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Emergency Department Approach To Electrical Toothbrush Associated Hand Injury, A Unique Case Of Non-Oropharyngeal Injury., Hannah Robinson, Neal Sikka, Chimere Little, Ali Pourmand 2017 George Washington University

Emergency Department Approach To Electrical Toothbrush Associated Hand Injury, A Unique Case Of Non-Oropharyngeal Injury., Hannah Robinson, Neal Sikka, Chimere Little, Ali Pourmand

GW Research Days 2016 - Present

Puncture wounds are common injuries treated in the emergency department (ED). Prior studies have shown that toothbrushes are common reservoirs for oral flora, especially in regions near the head of the toothbrush near the bristles. ED providers must be aware of the danger associated with bacterial contamination of the associated wound and should be familiar with different pathogens and options for treatment. We present a unique case of a 30-year-old male with non-intraoral injury who presented to the ED after puncturing his left palm with the metal post of an electric toothbrush.


Stakeholders' Perceptions Of A Hospital Based Emergency Medicine Education & Training Program: A System Change, Kate Douglass, Jay Pandya, Michael Brennan, Kyle Yoder, Janice Blanchard, Natasha Powell, Zohray Talib 2017 George Washington University

Stakeholders' Perceptions Of A Hospital Based Emergency Medicine Education & Training Program: A System Change, Kate Douglass, Jay Pandya, Michael Brennan, Kyle Yoder, Janice Blanchard, Natasha Powell, Zohray Talib

GW Research Days 2016 - Present

Background: Emergency Medicine (EM) is a new and developing specialty around the world. In India, one model for capacity building has been the development of partnerships between US academic institutions and private healthcare institutions for implementing post-graduate education and training in EM. Initiated in 2007, programs have grown both in number and scope and have continued to attract new students and partner institutions. This study was undertaken to better understand the impact of EM training programs on hospital systems.

Methods: A mixed-methods evaluation was undertaken at 5 program sites across India in the summer of 2016. Two researchers conducted onsite ...


Concussion Screening Evaluation: Bess Vs Sway, Zachariah Hatoum, Aidan Neustadtl, Jeremy Altman, Aurash Zarrinbakhsh, David Milzman 2017 George Washington University

Concussion Screening Evaluation: Bess Vs Sway, Zachariah Hatoum, Aidan Neustadtl, Jeremy Altman, Aurash Zarrinbakhsh, David Milzman

GW Research Days 2016 - Present

Introduction: Rapid evaluation of concussion is important in the pre-hospital setting as an easy test. It is also useful in the ED, as too often little is done for concussed patients. The Balance Error Scoring System (BESS) is the current gold standard for evaluating balance, one of the best predictors of concussion. SWAY, a new gyroscope based iPhone application, is being proposed as a more sensitive and more objective test than BESS. This study will compare Sway to BESS to determine if there is equal efficacy.
Method: 74 scholastic and collegiate athletes were administered baseline balance evaluations using Sway. Sway ...


Cerebrovascular Accident Survival: Strategies Of Flight Nursing And Aeromedical Transport, Alexis Caudle 2017 Liberty University

Cerebrovascular Accident Survival: Strategies Of Flight Nursing And Aeromedical Transport, Alexis Caudle

Senior Honors Theses

Cerebrovascular accidents (CVA), known as strokes, are a leading cause of death worldwide. The delivery and timing of treatment for CVAs is a critical factor in restoring health to the patient. One of the variables in recovery is the method of transport used in bringing the patient to a health care facility. Aeromedical transport remains a valuable resource to achieve full recovery in stroke patients. An ongoing debate of risk versus benefit of helicopter emergency services will be included as well as examination of variables including location, time, physiology of the flight, and the patient’s condition to be scrutinized ...


Academic Primer Series: Five Key Papers For Consulting Clinician Educators., Teresa M. Chan, Michael Gottlieb, Antonia Quinn, Kory S. London, Lauren W. Conlon, Felix Ankel 2017 McMaster University

Academic Primer Series: Five Key Papers For Consulting Clinician Educators., Teresa M. Chan, Michael Gottlieb, Antonia Quinn, Kory S. London, Lauren W. Conlon, Felix Ankel

Department of Emergency Medicine Faculty Papers

INTRODUCTION: Clinician educators are often asked to perform consultations for colleagues. Invitations to consult and advise others on local problems can help foster great collaborations between centers, and allows for an exchange of ideas between programs. In this article, the authors identify and summarize several key papers to assist emerging clinician educators with the consultation process.

