Medicine and Health Sciences Commons^™

Cardiopulmonary Resuscitation Prescription Program: A Pilot Randomized Comparator Trial (Poster), Marna R. Greenberg Do, Mph, Facep, Gavin C. Barr Jr. Md, Valerie Rupp Rn, Bsn, Nainesh Patel Md, Kevin Weaver Do, Kimberly Hamilton Ba, James Reed Iii, Phd

Nainesh C Patel MD

No abstract provided.

Impact Of Pre-Hospital Myocardial Infarction Alert Process Education On Door To Balloon Times At Sites Within A Regional Heart Center, Gerald Coleman Do, Andrew C. Miller Do, David Richardson Md, David Cox Md, Nainesh C. Patel Md, J Patrick Kleaveland Md, Bruce Feldman Do, Ron Freudenberger Md, Richard S. Mackenzie Md

Nainesh C Patel MD

No abstract provided.

Gender Differences In Cardiac Arrest Survivors Who Receive Therapeutic Hypothermia (Poster), Marna R. Greenberg Do, Mph, Facep, Amy M. Ahnert Md, Nainesh C. Patel Md, Courtney Bennett Do, Nicole Elliott Do, Mark Lundquist, Andrew C. Miller Do, Ellina C. Feiner Md, Anita Kurt Phd, Rn, Bernadette Gl-Porter Bs, Mercedes Rios-Scott Bs, David B. Burmeister Do, Facep

Nainesh C Patel MD

No abstract provided.

Gender Differences In Perceptions And Self-Reported Driving Behaviors Among Teenagers., Gavin Barr, Kathleen Kane, Robert Barraco, Timarie Rayburg, Lauren Demers, Chadd Kraus, Marna Greenberg, Valerie Rupp, Kimberly Hamilton, Bryan Kane

Robert D Barraco MD, MPH

BACKGROUND: The Centers for Disease Control reports that motor vehicle crashes (MVCs) are the leading cause of injury and death among U.S. teenagers, and disproportionately affect males. Among preventable causes of MVCs involving teenage drivers, distracted driving continues to be a serious public health problem. OBJECTIVES: To describe gender differences in teenage drivers' self-perceptions of safe driving behaviors, and self-reported risk behaviors and distractions while driving. METHODS: We prospectively surveyed teenage drivers from four high schools in Pennsylvania and New Jersey. Gender comparisons were made between self-reported perceptions and self-reported driving behaviors. Descriptive statistics and chi-squared testing were used in …

The Correlation Between Adolescent Driving Behaviors, Robert D. Barraco Md, Bryan G. Kane Md, Shawna Murphy Do, Valerie Rupp Rn, Bsn, Kimberly Hamilton Ba, Traci Anselmo Do, James F. Reed Iii, Phd

Robert D Barraco MD, MPH

No abstract provided.

Modified Cage As A Screening Tool For Mechanical Fall Risk Assessment: A Pilot Survey, Marna R. Greenberg Do, Mph, Facep, Michael Nguyen Md, Bernadette Gl-Porter Bs, Robert D. Barraco Md, Brian Stello Md, Arnold R. Goldberg Md, Clare M. Lenhart Phd, Mph, Anita Kurt Phd, Rn, Bryan G. Kane Md

Robert D Barraco MD, MPH

Modified CAGE as a Screening Tool for Mechanical Fall Risk Assessment: A Pilot Survey

Marna Rayl Greenberg DO, MPH, Michael C Nguyen MD, Bernadette G Porter BA,Robert DBarraco, MD MPH, Brian Stello MD, Arnold Goldberg MD, Clare M Lenhart, PhD MPH,Anita Kurt PhD, RN, Bryan G Kane, MD

Background: Falls in the elderly cause serious injury. The literature does not hold answers to patient perceptions about their personal fall risk, their comfort level in discussing their fall history, or a home safety plan with their healthcare provider. Existing risk-assessing tools may be prohibitive in the Emergency Department due to their …

