Open Access. Powered by Scholars. Published by Universities.®

Emergency Medicine Commons

Open Access. Powered by Scholars. Published by Universities.®

1,196 Full-Text Articles 3,340 Authors 102,108 Downloads 84 Institutions

All Articles in Emergency Medicine

Faceted Search

1,196 full-text articles. Page 1 of 55.

Icatibant Is Not Helpful For The Treatment Of Ace Inhibitor-Induced Angioedema, Samantha R. Schwartz 2019 Wayne State University School of Medicine

Icatibant Is Not Helpful For The Treatment Of Ace Inhibitor-Induced Angioedema, Samantha R. Schwartz

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Sinert R, Levy P, Bernstein JA, et al. Randomized trial of icatibant for angiotensin-converting enzyme inhibitor-induced upper airway angioedema. J Allergy Clin Immunol Pract. 2017; 5(5): 1402-1409. doi: 10.1016/j.jaip.2017.03.003.


Early Dexamethasone Administration In Adults With Suspected Meningitis Lowers Morbidity And Mortality, Dana Siegel 2019 Wayne State University

Early Dexamethasone Administration In Adults With Suspected Meningitis Lowers Morbidity And Mortality, Dana Siegel

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of de Gans J, van de Beek D, Investigators EDiABMS. Dexamethasone in adults with bacterial meningitis. New Eng J Med. 2002;347(20):1549-1556. doi: 10.1056/NEJMoa021334.


Predicting Unplanned Medical Visits Among Patients With Diabetes Using Machine Learning, Arielle Selya, Eric L. Johnson 2019 Sanford Health

Predicting Unplanned Medical Visits Among Patients With Diabetes Using Machine Learning, Arielle Selya, Eric L. Johnson

SDSU Data Science Symposium

Diabetes poses a variety of medical complications to patients, resulting in a high rate of unplanned medical visits, which are costly to patients and healthcare providers alike. However, unplanned medical visits by their nature are very difficult to predict. The current project draws upon electronic health records (EMR’s) of adult patients with diabetes who received care at Sanford Health between 2014 and 2017. Various machine learning methods were used to predict which patients have had an unplanned medical visit based on a variety of EMR variables (age, BMI, blood pressure, # of prescriptions, # of diagnoses on problem list, A1C, HDL ...


Assessing The Use Of Social Media In Physician Assistant Education., Gregory K. Wanner, Andrew W. Phillips, Dimitrios Papanagnou, MD 2019 Christiana Care Health System

Assessing The Use Of Social Media In Physician Assistant Education., Gregory K. Wanner, Andrew W. Phillips, Dimitrios Papanagnou, Md

Department of Emergency Medicine Faculty Papers

Objectives: This study aims to assess physician assistant (PA) students' experiences with social media (SM) as a part of their medical education.

Methods: The study is split into two phases: Phase 1- A cross-sectional survey emailed to all PA students at four PA school campuses to assess students' prior SM experiences (226 responses, 71.1% response rate); and Phase 2- Inclusion of SM educational resources, via Twitter, within lectures performed at two PA schools. A phase-2 survey assessed students' opinions of educational SM (50 responses, 59.5% response rate) and SM usage was tracked.

Results: The phase-1 survey respondents indicated ...


Emergency Medicine Palliative Care Access (Empalla): Protocol For A Multicentre Randomised Controlled Trial Comparing The Effectiveness Of Specialty Outpatient Versus Nurse-Led Telephonic Palliative Care Of Older Adults With Advanced Illness, Corita R. Grudzen, Deborah J. Shim, Abigail M. Schmucker, Jeanne Cho, Keith S. Goldfeld 2019 New York University School of Medicine

Emergency Medicine Palliative Care Access (Empalla): Protocol For A Multicentre Randomised Controlled Trial Comparing The Effectiveness Of Specialty Outpatient Versus Nurse-Led Telephonic Palliative Care Of Older Adults With Advanced Illness, Corita R. Grudzen, Deborah J. Shim, Abigail M. Schmucker, Jeanne Cho, Keith S. Goldfeld

Student Papers & Posters

Introduction Emergency department (ED)-initiated palliative care has been shown to improve patient-centred outcomes in older adults with serious, life-limiting illnesses. However, the optimal modality for providing such interventions is unknown. This study aims to compare nurse-led telephonic case management to specialty outpatient palliative care for older adults with serious, life-limiting illness on: (1) quality of life in patients; (2) healthcare utilisation; (3) loneliness and symptom burden and (4) caregiver strain, caregiver quality of life and bereavement.

