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Acute Cardiac Air Embolism, Leslie Billello, Brian Gacioch, James P. Phillips 2018 George Washington University

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

Emergency Medicine Faculty Publications

No abstract provided.


Are Audience Response Systems Worth The Cost? Comparing Question-Driven Teaching Strategies For Emergency Medical Technician Education, Lauren M. Maloney, James P. Dilger, Paul A. Werfel, Linda M. Cimino 2017 Stony Brook University School of Medicine

Are Audience Response Systems Worth The Cost? Comparing Question-Driven Teaching Strategies For Emergency Medical Technician Education, Lauren M. Maloney, James P. Dilger, Paul A. Werfel, Linda M. Cimino

Internet Journal of Allied Health Sciences and Practice

Purpose: As Emergency Medical Technician educators develop curricula to meet new national educational standards, effective teaching strategies validated for course content and unique student demographics are warranted. Three methods for answering multiple choice questions presented during lectures were compared: a) Audience Response System (ARS, clickers), b) hand-raising-with-eyes-closed (no-cost option), and c) passive response (no-cost option). The purpose was to determine if using the ARS resulted in improved exam scores. Method: 113 Emergency Medical Technician (EMT) students participated in this cross-over, block randomized, controlled trial, which was incorporated into their Cardiac Emergencies and Pulmonary Emergencies course lectures. Students took pretests, immediate ...


Turning A Blind Eye: How Lack Of Communication With Er Nurses Nearly Cost A Patient Permanent Vision Loss, Kenneth Royal, April Kedrowicz 2017 North Carolina State University

Turning A Blind Eye: How Lack Of Communication With Er Nurses Nearly Cost A Patient Permanent Vision Loss, Kenneth Royal, April Kedrowicz

Patient Experience Journal

This narrative presents a case in which a patient was treated for conjunctivitis, but a breakdown in several layers of communication (between the hospital and the patient, and between hospital personnel) resulted in multiple medical errors that nearly costs the patient permanent vision loss. This real-life case underscores how simple communication errors may lead to life-altering consequences. Recommendations for improving communication to ensure similar errors do not happen to others are provided.


Decreasing Time To Broad Spectrum Antibiotics For Septic Patients In The Emergency Department, Joseph J. Zieminski, Emily E. Bryant 2017 Department of Pharmacy, Aurora St. Luke’s Medical Center

Decreasing Time To Broad Spectrum Antibiotics For Septic Patients In The Emergency Department, Joseph J. Zieminski, Emily E. Bryant

Journal of Patient-Centered Research and Reviews

Background: Timely administration of broad spectrum antibiotics has been shown to be directly correlated with decreased mortality for patients with severe sepsis and septic shock. As such, both the Surviving Sepsis Campaign and the SEP-1 CMS measure recognize timely antibiotic administration as a cornerstone of therapy for patients with severe sepsis or septic shock.

Purpose: Decrease time to broad spectrum antibiotic administration for septic patients in the emergency department (ED) of Aurora St. Luke’s Medical Center.

Methods: An alert within the electronic medical record was created to more rapidly identify potentially septic patients in the ED. After receiving the ...


New Approaches To The Trauma Patient With Life-Threatening Bleeding With Notes.Pptx, Richard N. Bradley 2017 The University of Texas Health Science Center at Houston

New Approaches To The Trauma Patient With Life-Threatening Bleeding With Notes.Pptx, Richard N. Bradley

Richard N Bradley

Trauma patients are still bleeding to death — but improved response to hemorrhage through new approaches and technology will reduce morbidity and mortality from trauma. Dr. Bradley will review the lethal triad that leads to death in trauma patients, and how we can do a better job of treating these patients. The session will include an overview of the latest guidelines on bleeding control, use of ultrasound to detect hidden bleeding, out-of-hospital therapy including transfusion of blood products and hypotensive resuscitation, aortic balloon occlusion, thromboelastography, blood substitutes and antifibrinolytic therapy.


A Historical Perspective On Presentations Of Hypertensive Acute Heart Failure, Chad E. Darling, Jiaoyuan Elisabeth Sun, Jordan Goldberg, Peter Pang, Christopher W. Baugh, Darleen M. Lessard, David D. McManus 2017 University of Massachusetts Medical School

A Historical Perspective On Presentations Of Hypertensive Acute Heart Failure, Chad E. Darling, Jiaoyuan Elisabeth Sun, Jordan Goldberg, Peter Pang, Christopher W. Baugh, Darleen M. Lessard, David D. Mcmanus

David D. McManus

BACKGROUND: The initial systolic blood pressure (SBP) in patients presenting to the hospital with acute heart failure (AHF) informs prognosis, diagnosis, and guides initial treatment. However, over time AHF presentations with elevated SBP appear to have declined. The present study examined whether the frequency of AHF presentations with systolic hypertension (SBP > 160 mmHg) declined over a nearly two-decade time interval. METHODS: This study compares four historical, cross-sectional cohorts with AHF who were admitted to tertiary care medical centres in the North-eastern USA in 1995, 2000, 2006, and 2011-13. The main outcome was the proportion of AHF patients presenting with an ...