Gender Differences In Emergency Department (Ed) Patient Mechanical Fall Risk And Openness To Communication With Providers, Bryan G. Kane Md, Michael Nguyen Md, Robert D. Barraco Md, Brian Stello Md, Arnold R. Goldberg Md, Clare M. Lenhart Phd, Mph, Bernadette Gl-Porter Bs, Anita Kurt Phd, Rn, Marna R. Greenberg Do, Mph, Facep

Robert D Barraco MD, MPH

Gender Differences in Emergency Department (ED) Patient Mechanical Fall Risk and Openness to Communication with Providers

Bryan G Kane, MD, Michael C Nguyen MD, Robert D Barraco, MD MPH, Brian Stello MD, Arnold Goldberg MD, Clare M Lenhart, PhD MPH, Bernadette G Porter BA ,Anita Kurt PhD, RN, Marna Rayl Greenberg DO, MPH

Objectives: The CDC reports that among older adults (≥65), falls are the leading cause of injury-related death and rates of fall-related fractures among older women are more than twice those for men. We set out to determine ED patient perceptions (analyzed by gender) about their personal fall …

Gender Differences In Perceptions And Self-Reported Driving Behaviors Among Teenagers. (Poster), Gavin C. Barr Jr. Md, Kathleen E. Kane Md, Robert D. Barraco Md, Timarie Rayburg Do, Lauren Dugan Do, Chadd K. Kraus Do, Mph, Marna R. Greenberg Do, Mph, Facep, Valerie Rupp Rn, Bsn, Kimberly Hamilton, Bryan G. Kane Md

Robert D Barraco MD, MPH

No abstract provided.

Sex Differences In Emergency Department Patient Mechanical Fall Risk And Openess To Communication With Providers, Bryan G. Kane Md, Michael Nguyen Md, Robert D. Barraco Md, Brian Stello Md, Arnold R. Goldberg Md, C M. Lenhart, Bernadette Gl-Porter Bs

Robert D Barraco MD, MPH

No abstract provided.

Injury Due To Mechanical Falls: Future Directions In Gender-Specific Surveillance, Screening, And Interventions In Emergency Department Patients., Marna Greenberg, Bryan Kane, Vicken Y Totten, Neha P Raukar, Elizabeth C Moore, Tracy Sanson, Robert Barraco, Michael Nguyen, Federico E Vaca

Robert D Barraco MD, MPH

The Centers for Disease Control and Prevention report that among older adults (≥65 years), falls are the leading cause of injury-related death. Fall-related fractures among older women are more than twice as frequent as those for men. Gender-specific evidence-based fall prevention strategy and intervention studies show that improved patient-centered outcomes are elusive. There is a paucity of emergency medicine literature on the topic. As part of the 2014 Academic Emergency Medicine (AEM) consensus conference on "Gender-Specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes," a breakout group convened to generate a research agenda on priority …

Mechanical Falls: Are Patients Willing To Discuss Their Risk With A Health Care Provider?, Marna Greenberg, Michael Nguyen, Brian Stello, Arnold Goldberg, Robert Barraco, Bernadette Glenn-Porter, Anita Kurt, Stephen Dusza, Bryan Kane

Robert D Barraco MD, MPH

Background: Falls in the elderly cause serious injury. Objective: We aimed to determine subjects’ comfort in discussing fall risk and home safety evaluations. Methods: This prospective study surveyed a convenience sample of subjects ($50 years old) in an emergency department (ED), health fair (HF), and family practice (FP). The survey included the Falls Efficacy Scale and Vulnerable Elders Survey—validated surveys measuring fall concern and functional decline. Other data—environmental living conditions, participant behaviors, fall frequency—were collected. The associations between perceived fall risk and participant characteristics were assessed using descriptive statistics and random-effects logistic regression. Results: Participants (n = 416, 38% males, …

The Impact Of A Brief Educational Intervention On Adolescent Driving Behaviors, Shawna Murphy Do, Gavin C. Barr Jr. Md, Bryan G. Kane Md, Valerie Rupp Rn, Bsn, Kimberly Fredericks, Kathleen E. Kane Md, Robert D. Barraco Md, Traci Anselmo

Robert D Barraco MD, MPH

No abstract provided.