Methods and analysis This is a protocol for a pragmatic, multicentre, parallel, two-arm randomised controlled trial in ED patients comparing two established models ...


Association Of Obstructive Sleep Apnea With Cardiovascular Outcomes In Patients With Acute Coronary Syndrome., Jingyao Fan, Xiao Wang, Xin-Liang Ma, Virend K. Somers, Shaoping Nie, Yongxiang Wei 2019 Capital Medical University

Association Of Obstructive Sleep Apnea With Cardiovascular Outcomes In Patients With Acute Coronary Syndrome., Jingyao Fan, Xiao Wang, Xin-Liang Ma, Virend K. Somers, Shaoping Nie, Yongxiang Wei

Department of Emergency Medicine Faculty Papers

Background The prognostic significance of obstructive sleep apnea ( OSA ) in patients with acute coronary syndrome ( ACS ) in the contemporary era is unclear. We performed a large, prospective cohort study and did a landmark analysis to delineate the association of OSA with subsequent cardiovascular events after ACS onset. Methods and Results Between June 2015 and May 2017, consecutive eligible patients admitted for ACS underwent cardiorespiratory polygraphy during hospitalization. OSA was defined as an apnea-hypopnea index ≥15 events·h-1. The primary end point was major adverse cardiovascular and cerebrovascular event ( MACCE ), including cardiovascular death, myocardial infarction, stroke, ischemia-driven revascularization, or hospitalization for ...


The Power Of The Group: Comparison Of Interviews And Group Concept Mapping For Identifying Patient-Important Outcomes Of Care., Kristin L. Rising, Marianna LaNoue, Alexzandra Gentsch, Amanda Doty, Amy Cunningham, Brendan G. Carr, Judd E. Hollander, Lori Latimer, Larry Loebell, Gail Weingarten, Neva White, Geoffrey Mills 2019 Thomas Jefferson University

The Power Of The Group: Comparison Of Interviews And Group Concept Mapping For Identifying Patient-Important Outcomes Of Care., Kristin L. Rising, Marianna Lanoue, Alexzandra Gentsch, Amanda Doty, Amy Cunningham, Brendan G. Carr, Judd E. Hollander, Lori Latimer, Larry Loebell, Gail Weingarten, Neva White, Geoffrey Mills

Department of Emergency Medicine Faculty Papers

BACKGROUND: Data are limited regarding how to effectively and efficiently identify patient priorities for research or clinical care. Our goal was to compare the comprehensiveness and efficiency of group concept mapping (GCM), a group participatory method, to interviews for identifying patient goals when seeking care.

METHODS: We engaged patients with moderately- to poorly-controlled diabetes mellitus in either GCM or an individual interview. The primary outcome was the comprehensiveness of GCM brainstorming (the first stage of GCM) as compared to interviews for eliciting patient-important outcomes (PIOs) related to seeking care. Secondary outcomes included 1) comprehensiveness of GCM brainstorming and interviews compared ...


The Use Of A “Cpr Posture” For Hemorrhage Control, Nathan Phillip Charlton, Robert Solberg, Nici Singletary, Craig Goolsby, Justin Rizer, William Woods 2019 University of Virginia, American Red Cross Scientific Advisory Council

The Use Of A “Cpr Posture” For Hemorrhage Control, Nathan Phillip Charlton, Robert Solberg, Nici Singletary, Craig Goolsby, Justin Rizer, William Woods

International Journal of First Aid Education

Bleeding from traumatic injury is a major source of morbidity and mortality, however, little data is available to aid guidelines and curriculum developers in best practice of applying direct pressure when treating or teaching how to stop life-threatening hemorrhage.

Hypothesis: This study investigated the use of two-handed pressure with bent arms versus two-handed pressure with straight arms to apply direct pressure to a hemorrhage model.

Methods: Participants, recruited as a convenience sample, were randomized and instructed to use either two hands overlapping using arm strength only, or two hands overlapping with arms straight in a “CPR-like” position to apply force ...


Integrate Behavioral Health In The Ed And Upstream, Katie Gilligan, Heidi Beazizo 2018 Providence Regional Medical Center - Everett

Integrate Behavioral Health In The Ed And Upstream, Katie Gilligan, Heidi Beazizo

Books, Presentations, Posters, Etc.