METHODS: A consensus-building process was used to generate a list of key papers that describe the importance and significance of educational consulting, informed by social media sources. A three-round voting methodology, akin to a Delphi study, determined the most impactful papers from the larger ...


Dysuria: An Uncommon Presentation In Emergency Department Following Bladder Neck Disruption., Ali Pourmand, Assya Abdallah, Hamid Shokoohi, Mindy Park, Marie White, Francis O'Connell 2017 George Washington University

Dysuria: An Uncommon Presentation In Emergency Department Following Bladder Neck Disruption., Ali Pourmand, Assya Abdallah, Hamid Shokoohi, Mindy Park, Marie White, Francis O'Connell

Emergency Medicine Faculty Publications

Prostate cancer is the most common life-threatening cancer diagnosed in men. Complications of prostatectomies vary and often include urinary incontinence, erectile dysfunction and pain, while other complications go unreported. While emergency physicians are already familiar with the more common post-operative complications presenting to their departments, including urinary retention, ileus, surgical site infections, venous thromboembolisms and urinary tract infections, they must have a high index of suspicion for rarer complications. We report a case of posterior bladder neck disruption as a complication of a robotic assisted laparoscopic prostatectomy that presented to the emergency department as dysuria and abdominal pain following urination.


T-Cadherin Deficiency Increases Vascular Vulnerability In T2dm Through Impaired No Bioactivity., Han Wang, Ling Tao, Anastasia Ambrosio, Wenjun Yan, Ross Summer, Wayne Bond Lau, Yajing Wang, Xin-Liang Ma 2017 Fourth Military Medical University; Thomas Jefferson University

T-Cadherin Deficiency Increases Vascular Vulnerability In T2dm Through Impaired No Bioactivity., Han Wang, Ling Tao, Anastasia Ambrosio, Wenjun Yan, Ross Summer, Wayne Bond Lau, Yajing Wang, Xin-Liang Ma

Department of Emergency Medicine Faculty Papers

BACKGROUND: Endothelial dysfunction plays a critical role in the development of type 2 diabetes (T2DM). T-cadherin (T-cad) has gained recognition as a regulator of endothelial cell (EC) function. The present study examined whether T-cad deficiency increases vascular vulnerability in T2DM.

METHODS: Vascular segments were isolated from WT or T-cad knockout mice. Endothelial function, total NO accumulation, and the expression of T-cad related proteins were determined.

RESULTS: Ach and acidified NaNO2 induced similar vasorelaxation in WT groups. T-cad KO mice exhibited normal response to acidified NaNO2, but manifested markedly reduced response to Ach. NO accumulation was also decreased in T-cad KO ...


Digital Pills To Measure Opioid Ingestion Patterns In Emergency Department Patients With Acute Fracture Pain: A Pilot Study, Peter R. Chai, Stephanie Carreiro, Brendan J. Innes, Rochelle K. Rosen, Conall O'Cleirigh, Kenneth Mayer, Edward W. Boyer 2017 Brigham and Women's Hospital

Digital Pills To Measure Opioid Ingestion Patterns In Emergency Department Patients With Acute Fracture Pain: A Pilot Study, Peter R. Chai, Stephanie Carreiro, Brendan J. Innes, Rochelle K. Rosen, Conall O'Cleirigh, Kenneth Mayer, Edward W. Boyer

UMass Center for Clinical and Translational Science Supported Publications

BACKGROUND: Nonadherence to prescribed regimens for opioid analgesic agents contributes to increasing opioid abuse and overdose death. Opioids are frequently prescribed on an as-needed basis, placing the responsibility to determine opioid dose and frequency with the patient. There is wide variability in physician prescribing patterns because of the lack of data describing how patients actually use as-needed opioid analgesics. Digital pill systems have a radiofrequency emitter that directly measures medication ingestion events, and they provide an opportunity to discover the dose, timing, and duration of opioid therapy.

OBJECTIVE: The purpose of this study was to determine the feasibility of a ...