Gender Differences In Perceptions And Self-Reported Driving Behaviors Among Teenagers., Gavin C. Barr Jr. Md, Kathleen E. Kane Md, Robert D. Barraco Md, Timarie Rayburg, Lauren Demers, Chadd K. Kraus Do, Mph, Marna R. Greenberg Do, Mph, Facep, Valerie Rupp Rn, Bsn, Kimberly Hamilton, Bryan G. Kane Md

Robert D Barraco MD, MPH

BACKGROUND: The Centers for Disease Control reports that motor vehicle crashes (MVCs) are the leading cause of injury and death among U.S. teenagers, and disproportionately affect males. Among preventable causes of MVCs involving teenage drivers, distracted driving continues to be a serious public health problem. OBJECTIVES: To describe gender differences in teenage drivers' self-perceptions of safe driving behaviors, and self-reported risk behaviors and distractions while driving. METHODS: We prospectively surveyed teenage drivers from four high schools in Pennsylvania and New Jersey. Gender comparisons were made between self-reported perceptions and self-reported driving behaviors. Descriptive statistics and chi-squared testing were used in …

Perceived Mechanical Fall Risk And Openness To Communication With Providers, Marna R. Greenberg Do, Mph, Facep, Michael Nguyen Md, Brian Stello Md, Robert D. Barraco Md, Arnold R. Goldberg Md, Colin L. Donnelly Do, Benjamin R. Preiss Do, Bernadette Gl-Porter Bs, Anita Kurt Phd, Rn, Bryan G. Kane Md

Robert D Barraco MD, MPH

No abstract provided.

Sydenham Chorea: Rare Consequence Of Rheumatic Fever., Paul Myers, Kathleen Kane, Bernadette Glenn-Porter, Richard Mazzaccaro

Kathleen E Kane MD

No abstract provided.

Gender Differences In Perceptions And Self-Reported Driving Behaviors Among Teenagers., Gavin C. Barr Jr. Md, Kathleen E. Kane Md, Robert D. Barraco Md, Mph, Timarie Rayburg, Lauren Demers, Chadd K. Kraus Do, Mph, Marna R. Greenberg Do, Mph, Facep, Valerie Rupp Rn, Bsn, Kimberly Hamilton, Bryan G. Kane Md

Kathleen E Kane MD, FACEP

BACKGROUND: The Centers for Disease Control reports that motor vehicle crashes (MVCs) are the leading cause of injury and death among U.S. teenagers, and disproportionately affect males. Among preventable causes of MVCs involving teenage drivers, distracted driving continues to be a serious public health problem. OBJECTIVES: To describe gender differences in teenage drivers' self-perceptions of safe driving behaviors, and self-reported risk behaviors and distractions while driving. METHODS: We prospectively surveyed teenage drivers from four high schools in Pennsylvania and New Jersey. Gender comparisons were made between self-reported perceptions and self-reported driving behaviors. Descriptive statistics and chi-squared testing were used in …

Recurrent (Stump) Appendicitis: A Case Series, Rolando Rios, Kara Mia Villaneuva, Joseph Stirparo, Kathleen Kane

Kathleen E Kane MD

No abstract provided.

Pediatric Stroke Presenting As A Seizure., Katie Ahmadzadeh, Vartika Bhardwaj, Steven A Johnson, Kathleen Kane

Kathleen E Kane MD

Background. Childhood arterial ischemic stroke (AIS) is rare and may be difficult to diagnose. Management of acute stroke in any age group is time sensitive, so awareness of the manifestations and appropriate diagnostic procedures for pediatric AIS is vital to establishing care. We present a pediatric case of arterial ischemic stroke that presented to the emergency department (ED) after two seizures. Case Report. A five-year-old female with an existing seizure disorder presented to a pediatric ED after having two seizures. Postictal upon arrival, she underwent a computed tomography (CT) scan of her head. Family reported that she had complained of …

