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Can Point-Of-Care Betahydroxybutyrate Testing Be Used To Predict Diabetic Ketoacidosis In The Pediatric Emergency Department?, Michelle Knoll 2019 Children's Mercy Hospital

Can Point-Of-Care Betahydroxybutyrate Testing Be Used To Predict Diabetic Ketoacidosis In The Pediatric Emergency Department?, Michelle Knoll

Research Days

No abstract provided.


Information And Readiness Build Resilience: The Role Of The Disaster Information Management Research Center, Stacey J. Arnesen, Florence Chang 2019 National Library of Medicine

Information And Readiness Build Resilience: The Role Of The Disaster Information Management Research Center, Stacey J. Arnesen, Florence Chang

Collaborative Librarianship

The National Library of Medicine (NLM) established the Disaster Information Management Research Center (DIMRC) in 2008 based on its history of providing health information for disaster preparedness, response, and recovery. The NLM long range plan (Charting a Course for the 21st Century: NLM's Long Range Plan 2006-2016) called for creation of a center to show "a strong commitment to disaster remediation and to provide a platform for demonstrating how libraries and librarians can be part of the solution to this national problem". NLM was urged to "ensure continuous access to health information and effective use of libraries and librarians ...


Development Of An Rcu Vertical Care Expedites Low Acuity Patients Through The Ed, Griselle Pastor, Julie Lamoureux, Andrew Friedman, Matthew Kadrie, Sebastian Abdelnur, Joseph Scott 2019 West Kendall Baptist Hospital

Development Of An Rcu Vertical Care Expedites Low Acuity Patients Through The Ed, Griselle Pastor, Julie Lamoureux, Andrew Friedman, Matthew Kadrie, Sebastian Abdelnur, Joseph Scott

Julie Lamoureux

No abstract provided.


Improving Length Of Stay: Transitioning Care From The Emergency Department To A Clinical Decision Unit, Griselle Pastor, Van Cronkhite, Natalie Mancuso, Emilia Villoch 2019 Doctors Hospital

Improving Length Of Stay: Transitioning Care From The Emergency Department To A Clinical Decision Unit, Griselle Pastor, Van Cronkhite, Natalie Mancuso, Emilia Villoch

Griselle Pastor

No abstract provided.


Development Of An Rcu Vertical Care Expedites Low Acuity Patients Through The Ed, Griselle Pastor, Julie Lamoureux, Andrew Friedman, Matthew Kadrie, Sebastian Abdelnur, Joseph Scott 2019 West Kendall Baptist Hospital

Development Of An Rcu Vertical Care Expedites Low Acuity Patients Through The Ed, Griselle Pastor, Julie Lamoureux, Andrew Friedman, Matthew Kadrie, Sebastian Abdelnur, Joseph Scott

Griselle Pastor

No abstract provided.


Acquiring Blood Pressures On High Risk Sepsis Patients In The Ed, McKenna Scharlau, Jacob Schneider 2019 Children's Mercy Hospital

Acquiring Blood Pressures On High Risk Sepsis Patients In The Ed, Mckenna Scharlau, Jacob Schneider

Nurse Presentations

Describes a project to improve use of the Sepsis Tool in the Emergency Department and to improve documentation of blood pressure measurements in high risk sepsis patients under three years of age.


Safety Oriented, Low-Cost Peritonsillar Abscess Needle Aspiration Model For Emergency Medicine Simulation, Anne Mai BS, Julie A. Fritzges DO, Gavin C. Barr Jr. MD, Marna R. Greenberg DO, MPH, FACEP, Smeet Bhimani DO 2019 Lehigh Valley Health Network

Safety Oriented, Low-Cost Peritonsillar Abscess Needle Aspiration Model For Emergency Medicine Simulation, Anne Mai Bs, Julie A. Fritzges Do, Gavin C. Barr Jr. Md, Marna R. Greenberg Do, Mph, Facep, Smeet Bhimani Do

Department of Emergency Medicine

No abstract provided.