Teaching The Emergency Department Patient Experience: Needs Assessment From The Cord-Em Task Force., Kory S. London, Jeffrey Druck, Matthew Silver, Douglas Finefrock 2017 Thomas Jefferson University

Teaching The Emergency Department Patient Experience: Needs Assessment From The Cord-Em Task Force., Kory S. London, Jeffrey Druck, Matthew Silver, Douglas Finefrock

Department of Emergency Medicine Faculty Papers

INTRODUCTION: Since the creation of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction (PS) scores, patient experience (PE) has become a metric that can profoundly affect the fiscal balance of hospital systems, reputation of entire departments and welfare of individual physicians. While government and hospital mandates demonstrate the prominence of PE as a quality measure, no such mandate exists for its education. The objective of this study was to determine the education and evaluation landscape for PE in categorical emergency medicine (EM) residencies.

METHODS: This was a prospective survey analysis of the Council of Emergency Medicine Residency ...


Characteristics Of Real-Time, Non-Critical Incident Debriefing Practices In The Emergency Department., Nur-Ain Nadir, Suzanne Bentley, Dimitrios Papanagnou, Komal Bajaj, Stephan Rinnert, Richard Sinert 2017 University of Illinois College of Medicine at Peoria; SUNY Downstate Medical Center

Characteristics Of Real-Time, Non-Critical Incident Debriefing Practices In The Emergency Department., Nur-Ain Nadir, Suzanne Bentley, Dimitrios Papanagnou, Komal Bajaj, Stephan Rinnert, Richard Sinert

Department of Emergency Medicine Faculty Papers

INTRODUCTION: Benefits of post-simulation debriefings as an educational and feedback tool have been widely accepted for nearly a decade. Real-time, non-critical incident debriefing is similar to post-simulation debriefing; however, data on its practice in academic emergency departments (ED), is limited. Although tools such as TeamSTEPPS® (Team Strategies and Tools to Enhance Performance and Patient Safety) suggest debriefing after complicated medical situations, they do not teach debriefing skills suited to this purpose. Anecdotal evidence suggests that real-time debriefings (or non-critical incident debriefings) do in fact occur in academic EDs;, however, limited research has been performed on this subject. The objective of ...


Protocol Based Screening Tools To Identify Sepsis Patients Transported By Emergency Medical Services, Isaiah Moser 2017 University of Central Florida

Protocol Based Screening Tools To Identify Sepsis Patients Transported By Emergency Medical Services, Isaiah Moser

Honors in the Major Theses

Sepsis is a complicated disorder in which an infection has reached the bloodstream and caused a cascade of events that in time will lead to death. Interventions aimed at identifying sepsis early in its progression are imperative to stopping the process. The purpose of this study is to examine the current state of the literature regarding sepsis screening tools utilized by emergency medical services. A literature review exploring the various tools in place was conducted to see their value in predicting sepsis and secondary what the initiation of a sepsis alert has on the patients’ outcome. Results found included that ...


Shared Decision Making In Patients With Low Risk Chest Pain: Prospective Randomized Pragmatic Trial., Erik P. Hess, Judd E. Hollander, Jason T. Schaffer, Jeffrey A. Kline, Carlos A. Torres, Deborah B. Diercks, Russell Jones, Kelly P. Owen, Zachary F. Meisel, Michel Demers, Annie Leblanc, Nilay D. Shah, Jonathan Inselman, Jeph Herrin, Ana Castaneda-Guarderas, Victor M. Montori 2016 Mayo Clinic

Shared Decision Making In Patients With Low Risk Chest Pain: Prospective Randomized Pragmatic Trial., Erik P. Hess, Judd E. Hollander, Jason T. Schaffer, Jeffrey A. Kline, Carlos A. Torres, Deborah B. Diercks, Russell Jones, Kelly P. Owen, Zachary F. Meisel, Michel Demers, Annie Leblanc, Nilay D. Shah, Jonathan Inselman, Jeph Herrin, Ana Castaneda-Guarderas, Victor M. Montori

Department of Emergency Medicine Faculty Papers

OBJECTIVE: To compare the effectiveness of shared decision making with usual care in choice of admission for observation and further cardiac testing or for referral for outpatient evaluation in patients with possible acute coronary syndrome.

DESIGN: Multicenter pragmatic parallel randomized controlled trial.

SETTING: Six emergency departments in the United States.