Medical Response Times And Their Effect On Prehospital Care, Storm Santos 2017 Murray State University

Medical Response Times And Their Effect On Prehospital Care, Storm Santos

Scholars Week

Medical Response Times and Their Effect on Prehospital Care

Storm J. Santos, Rural Health Scholar

Dr. Naber, Faculty Advisor

Department of Health Sciences

Abstract

Medical emergencies happen in a variety of different environments. Each environment comes with unique challenges that emergency medical responders must work through to safely alleviate any given medical emergency. This study examines the effect of medical team response times on the overall care of the patient as well as if population density (rural vs urban) further affects the overall care of the patient. This study was inspired by works that compared various environmental factors and their ...


Emergency Medicine Resident On Shift Clinical Teaching Efficacy As Measured By Student Evaluation And Self-Reflection Using A Previously Validated Metric, Alan R. Cherney MD, Dawn M. Yenser, Amy B. Smith PhD, Kevin Weaver D.O.,FACOEP, Charles C. Worrilow MD, Bryan G. Kane MD 2017 Lehigh Valley Health Network

Emergency Medicine Resident On Shift Clinical Teaching Efficacy As Measured By Student Evaluation And Self-Reflection Using A Previously Validated Metric, Alan R. Cherney Md, Dawn M. Yenser, Amy B. Smith Phd, Kevin Weaver D.O.,Facoep, Charles C. Worrilow Md, Bryan G. Kane Md

Amy B Smith PhD

No abstract provided.


The Effects Of Obesity On Outcomes In Trauma Injury: Overview Of The Current Literature, Milad Modarresi, Brad Gillon, Javad Najjar Mojarrab, Rodrigo Aguilar, Zackary Dylan Hunter, Matthew Steven Schade, Jackie Sanabria, Rebecca Klug, Seth Adkins, Juan R. Sanabria 2017 Marshall University Joan C. Edwards School of Medicine

The Effects Of Obesity On Outcomes In Trauma Injury: Overview Of The Current Literature, Milad Modarresi, Brad Gillon, Javad Najjar Mojarrab, Rodrigo Aguilar, Zackary Dylan Hunter, Matthew Steven Schade, Jackie Sanabria, Rebecca Klug, Seth Adkins, Juan R. Sanabria

Marshall Journal of Medicine

Obesity has reached epidemic proportions and is now considered a chronic disease by the National Institute of Health (NIH) in the West. Its impact on trauma outcomes is of particular interest with several studies presenting conflicting information. The present overview suggests a strong association between obesity and injury severity, hospital length of stay (LOS), intensive care unit (ICU) admission, pattern of injury, rate of complications and mortality. The nature of the observations may relate to an underlying physiological state of the obese patient and its associated comorbidities with a constant heightened inflammatory state aggravated by the second hit on an ...


Examining The Role Of Diagnosis In The Emergency Department Experience, Danielle Kovalsky, BS, Angela Gerolamo, PhD, APRN, BCPS, Amanda Doty, MS, Alexzandra Gentsch, LSW, Annemarie Jutel, RN, BPhEd (Hons), PhD, Kristin L. Rising, MD, MS 2017 Thomas Jefferson University

Examining The Role Of Diagnosis In The Emergency Department Experience, Danielle Kovalsky, Bs, Angela Gerolamo, Phd, Aprn, Bcps, Amanda Doty, Ms, Alexzandra Gentsch, Lsw, Annemarie Jutel, Rn, Bphed (Hons), Phd, Kristin L. Rising, Md, Ms

CWIC Posters

Study Objective:

To explore the social, functional, and emotional needs that patients want addressed when seeking a diagnosis at their ED visit.


Emergency Surgery And Limitation Of Therapeutic Effort In Relation To Neurologic Deterioration In Elderly Patients – A Survey Of European Surgeons, Mihai Paduraru, Luca Ponchietti, Isidro M. Casas, Jorge Pereira, Aitor Landaluce-Olavarria, Diego Mariani 2017 Milton Keynes University Hospital NHS Foundation Trust, Emergency Surgery Department, Milton Keynes, UK

Emergency Surgery And Limitation Of Therapeutic Effort In Relation To Neurologic Deterioration In Elderly Patients – A Survey Of European Surgeons, Mihai Paduraru, Luca Ponchietti, Isidro M. Casas, Jorge Pereira, Aitor Landaluce-Olavarria, Diego Mariani

Journal of Mind and Medical Sciences

Background. In emergency surgery, a very heterogeneous approach is required in the decision making process, especially when considering the patient’s postoperative quality of life as well as medical, ethical, and legal factors. In some cases, the presence of an Advance Directive (AD) form may potentially help resolve the surgeon’s dilemma. Objectives. The primary objective of this survey was to investigate the opinions of surgeons across a representative cross-section of European countries regarding the decision making process using a specific case scenario so as to identify similarities and differences in practice. A secondary objective was to identify the possibility ...