This interactive session will describe the changes being tested by 10 hospitals in the Integrating Behavioral Health in the ED and Upstream Learning Community, convened by IHI and Well Being Trust, to achieve meaningful improvements for patients with mental health and substance abuse conditions, their families, and ED staff. Participants will learn from experts and participating team members, share learning with other participants, and develop action plans for bringing this critical work to their organizations.

After this presentation you will be able to:

  1. Describe a theory of change and set of core measures to improve patient outcomes, experience, and staff ...


Rethinking Rethinking Emergency Response To Mass Casualty Incidents: Disaster Medicine Education And The Role Of Medical Students, Claire Zurlo, Edward Jasper, MD, MPH 2018 Thomas Jefferson University

Rethinking Rethinking Emergency Response To Mass Casualty Incidents: Disaster Medicine Education And The Role Of Medical Students, Claire Zurlo, Edward Jasper, Md, Mph

Phase 1

Introduction: The threat of a mass casualty incident (MCI) is one that must be taken seriously and for which hospitals must be prepared. In the wake of a disaster, emergency departments are often taxed beyond their ability to handle the demands of incoming traumas. In response to this, Dr. Edward Jasper, an emergency physician at Thomas Jefferson Hospital, designed the Hospital Emergency Response Team (HERT) to alleviate the pressure on the ED during a MCI. The HERT is a team of nursing and medical students who are FEMA trained to respond in the event of a MCI.

Objective: The primary ...


The Effects Of Reentry Programs On Healthcare Accessibility And Resulting Emergency Department Strain By Ex-Inmates: An Integrative Literature Review, Kaitlyn Muratori 2018 DePaul University

The Effects Of Reentry Programs On Healthcare Accessibility And Resulting Emergency Department Strain By Ex-Inmates: An Integrative Literature Review, Kaitlyn Muratori

Grace Peterson Nursing Research Colloquium

THE EFFECTS OF REENTRY PROGRAMS ON HEALTHCARE ACCESSIBILITY AND RESULTING EMERGENCY DEPARTMENT STRAIN BY EX-INMATES

Kaitlyn Muratori

Faculty Sponsor: Dr. Christina Lattner

Background: Ex-inmates are significantly more likely to use emergency rooms to seek treatment for substance abuse, mental health disorders, or poor management of chronic conditions which, if not treated on a community level, ultimately contributes to overboarding in the emergency department.

Objectives: The purpose of this literature review is to use current research to examine the relationship between reentry programs across the US and healthcare accessibility, as well as the resulting strain of emergency room misuse by ex-inmates ...


Pressure Methods For Primary Hemorrhage Control: A Randomized Crossover Trial., Nathan Phillip Charlton, Robert Solberg, Justin Rizer, Nici Singletary, William A. Woods 2018 University of Virginia and American Red Cross Scientific Advisory Council

Pressure Methods For Primary Hemorrhage Control: A Randomized Crossover Trial., Nathan Phillip Charlton, Robert Solberg, Justin Rizer, Nici Singletary, William A. Woods

International Journal of First Aid Education

Background: The importance of hemorrhage control in traumatic injury has been highlighted by the 2015 Stop the Bleed federal campaign in the United States and subsequent development of modular bleeding control courses offered by organizations such as the American Red Cross (https://www.dhs.gov/stopthebleed). However, the scientific evidence regarding the best methods and mechanisms of applying direct manual pressure to stop hemorrhage is lacking to inform first aid education skill development.

Hypothesis: The purpose of this tri-phase study is to evaluate the pressure generated when adding increasing layers of gauze dressings and to compare the force generated using ...


Deaf And Hard-Of-Hearing Learners In Emergency Medicine, Lisa M. Meeks, Alina Engelman, Alicia Booth, Michael Argenyi 2018 The University Of Michigan

Deaf And Hard-Of-Hearing Learners In Emergency Medicine, Lisa M. Meeks, Alina Engelman, Alicia Booth, Michael Argenyi

Open Access Articles

Approximately 23% of Americans over age 12 have some level of hearing loss.1 Emergency departments can reduce healthcare barriers for deaf and hard-of-hearing (DHoH) patients through improved patient-physician communication. DHoH students, once they become physicians, may provide one mechanism for reducing existing healthcare disparities and communication barriers for DHoH patients, and may be more adept with patients facing other communication barriers. A renewed interest in disability access and a commitment to social justice has increased efforts toward the inclusion of individuals with disabilities in medical education and training. Despite this increased interest and a growing number of DHoH students ...