Mechanical Falls: Are Patients Willing To Discuss Their Risk With A Health Care Provider?, Marna Greenberg, Michael Nguyen, Brian Stello, Arnold Goldberg, Robert Barraco, Bernadette Glenn-Porter, Anita Kurt, Stephen Dusza, Bryan Kane

Marna R Greenberg DO, MPH, FACEP

Background: Falls in the elderly cause serious injury. Objective: We aimed to determine subjects’ comfort in discussing fall risk and home safety evaluations. Methods: This prospective study surveyed a convenience sample of subjects ($50 years old) in an emergency department (ED), health fair (HF), and family practice (FP). The survey included the Falls Efficacy Scale and Vulnerable Elders Survey—validated surveys measuring fall concern and functional decline. Other data—environmental living conditions, participant behaviors, fall frequency—were collected. The associations between perceived fall risk and participant characteristics were assessed using descriptive statistics and random-effects logistic regression. Results: Participants (n = 416, 38% males, …

Effect Of Triage-Based Use Of The Ottawa Foot And Ankle Rules On The Number Of Orders For Radiographic Imaging., John Ashurst, Thomas Nappe, Stephanie Digiambattista, Avinash Kambhampati, Sarfraz Alam, Michelle Ortiz, Paul Delpais, Bernadette Glenn-Porter, Anita Kurt, Bryan Kane, Marna Greenberg

Marna R Greenberg DO, MPH, FACEP

CONTEXT: Reducing unnecessary testing lessens the cost burden of medical care, but decreasing use depends on consistently following evidence-based clinical decision rules. The Ottawa foot and ankle rules (OFARs) are validated, longstanding evidence-based guidelines to predict fractures. Frequently, radiography is automatically ordered for acute ankle injuries despite findings from OFARs suggesting no fracture. OBJECTIVES: First, to determine whether implementation of protocol-driven use of the OFARs at triage would decrease the number of radiography orders and length of stay (LOS) in the emergency department. Second, to quantify the incidence of OFARs use at triage and to assess patient expectations of radiography …

In Reply., Marna Greenberg, Deepak Jayant, Gavin Barr

Marna R Greenberg DO, MPH, FACEP

No abstract provided.

Absolute And Relative Changes (Delta) In Troponin I For Early Diagnosis Of Myocardial Infarction: Results Of A Prospective Multicenter Trial., Alan B Storrow, Richard M Nowak, Deborah B Diercks, Adam J Singer, Alan H B Wu, Erik Kulstad, Frank Lovecchio, Christian Fromm, Gary Headden, Tracie Potis, Christopher J Hogan, Jon W Schrock, Daniel P Zelinski, Marna Greenberg, Robert H Christenson, James C Ritchie, Janna S Chamberlin, Kurtis R Bray, Daniel W Rhodes, Deirdre Trainor, Paula C Southwick

Marna R Greenberg DO, MPH, FACEP

OBJECTIVES: We investigated absolute and relative cardiac troponin I (TnI) delta changes, optimal sampling protocols, and decision thresholds for early diagnosis of myocardial infarction (MI). Serial cardiac biomarker values demonstrating a rise and/or fall define MI diagnosis; however the magnitude of change, timing, and diagnostic accuracy of absolute versus relative (percentage) deltas remains unsettled. METHODS: We prospectively measured TnI (AccuTnI+3™, Beckman Coulter) at serial time intervals in 1929 subjects with chest pain or equivalent symptoms of acute coronary syndrome at 14 medical centers. Diagnosis was adjudicated by an independent central committee. RESULTS: Elevated TnI above a threshold of 0.03ng/mL demonstrated …

Future Directions In Sex- And Gender-Specific Emergency Medicine., Marna Greenberg, Basmah Safdar, Esther K Choo, Alyson J Mcgregor, Lance B Becker, David C Cone

Marna R Greenberg DO, MPH, FACEP

The 2014 Academic Emergency Medicine (AEM) consensus conference "Gender-Specific Research in Emergency Medicine: Investigate, Understand, and Translate How Gender Affects Patient Outcomes" convened a diverse group of stakeholders to target gaps in emergency medicine (EM) sex- and gender-specific research and identify research priorities. At the close of the conference, the executive committee sought feedback from group leaders and conference attendees about the next critical steps in EM sex- and gender-specific research, goals for their own future research, and anticipated barriers in pursuing this research. This article summarizes this feedback on the future directions in sex- and gender-specific research in emergency …