Not All Evidence Is Created Equal: Changes In Practice Require The Highest Possible Level Of Statistical Testing, Sandy Hunter 2017 Eastern Kentucky University

Not All Evidence Is Created Equal: Changes In Practice Require The Highest Possible Level Of Statistical Testing, Sandy Hunter

EKU Faculty and Staff Scholarship

The practice of medicine has come a long way over the past 150 years. For example, routine use of leeches to remove “bad blood” no longer occurs, and everyone involved in healthcare knows to wear personal protective equipment.

Changes to practice have (at times) been slow in coming. However, we simply can no longer routinely rely on providing care without evidence that it works. Investigators conduct rigorous studies to determine the efficacy of treatments. This philosophy of testing clinical practices using research methods to validate their efficacy and safety is known as evidence-based medicine.1


Impact Of Superstorm Sandy On Medicare Patients' Utilization Of Hospitals And Emergency Departments., Benoit Stryckman, Lauren Walsh, Brendan G. Carr, Nathaniel Hupert, Nicole Lurie 2017 U.S. Department of Health and Human Services

Impact Of Superstorm Sandy On Medicare Patients' Utilization Of Hospitals And Emergency Departments., Benoit Stryckman, Lauren Walsh, Brendan G. Carr, Nathaniel Hupert, Nicole Lurie

Department of Emergency Medicine Faculty Papers

INTRODUCTION: National health security requires that healthcare facilities be prepared to provide rapid, effective emergency and trauma care to all patients affected by a catastrophic event. We sought to quantify changes in healthcare utilization patterns for an at-risk Medicare population before, during, and after Superstorm Sandy's 2012 landfall in New Jersey (NJ).

METHODS: This study is a retrospective cohort study of Medicare beneficiaries impacted by Superstorm Sandy. We compared hospital emergency department (ED) and healthcare facility inpatient utilization in the weeks before and after Superstorm Sandy landfall using a 20% random sample of Medicare fee-for-service beneficiaries continuously enrolled in ...


Sex Differences In Intentional Exposures Among Adolescents And Adults: A Retrospective Review Of National Poison Data System (Npds) Pharmaceutical Exposures 2007-2016, Gillian A. Beauchamp MD, Zane Horowitz MD, Esther Choo MD, MPH, Marna R. Greenberg DO, MPH, FACEP, Daniel A. Spyker PhD, MD 2017 Lehigh Valley Health Network

Sex Differences In Intentional Exposures Among Adolescents And Adults: A Retrospective Review Of National Poison Data System (Npds) Pharmaceutical Exposures 2007-2016, Gillian A. Beauchamp Md, Zane Horowitz Md, Esther Choo Md, Mph, Marna R. Greenberg Do, Mph, Facep, Daniel A. Spyker Phd, Md

Department of Emergency Medicine

No abstract provided.


Acute Bacterial Cellulitis: Emergency Department Management, Aetiological Epidemiology And Clinical Risk Factors For Antibiotic Treatment Failure, Michael Quirke 2017 Royal College of Surgeons in Ireland

Acute Bacterial Cellulitis: Emergency Department Management, Aetiological Epidemiology And Clinical Risk Factors For Antibiotic Treatment Failure, Michael Quirke

MD theses

This thesis consists of 6 work-packages (WPs) that describe the Emergency Department (ED) management of cellulitis; it’s aetiological epidemiology, and risk factors for antibiotic treatment failure.

In order to provide a context for this thesis, I performed a scientometric analysis of research output related to skin and soft tissue infections (SSTIs) between 1945 and 2014. Overall, research output was low but increased as a result of the community associated methicillin-resistant Staphylococcus aureus (CA-MRSA) epidemic in North American settings.

My observational research work began with two studies describing the ED incidence of cellulitis, antibiotic prescribing practices and physician adherence to ...