Improving Safe Handoffs & Transitions From The Ed To Adult Inpatient: A Response To The Ahrq Hospital Patient Safety Culture Survey, Natalie Talbot, Joanne Chapman, Rhonda DiPhilippo, Gail Savage, Michele Higgins, Nancijean Goudey, Lori Sweatt, Erin Graydon Baker, Joseph East, Stephen Tyzik, Suneela Nayak, Mark Parker, Ruth Hanselman, Amy Sparks 2018 Maine Medical Center

Improving Safe Handoffs & Transitions From The Ed To Adult Inpatient: A Response To The Ahrq Hospital Patient Safety Culture Survey, Natalie Talbot, Joanne Chapman, Rhonda Diphilippo, Gail Savage, Michele Higgins, Nancijean Goudey, Lori Sweatt, Erin Graydon Baker, Joseph East, Stephen Tyzik, Suneela Nayak, Mark Parker, Ruth Hanselman, Amy Sparks

Operational Excellence

SAFE TRANSITIONS AND PATIENT HANDOFFS IN A LARGE ACUTE CARE HOSPITAL

It is well documented in the literature that ineffective patient handoffs and transitions continues to be an area that can lead to adverse patient safety events so it is an urgent opportunity for a performance improvement plan. At an academic tertiary care medical center, the lowest scoring domain from the FY2017 AHRQ Patient Safety Culture Survey was patient handoffs and transitions.

A team was established consisting of staff from the Emergency Department and a medical/surgical unit to develop a plan for implementing improvement interventions. Their goal was to ...


Strategies To Improve Post-Procedural Safe Patient Handoffs, Marguerite Anderson, Tara Herman, Janice Nichols, Robyn Dixon, Elizabeth Van Der Linden, Bonnie Boivin, Stephen Tyzik, MMC ASU, MMC PACU, SSU, Endoscopy, Advanced Endoscopy, One Call Center 2018 Maine Medical Center

Strategies To Improve Post-Procedural Safe Patient Handoffs, Marguerite Anderson, Tara Herman, Janice Nichols, Robyn Dixon, Elizabeth Van Der Linden, Bonnie Boivin, Stephen Tyzik, Mmc Asu, Mmc Pacu, Ssu, Endoscopy, Advanced Endoscopy, One Call Center

Operational Excellence

STRATEGIES TO IMPROVE SAFE PATIENT HANDOFFS AND POST PROCEDURAL FLOW

During patient transfers from one care unit to another, it is imperative for patient safety and satisfaction that timely and complete communication between staff occurs. In an academic tertiary care medical center, a team consisting of representatives from 6 patient care units used improvement methods of operational excellence to improve patient centered movement.

The goal of this project was to improve the percentages of two questions related to information sharing on the FY2018 AHRQ Culture of Patient Safety Survey. Using baseline metrics to reflect the current state of patient wait ...


Harmonization Of Delirium Severity Instruments: A Comparison Of The Drs-R-98, Mdas, And Cam-S Using Item Response Theory, Alden L. Gross, Doug Tommet, Madeline D'Aquila, Eva Schmitt, Edward R. Marcantonio, Benjamin Helfand, Sharon K. Inouye, Richard N. Jones 2018 Johns Hopkins University

Harmonization Of Delirium Severity Instruments: A Comparison Of The Drs-R-98, Mdas, And Cam-S Using Item Response Theory, Alden L. Gross, Doug Tommet, Madeline D'Aquila, Eva Schmitt, Edward R. Marcantonio, Benjamin Helfand, Sharon K. Inouye, Richard N. Jones

Open Access Articles

BACKGROUND: This study aimed to describe the level of agreement of three commonly used delirium instruments: the Delirium Rating Scale-Revised-98 (DRS-R-98), Memorial Delirium Assessment Scale (MDAS), and Confusion Assessment Method-Severity (CAM-S).

METHODS: We used data from a prospective clinical research study, in which a team of trained lay interviewers administered each instrument along with supporting interview and cognitive assessments in the same group of patients daily while in the hospital (N = 352). We used item response theory methods to co-calibrate the instruments.

RESULTS: The latent traits underlying the three measures, capturing the severity of a delirium assessment, had a high ...