Comparison Of Airway Intubation Devices When Using A Biohazard Suit: A Feasibility Study, Kevin Weaver Do, Kayla R. Long Do, Gavin C. Barr Jr. Md, Jeffery P. Reboul Do, Aaron S. Ratner Do, Leonel Diaz Jr.,Do, Dougals A. Sturm Do, Bernadette Glenn-Porter Bs, Marna R. Greenberg Do, Mph, Facep, Bryan G. Kane Md

Marna R Greenberg DO, MPH, FACEP

No abstract provided.

Post Transapical Aortic Valve Replacement (Tavr) Pseudoaneurysm., Michael W Manning, Leonel Diaz, Michael Weigner, Colin L Donnelly, Marna Greenberg

Marna R Greenberg DO, MPH, FACEP

No abstract provided.

Injury Due To Mechanical Falls: Future Directions In Gender-Specific Surveillance, Screening, And Interventions In Emergency Department Patients., Marna Greenberg, Bryan Kane, Vicken Y Totten, Neha P Raukar, Elizabeth C Moore, Tracy Sanson, Robert Barraco, Michael Nguyen, Federico E Vaca

Marna R Greenberg DO, MPH, FACEP

The Centers for Disease Control and Prevention report that among older adults (≥65 years), falls are the leading cause of injury-related death. Fall-related fractures among older women are more than twice as frequent as those for men. Gender-specific evidence-based fall prevention strategy and intervention studies show that improved patient-centered outcomes are elusive. There is a paucity of emergency medicine literature on the topic. As part of the 2014 Academic Emergency Medicine (AEM) consensus conference on "Gender-Specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes," a breakout group convened to generate a research agenda on priority …

Alignment Of Lean Management Process To Quality And Safety In A Academic Community Hospital: Psychiatry For The Twenty First Century., Ronald Swinfard, Michael Kaufmann, Ralph Primelo, Laurence Karper, Muhamad Rifai, Edward Norris, Debbie Salas-Lopez, David Burmeister, Gail Stern, David Dylewski, D Ezrow, Rosanne Teders, Courtney Vose

Debbie Salas-Lopez MD, MPH

No abstract provided.

The ‘‘Ice’’ Study: Feasibility Of Inexpensive Commercial Coolers On Mobile Ems Units, Kathleen E. Kane Md, Robert J. Tomsho Do, Ms, Karen Pheasant Do, Thomas Stauffer Do, Brent R. Schoenfeldt Do, Scott Hamilton Do, Travis Kain Do, Bryan G. Kane Md

Kathleen E Kane MD, FACEP

Introduction: Prehospital postresuscitation induced hypothermia (IH) has been shown to reduce neurological complications in comatose cardiac-arrest survivors. Retrofitting ambulances to include equipment appropriate to initiate hypothermia, such as refrigeration units for cooled saline, is expensive. The objective of this nonhuman subject research study was to determine if inexpensive, commercially available coolers could, in conjunction with five reusable ice packs, keep two 1 L bags of precooled 0.9% normal saline solution (NSS) at or below 48C for an average shift of eight to 12 hours in a real-world environment, on board in-service Emergency Medical Service (EMS) units, over varying weather conditions …

Airway Carts: A Systems-Based Approach To Airway Safety, Bryan Kane, William Bond, Charles Worrilow, David Richardson

Bryan G Kane MD

No abstract provided.

Introduction Of Evidence-Based Diagnostic Order Sets In An Electronic Medical Record Is Associated With An Increase In Laboratory Orders, Bryan G. Kane Md, Justin Arnold Do, Joshua Morrison Do, Ryan Southworth Do, William Greenhut Do, Will Russell Do, Jeremy Selley Do, Michael Stanley Do

Bryan G Kane MD

No abstract provided.