Engaging Emergency Department Patients In The Creation Of A Shared Decision-­Making Tool Regarding Ct Scanning In Kidney Stones: Challenges To Traditional Stakeholder Engagement, Elizabeth M. Schoenfeld, Connor J. Houghton, Pooja P. Patel, Leonora Merwin, Kathleen M. Mazor, Erik Hess, Charles Scales, Maggie Breslin, Peter K. Lindenauer 2019 University of Massachusetts Medical School

Engaging Emergency Department Patients In The Creation Of A Shared Decision-­Making Tool Regarding Ct Scanning In Kidney Stones: Challenges To Traditional Stakeholder Engagement, Elizabeth M. Schoenfeld, Connor J. Houghton, Pooja P. Patel, Leonora Merwin, Kathleen M. Mazor, Erik Hess, Charles Scales, Maggie Breslin, Peter K. Lindenauer

Community Engagement and Research Symposia

Background: Every year approximately 2 million patients are seen in US EDs for suspected renal colic, and the majority receive CT scans. The objective of our study was to develop a stakeholder-informed conversation aid to help clinicians use SDM regarding CT scanning in patients with suspected renal colic.

Methods: Using a published decision aid development framework, and under the direction of a multi-disciplinary Steering Committee, we engaged a diverse set of stakeholders via qualitative methods. EM clinicians, urologists, radiologists, researchers, and emergency department patients participated in focus groups and semi-structured interviews. All groups were recorded, transcribed, and analyzed in an ...


Perceptions On The Opioid Epidemic: A Qualitative Study, Rebecca Leach, Brittany Chapman, Ailish Hanly, Stephanie Carreiro 2019 University of Massachusetts Medical School

Perceptions On The Opioid Epidemic: A Qualitative Study, Rebecca Leach, Brittany Chapman, Ailish Hanly, Stephanie Carreiro

Community Engagement and Research Symposia

Background: Opioid use disorder (OUD) and resultant opioid overdoses have amplified over the last 20 years, despite efforts to identify best practices for treatment. Little research has focused on the disconnect between individuals with OUD and their healthcare providers.

Hypothesis: We hypothesize that discrepancies exist between individuals with OUD and their healthcare providers with respect to perceptions of and experiences with medical care, the opioid antidote naloxone, and current treatment paradigms. Highlighting these discrepancies will inform future healthcare models.

Methods: Using electronic surveys and semi-structured interviews, we will collect qualitative data from both individuals with OUD and emergency providers to ...


At-Risk Ems Employees- A Model Of Assessment And Intervention.Pdf, Ron J. Hammond, Kate Miller 2019 Utah Valley University

At-Risk Ems Employees- A Model Of Assessment And Intervention.Pdf, Ron J. Hammond, Kate Miller

Ron J. Hammond

This paper includes data results from a survey of Utah (U.S.) EMS personnel.  Those who reported having already reach a point of wanting to quit the field and having reached a point of wanting to resign their current position were classified as being “At Risk” (N=142) and were compared to those who had not (N=395).  T-Test and ratio analysis indicated that those At Risk were found to have significantly higher incidences of difficult past calls, PTSD-like symptoms, and a variety of personal hardships. Both groups had relatively high indicators of negative impact of working in the EMS ...


An Exploration Of Why Healthcare Professionals Under-Report Observed Patient Aggression, Sydney Bonta 2019 University of Nebraska at Omaha

An Exploration Of Why Healthcare Professionals Under-Report Observed Patient Aggression, Sydney Bonta

Student Research and Creative Activity Fair

An Exploration of Why Healthcare Professionals Under-Report Observed Patient Aggression

Authors: Sydney Bonta & Lisa L. Scherer, Ph.D.

Advisor: Lisa L. Scherer, Ph.D.

According to the 2011 US Bureau of Justice Statistics report, medical professionals experienced the third highest proportion of workplace violence (WPV), with violence primarily emanating from patient. In a national survey of nurses employed in hospitals, 76% stated that they had encountered some sort of violence in their workplace (Speroni, Fitch, Dawson, Dugan, Atherton, & Leesburg, 2014). Similarly, patient aggression against physicians has long been a problem (Morrison, Lantos, Levinson, 1998). Despite this widespread exposure to WPV ...


The Opioid Crisis: Exploring The Effects On First Responders And Healthcare Professionals, Rachel Lubischer, Dawne Frain 2019 University of Nebraska at Omaha

The Opioid Crisis: Exploring The Effects On First Responders And Healthcare Professionals, Rachel Lubischer, Dawne Frain

Student Research and Creative Activity Fair

In 2017, the National Department of Health and Human Services declared the opioid crisis a public health emergency (The White House, 2018). Although Nebraska ranks among the states with the lowest number of drug overdose deaths, rising opioid use creates safety concerns for first responders and healthcare professionals, and leads to strained resources in many jurisdictions. We hope to increase our audience’s knowledge on the opioid crisis, how it effects first responders and healthcare professionals, and pertinent policies and initiatives in Nebraska. Our audience will leave this presentation better equipped to initiate discussions with friends, family, and community members ...