Accuracy Of Height Estimation Among Bystanders, Sara Carey, Michaeleena Carr, Komaira Ferdous, Gina Marie Moffa, Jennifer Axelband, Shaila Quazi 2018 Aria Health

Accuracy Of Height Estimation Among Bystanders, Sara Carey, Michaeleena Carr, Komaira Ferdous, Gina Marie Moffa, Jennifer Axelband, Shaila Quazi

Aria Health Papers

Introduction: High-risk mechanisms in trauma usually dictate certain treatment and evaluation in protocolized care. A 10-15 feet (ft) fall is traditionally cited as an example of a high-risk mechanism, triggering trauma team activations and costly work-ups. The height and other details of mechanism are usually reported by lay bystanders or prehospital personnel. This small observational study was designed to evaluate how accurate or inaccurate height estimation may be among typical bystanders. Methods: This was a blinded, prospective study conducted on the grounds of a community hospital. Four panels with lines corresponding to varying heights from 1-25 ft were hung within ...


Evaluation Of Quality Of Warfarin Therapy By Assessing Patient's Time In Therapeutic Range At A Tertiary Care Hospital In Pakistan, Haris Hakeem, Ammar Zaman Khan, Kashif Aziz, Ayesha Abbasi, Anam Haider, Bushra Moiz, Mohammad Wasay 2018 Aga Khan University

Evaluation Of Quality Of Warfarin Therapy By Assessing Patient's Time In Therapeutic Range At A Tertiary Care Hospital In Pakistan, Haris Hakeem, Ammar Zaman Khan, Kashif Aziz, Ayesha Abbasi, Anam Haider, Bushra Moiz, Mohammad Wasay

Section of Neurology

Objective: To assess the time in therapeutic range in patients on warfarin anti-coagulation therapy.

Methods: The retrospective chart review was conducted at Aga Khan University Hospital, Karachi, and comprised data of patients having undergone anti-coagulation with warfarin from January 2013 to April 2015. To determine the mean time in therapeutic range, Rosendaal method was used. Association of time in therapeutic range with the composite outcome, bleeding and thromboembolic events was also assessed. Percentage of patients with time in therapeutic range <60% was calculated.

Results: There were 92 patients whose median time in therapeutic range was 34.9% (interquartile range: 20.0- 55.7 ...


The Association Of Qsofa, Sofa, And Sirs With Mortality In Emergency Department Pneumonia, Ian D. Mecham, Nathan C. Dean, Emily L. Wilson, Al R. Jephson, Michael J. Lanpsa 2018 University of Utah

The Association Of Qsofa, Sofa, And Sirs With Mortality In Emergency Department Pneumonia, Ian D. Mecham, Nathan C. Dean, Emily L. Wilson, Al R. Jephson, Michael J. Lanpsa

The University of Louisville Journal of Respiratory Infections

Objective: To determine the association between 30-day mortality with Systemic Inflammatory Response Syndrome (SIRS), Sequential Organ Failure Assessment (SOFA), and quick SOFA (qSOFA) in emergency department patients with pneumonia. Secondary outcomes included the association of sepsis scores with hospital admission and direct ICU admission.

Methods: This is a secondary analysis of a pneumonia population conducted in the emergency department of 3 tertiary care medical centers and 4 community hospitals. Adult immunocompetent patients diagnosed with pneumonia were included from 3 twelve-month periods spanning December 2009 to October 2015. We generated area under the receiver operating characteristic curve (AUC) values for each ...


Association Between Practice Participation In A Pediatric-Focused Medical Home Learning Collaborative And Reduction Of Preventable Emergency Department Visits By Publicly-Insured Children In Massachusetts, Paul Kirby, Anna Christensen, Louise Bannister, Valerie Konar 2018 University of Massachusetts Medical School

Association Between Practice Participation In A Pediatric-Focused Medical Home Learning Collaborative And Reduction Of Preventable Emergency Department Visits By Publicly-Insured Children In Massachusetts, Paul Kirby, Anna Christensen, Louise Bannister, Valerie Konar

Commonwealth Medicine Publications

Introduction: This study evaluates the impact of practice participation in a pediatric patient-centered medical home learning collaborative on preventable emergency department (ED) visits among children in MassHealth (Massachusetts Medicaid/Children's Health Insurance Program).

Methods: Claims and enrollment data were extracted for child MassHealth members (aged 3–18) comprising 2 groups: members enrolled in a group of 13 child-serving practices that participated in an intensive, 29-month long patient-centered medical home learning collaborative (intervention group), and members enrolled in a group of 12 comparison practices with roughly similar panel size, type, and geographic location (comparison group). Preventable ED visits were identified ...


Digital Commons powered by bepress