Sex Differences In Pediatric Exploratory Exposures: A Retrospective Review Of National Poison Data System (Npds) Exposures 2007-2016, Gillian A. Beauchamp MD, Zane Horowitz MD, Esther Choo MD, MPH, Marna R. Greenberg DO, MPH, FACEP, Daniel A. Spyker MD 2017 Lehigh Valley Health Network

Sex Differences In Pediatric Exploratory Exposures: A Retrospective Review Of National Poison Data System (Npds) Exposures 2007-2016, Gillian A. Beauchamp Md, Zane Horowitz Md, Esther Choo Md, Mph, Marna R. Greenberg Do, Mph, Facep, Daniel A. Spyker Md

Department of Emergency Medicine

No abstract provided.


Sex Differences In Adverse Drug Reactions And Adverse Drug Events In Older Adults: A Retrospective Review Of National Poison Data System Cases 2007-2016., Gillian A. Beauchamp MD, Zane Horowitz MD, Esther Choo MPH, Marna R. Greenberg DO, MPH, FACEP, Daniel Spyker PhD, MD 2017 Lehigh Valley Health Network

Sex Differences In Adverse Drug Reactions And Adverse Drug Events In Older Adults: A Retrospective Review Of National Poison Data System Cases 2007-2016., Gillian A. Beauchamp Md, Zane Horowitz Md, Esther Choo Mph, Marna R. Greenberg Do, Mph, Facep, Daniel Spyker Phd, Md

Department of Emergency Medicine

No abstract provided.


Sex Differences In Rt-Pa Utilization At Hospitals Treating Stroke: The National Inpatient Sample., Amelia K. Boehme, Brendan G. Carr, Scott Eric Kasner, Karen C Albright, Michael J. Kallan, Mitchell S V S.V. Elkind, Charles C. Branas, Michael T. Mullen 2017 Columbia University

Sex Differences In Rt-Pa Utilization At Hospitals Treating Stroke: The National Inpatient Sample., Amelia K. Boehme, Brendan G. Carr, Scott Eric Kasner, Karen C Albright, Michael J. Kallan, Mitchell S V S.V. Elkind, Charles C. Branas, Michael T. Mullen

Department of Emergency Medicine Faculty Papers

BACKGROUND AND PURPOSE: Sex and race disparities in recombinant tissue plasminogen activator (rt-PA) use have been reported. We sought to explore sex and race differences in the utilization of rt-PA at primary stroke centers (PSCs) compared to non-PSCs across the US.

METHODS: Data from the National (Nationwide) Inpatient Sample (NIS) 2004-2010 was utilized to assess sex differences in treatment for ischemic stroke in PSCs compared to non-PSCs.

RESULTS: There were 304,152 hospitalizations with a primary diagnosis of ischemic stroke between 2004 and 2010 in the analysis: 75,160 (24.7%) patients were evaluated at a PSC. A little over ...


Accuracy Of Emergency Medical Services Dispatcher And Crew Diagnosis Of Stroke In Clinical Practice., Judy Jia, Roger Band, Michael E. Abboud, William Pajerowski, Michelle Guo, Guy David, C. Crawford Mechem, Steven R Messé, Brendan G. Carr, Michael T Mullen 2017 University of Pennsylvania

Accuracy Of Emergency Medical Services Dispatcher And Crew Diagnosis Of Stroke In Clinical Practice., Judy Jia, Roger Band, Michael E. Abboud, William Pajerowski, Michelle Guo, Guy David, C. Crawford Mechem, Steven R Messé, Brendan G. Carr, Michael T Mullen

Department of Emergency Medicine Faculty Papers

BACKGROUND: Accurate recognition of stroke symptoms by Emergency Medical Services (EMS) is necessary for timely care of acute stroke patients. We assessed the accuracy of stroke diagnosis by EMS in clinical practice in a major US city.

METHODS AND RESULTS: Philadelphia Fire Department data were merged with data from a single comprehensive stroke center to identify patients diagnosed with stroke or TIA from 9/2009 to 10/2012. Sensitivity and positive predictive value (PPV) were calculated. Multivariable logistic regression identified variables associated with correct EMS diagnosis. There were 709 total cases, with 400 having a discharge diagnosis of stroke or ...


Growing Old In The Emergency Department, Paul Liston, G Conyngham, Malcolm Brady, P J. Byrne, Peadar Gilligan 2017 Dublin City University

Growing Old In The Emergency Department, Paul Liston, G Conyngham, Malcolm Brady, P J. Byrne, Peadar Gilligan

Emergency Medicine Articles

The research team were concerned that older patients requiring emergency admission seemed to wait longer for a hospital bed, and as such were disproportionately affected by Emergency Department overcrowding. To investigate this theory and explore any changes over time, a ten year dataset (2005-2014 inclusive) was extracted from the information systems at Beaumont Hospital, Dublin. This research examines the changing age profile of ED patients, identifies the relationship between age and the total time spent in the Emergency Department (Patient Experience Time (PET)), and examines the public belief that EDs are busiest in winter when reports of overcrowding and elderly ...


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