PARTICIPANTS: 898 adults (aged >17 years) with a primary complaint of chest pain who were being considered for admission to an observation unit for cardiac testing (451 were allocated to the decision aid and 447 to usual care), and 361 emergency clinicians (emergency physicians, nurse practitioners, and physician assistants) caring ...


Improving Healthcare Provider Knowledge In Acute And Primary Transgender Health Needs: The Implementation Of A Clinical Education Program With Urgent Care And Emergency Room Staff And Providers, Tonia Lower 2016 Otterbein University

Improving Healthcare Provider Knowledge In Acute And Primary Transgender Health Needs: The Implementation Of A Clinical Education Program With Urgent Care And Emergency Room Staff And Providers, Tonia Lower

Doctoral Theses

The purpose of this project was to improve knowledge and identify personal bias and beliefs in the acute and primary healthcare needs of transgender persons, through the implementation of a clinical education program with healthcare providers and staff working within the urgent care and emergency department settings. The need for such a program exists due to the lack of suitable and accessible healthcare that may lead to misdiagnosis, delay of treatment and poor health outcomes. Including clinical education in the acute and primary healthcare needs of transgender persons that can be integrated into healthcare organizations may aid in the improvement ...


Uchunguzi (Journal Watch/Montre De Journal) December 2016, Benjamin Wachira 2016 Aga Khan University

Uchunguzi (Journal Watch/Montre De Journal) December 2016, Benjamin Wachira

Emergency Medicine, East Africa

Uchunguzi means investigation in Swahili and provides a summary of some of the most recent international literature as presented in other leading journals, but with an emphasis on what is relevant to our continent


Pediatric Emergency Medicine Point-Of-Care Ultrasound: Summary Of The Evidence., Jennifer R Marin, Alyssa M. Abo, Alexander C Arroyo, Stephanie J Doniger, Jason W Fischer, Rachel Rempell, +21 additional authors 2016 George Washington University

Pediatric Emergency Medicine Point-Of-Care Ultrasound: Summary Of The Evidence., Jennifer R Marin, Alyssa M. Abo, Alexander C Arroyo, Stephanie J Doniger, Jason W Fischer, Rachel Rempell, +21 Additional Authors

Pediatrics Faculty Publications

The utility of point-of-care ultrasound is well supported by the medical literature. Consequently, pediatric emergency medicine providers have embraced this technology in everyday practice. Recently, the American Academy of Pediatrics published a policy statement endorsing the use of point-of-care ultrasound by pediatric emergency medicine providers. To date, there is no standard guideline for the practice of point-of-care ultrasound for this specialty. This document serves as an initial step in the detailed "how to" and description of individual point-of-care ultrasound examinations. Pediatric emergency medicine providers should refer to this paper as reference for published research, objectives for learners, and standardized reporting ...


Brief Compression-Only Cardiopulmonary Resuscitation Training Video And Simulation With Homemade Mannequin Improves Cpr Skills., Gregory K Wanner, Arayel Osborne, Charlotte H. Greene PhD 2016 Philadelphia College of Osteopathic Medicine

Brief Compression-Only Cardiopulmonary Resuscitation Training Video And Simulation With Homemade Mannequin Improves Cpr Skills., Gregory K Wanner, Arayel Osborne, Charlotte H. Greene Phd

PCOM Scholarly Papers

BACKGROUND: Cardiopulmonary resuscitation (CPR) training has traditionally involved classroom-based courses or, more recently, home-based video self-instruction. These methods typically require preparation and purchase fee; which can dissuade many potential bystanders from receiving training. This study aimed to evaluate the effectiveness of teaching compression-only CPR to previously untrained individuals using our 6-min online CPR training video and skills practice on a homemade mannequin, reproduced by viewers with commonly available items (towel, toilet paper roll, t-shirt).

METHODS: Participants viewed the training video and practiced with the homemade mannequin. This was a parallel-design study with pre and post training evaluations of CPR skills ...