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 ...


Utilizing The Boston Syncope Observation Management Pathway To Reduce Hospital Admission And Decrease Adverse Outcomes, Oren J. Mechanic, Celine Y. Pascheles, Gregory J. Lopez, Alina M. Winans, Nathan I. Shapiro, Carrie Tibbles, Richard E. Wolfe, Shamai A. Grossman 2019 Harvard Medical School

Utilizing The Boston Syncope Observation Management Pathway To Reduce Hospital Admission And Decrease Adverse Outcomes, Oren J. Mechanic, Celine Y. Pascheles, Gregory J. Lopez, Alina M. Winans, Nathan I. Shapiro, Carrie Tibbles, Richard E. Wolfe, Shamai A. Grossman

Student Papers & Posters

Introduction: In an age of increasing scrutiny of each hospital admission, emergency department (ED) observation has been identified as a low-cost alternative. Prior studies have shown admission rates for syncope in the United States to be as high as 70%. However, the safety and utility of substituting ED observation unit (EDOU) syncope management has not been well studied. The objective of this study was to evaluate the safety of EDOU for the management of patients presenting to the ED with syncope and its efficacy in reducing hospital admissions.

Methods: This was a prospective before-and-after cohort study of consecutive patients presenting ...


Emergency Medicine Palliative Care Access (Empalla): Preliminary Data From A Multi-Center Randomized Controlled Trial, Abigail M. Schmucker, BA, Deborah J. Shim, BS, Corita R. Grudzen, MD, MSHS, Jeanne Cho, MPH, Keith Goldfeld, DrPH 2019 Thomas Jefferson University

Emergency Medicine Palliative Care Access (Empalla): Preliminary Data From A Multi-Center Randomized Controlled Trial, Abigail M. Schmucker, Ba, Deborah J. Shim, Bs, Corita R. Grudzen, Md, Mshs, Jeanne Cho, Mph, Keith Goldfeld, Drph

Phase 1

Introduction: Emergency department (ED)-initiated palliative care has been shown to improve patient-centered outcomes in older adults with serious illnesses, but the optimal modality for providing such interventions is unknown. The EMPallA trial compares nurse-led, telephonic case management with specialty, outpatient palliative care on: 1) patient quality of life (QOL); 2) healthcare utilization; 3) loneliness and symptom burden; and 4) caregiver strain, QOL, and bereavement.

Objective: Summarize preliminary demographic and QOL data for the EMPallA cohort.

Methods: A pragmatic, parallel, two-arm randomized controlled trial is enrolling 1350 ED patients across 9 EDs over 3 years to compare the effectiveness of ...


Acute Pancreatitis In The Emergency Department, Gregory J. Lopez, BS, Matt Hall, MD, Matthew Babineau, MD, Darshan Kothari, MD, Ryan C. Burke, PhD, MPH, Richard E. Wolfe, MD, Sunil G. Sheth, MD, Stephen Freedman, MD, Nathan I. Shapiro, MD, Carrie Tibbles, MD 2019 Thomas Jefferson University

Acute Pancreatitis In The Emergency Department, Gregory J. Lopez, Bs, Matt Hall, Md, Matthew Babineau, Md, Darshan Kothari, Md, Ryan C. Burke, Phd, Mph, Richard E. Wolfe, Md, Sunil G. Sheth, Md, Stephen Freedman, Md, Nathan I. Shapiro, Md, Carrie Tibbles, Md

Phase 1

Introduction: Acute pancreatitis (AP) is a common emergency department (ED) presentation with a variety of outcomes. Stratifying AP severity with scoring systems can allow physicians to effectively manage patient disposition.

Objective: To identify ED pancreatitis patients who will likely be admitted to the ICU or be discharged within 48 hours, and to validate existing pancreatitis severity scores.

Methods: Patients with a final ED diagnosis of AP and/or lipase ≥ 3 times the upper limit of normal were enrolled in a prospective, observational chart review study. Parametric and non-parametric descriptive statistics were used to describe the patient population. Area under receiver ...


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 ...


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