next and more perfect life. Although medical technology has created many possibilities for increasing the quality and duration of life in many cases, its use must be appropriately and cautiously implemented. The role of medicine and technology should be to assist in providing cure and comfort to patients in need, rather than the artificial postponement of the natural process of dying.

Unchanged Maladies: Current Perspectives On Old Testament Diseases, Catherine A. Marco

Emergency Medicine Faculty Publications

As a physician reading the Old Testament this year, I often find myself speculating about some of the medical conditions referred to in the Old Testament. Although many disease entities have surely changed significantly over the past several thousand years, the human anatomy remains basically unchanged, thus rendering man susceptible to the same categories of disease in any day and age.

Coping With Unexpected Death, Catherine A. Marco

Emergency Medicine Faculty Publications

As physicians, we frequently encounter the task of notifying and supporting family members during critical situations. Perhaps the heaviest of burdens is the responsibility of informing family members and friends of the unexpected death of a loved one.