Can Bedside Ultrasound Inferior Vena Cava Measurements Accurately Diagnose Congestive Heart Failure In The Emergency Department? A Clin-Iq, Miranda Gaskamp, Mark Blubaugh, Laine H. McCarthy, Dewey C. Scheid 2016 Northeastern Health Systems

Can Bedside Ultrasound Inferior Vena Cava Measurements Accurately Diagnose Congestive Heart Failure In The Emergency Department? A Clin-Iq, Miranda Gaskamp, Mark Blubaugh, Laine H. Mccarthy, Dewey C. Scheid

Journal of Patient-Centered Research and Reviews

Congestive heart failure (CHF) is a major cause of morbidity and mortality. Early diagnosis of CHF in patients presenting to the emergency department with undifferentiated dyspnea would allow clinicians to begin appropriate treatment more promptly. Current guidelines recommend B-type natriuretic peptide (BNP) levels for more accurate diagnosis of CHF in dyspneic patients. Although BNP levels are relatively inexpensive, the test is not usually performed at bedside and results may take up to an hour or more. BNP also may have a “gray zone” in which the values can neither confirm nor rule out CHF. BNP has a reported sensitivity of ...


Endotracheal Tube Cuff Pressures In Patients Intubated Prior To Helicopter Ems Transport, Joseph Tennyson, Tucker Ford-Webb, Stacy Weisberg, Donald LeBlanc 2016 University of Massachusetts Medical School

Endotracheal Tube Cuff Pressures In Patients Intubated Prior To Helicopter Ems Transport, Joseph Tennyson, Tucker Ford-Webb, Stacy Weisberg, Donald Leblanc

Open Access Articles

INTRODUCTION: Endotracheal intubation is a common intervention in critical care patients undergoing helicopter emergency medical services (HEMS) transportation. Measurement of endotracheal tube (ETT) cuff pressures is not common practice in patients referred to our service. Animal studies have demonstrated an association between the pressure of the ETT cuff on the tracheal mucosa and decreased blood flow leading to mucosal ischemia and scarring. Cuff pressures greater than 30 cmH2O impede mucosal capillary blood flow. Multiple prior studies have recommended 30 cmH2O as the maximum safe cuff inflation pressure. This study sought to evaluate the inflation pressures in ETT cuffs of patients ...


Prevalence Of Homelessness Or At-Risk For Homelessness In The Ed Setting, Marna R. Greenberg DO, MPH, FACEP, Brett Feldman PA-C, Osman Z. Abbasi DO, Joshua Enyart DO, Yasir Abunamous BA, Timothy Batchelor, Emily L. Bennett BS, Cristina G. Calogero BS, Kareem S. Elsayed, Rachel F. Ledyard BS, Mikdat Ulas BS, Alexis M. Begliomini BA, Zachary J. Ezrow BS, Timothy J. Friel MD 2016 Lehigh Valley Health Network

Prevalence Of Homelessness Or At-Risk For Homelessness In The Ed Setting, Marna R. Greenberg Do, Mph, Facep, Brett Feldman Pa-C, Osman Z. Abbasi Do, Joshua Enyart Do, Yasir Abunamous Ba, Timothy Batchelor, Emily L. Bennett Bs, Cristina G. Calogero Bs, Kareem S. Elsayed, Rachel F. Ledyard Bs, Mikdat Ulas Bs, Alexis M. Begliomini Ba, Zachary J. Ezrow Bs, Timothy J. Friel Md

Department of Emergency Medicine

No abstract provided.


Lack Of Gender Differences In Prevalence Of Homelessness In The Emergency Department (Poster), Marna R. Greenberg DO, MPH, FACEP, Brett Feldman PA-C, Alexandra M. Craen, Zachary M. Dillon MD, Kenneth Dzike MD, Julie A. Fritzges DO, Jessica L. Glaubman DO, Nathaniel M. Yoder DO, Emily A. Kiernan DO, Shaye M. Glovas, Danielle E. Mustin BS, Korrinne N. Yurick BS, Timothy J. Friel MD 2016 Lehigh Valley Health Network

Lack Of Gender Differences In Prevalence Of Homelessness In The Emergency Department (Poster), Marna R. Greenberg Do, Mph, Facep, Brett Feldman Pa-C, Alexandra M. Craen, Zachary M. Dillon Md, Kenneth Dzike Md, Julie A. Fritzges Do, Jessica L. Glaubman Do, Nathaniel M. Yoder Do, Emily A. Kiernan Do, Shaye M. Glovas, Danielle E. Mustin Bs, Korrinne N. Yurick Bs, Timothy J. Friel Md

Department of Emergency Medicine

No abstract provided.


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