Medical Specialties Commons^™

Enhanced Macrophage Pannexin 1 Expression And Hemichannel Activation Exacerbates Lethal Experimental Sepsis, W. Chen, S. Zhu, Y. Wang, J. Li, X. Qiang, X. Zhao, L. Becker, P. Wang, K. J. Tracey, H. Wang, +2 Additional Authors

Journal Articles

No abstract provided.

Standardized Video Interviews Do Not Correlate To United States Medical Licensing Examination Step 1 And Step 2 Scores, D. J. Egan, A. Husain, M. C. Bond, W. Caputo, L. Cygan, J. Van Dermark, J. M. Shoenberger, I. Li, B. Ardolic, M. Weizberg, +7 Additional Authors

Journal Articles

© 2019 Egan et al. Introduction: In 2017, the Standardized Video Interview (SVI) was required for applicants to emergency medicine (EM). The SVI contains six questions highlighting professionalism and interpersonal communication skills. The responses were scored (6-30). As it is a new metric, no information is available on correlation between SVI scores and other application data. This study was to determine if a correlation exists between applicants' United States Medical Licensing Examination (USMLE) and SVI scores. We hypothesized that numeric USMLE Step 1 and Step 2 Clinical Knowledge (CK) scores would not correlate with the SVI score, but that performance …

Does Training Level Affect The Accuracy Of Visual Assessment Of Capillary Refill Time?, K. Shinozaki, L. S. Jacobson, K. Saeki, N. Kobayashi, S. Weisner, J. M. Falotico, T. Li, J. Kim, J. W. Lampe, L. B. Becker

Journal Articles

No abstract provided.

Free Open Access Medical Education Applications: A Critical Appraisal Of Techniques For Quality Assessment And Content Discovery, A. Zhi, A. Husain

Journal Articles

No abstract provided.

How Well Does The Standardized Video Interview Score Correlate With Traditional Interview Performance?, A. S. Chung, K. H. Shah, M. Bond, B. Ardolic, A. Husain, I. Li, L. Cygan, W. Caputo, J. Shoenberger, M. Weizberg, +2 Additional Authors

Journal Articles

© 2019 Chung et al. Introduction: In 2017, all medical students applying for residency in emergency medicine (EM) were required to participate in the Standardized Video Interview (SVI). The SVI is a video-recorded, unidirectional interview consisting of six questions designed to assess interpersonal and communication skills and professionalism. It is unclear whether this simulated interview is an accurate representation of an applicant’s competencies that are often evaluated during the in-person interview. Objective: The goal of this study was to determine whether the SVI score correlates with a traditional in-person interview score. Methods: Six geographically and demographically diverse EM residency programs …

Incoming Interns Perceived Preparedness For Core Entrustable Professional Activities, R. E. Pearlman, M. A. Pawelczak, J. B. Bird, A. C. Yacht, G. A. Farina

Journal Articles

© 2019, International Association of Medical Science Educators. Introduction: The AAMC described 13 core entrustable professional activities (EPAs) for which every graduating medical student should perform proficiently on day 1 of residency. We studied how prepared starting interns felt in the core EPAs. Methods: Interns from a diverse health system were surveyed on how well medical school prepared them in the 13 core EPAs. Data were collected on type of medical school, participation in an acting/sub-internship (AI/SI), knowledge of EPAs, and participation in an EPA experience. Results: We collected 224 surveys out of 384 (58%) interns. 61.2% attended allopathic, 14.6% …

Recent Advances In Personalizing Cardiac Arrest Resuscitation, C. E. Kuschner, L. B. Becker

Journal Articles

© 2019 Kuschner CE and Becker LB. Cardiac arrest remains a significant cause of death and disability throughout the world. However, as our understanding of cardiac arrest and resuscitation physiology has developed, new technologies are fundamentally altering our potential to improve survival and neurologic sequela. Some advances are relatively simple, requiring only alterations in current basic life support measures or integration with pre-hospital organization, whereas others, such as extra-corporeal membrane oxygenation, require significant time and resource investments. When combined with consistent rescuer and patient-physiologic monitoring, these innovations allow an unprecedented capacity to personalize cardiac arrest resuscitation to patient-specific pathophysiology. However, …

Sexual Dimorphism Of Gut Microbiota Dictates Therapeutics Efficacy Of Radiation Injuries, M. Cui, H. Xiao, Y. Li, S. Zhang, J. Dong, B. Wang, C. Zhu, M. Jiang, H. Wang, S. Fan, +2 Additional Authors

Journal Articles

© 2019 The Authors. Published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim Accidental or iatrogenic ionizing radiation exposure precipitates acute and chronic radiation injuries. The traditional paradigm of mitigating radiotherapy-associated adverse side effects has ignored the gender-specific dimorphism of patients' divergent responses. Here, the effects of sexual dimorphism on curative efficiencies of therapeutic agents is examined in murine models of irradiation injury. Oral gavage of simvastatin ameliorates radiation-induced hematopoietic injury and gastrointestinal tract dysfunction in male mice, but adversely deteriorates these radiation syndromes in female animals. In a sharp contrast, feeding animals with high-fat diet (HFD) elicites explicitly contrary …

The Relationship Between Generalized Anxiety Disorder And Patient Age Among Emergency Department Patients, Mitchell Mcmurray

Scholarship in Medicine - All Papers

The objective of this study was to determine the relationship between Generalized Anxiety Disorder (GAD) and patient age in emergency department patients. The GAD-7 screening tool was used in an urban ED setting to survey patients about their anxiety, with a score of 8 or higher suggesting a diagnosis of GAD. Eligible participants included ED patients over the age of 18 with a painful condition ranging from 1-10 on the verbal numeric rating pain scale (VNRS). Participants were excluded if they were in distress and/or did not speak English. Of the 320 patients surveyed, the mean patient age was determined …

Automobile Restraint Use Among Patients In Motor Vehicle Crashes: Factors Associated With Noncompliance, Ashley A. Brent

Scholarship in Medicine - All Papers

Despite the 1968 U.S. law requiring that all vehicles have seat belts in every seat, many drivers and passengers choose not to use them. This is an important healthcare issue when the there is an estimated $917 billion spent annually on hospital services due to noncompliance with seat belt use.1 Previous literature has demonstrated that patients who are noncompliant with seatbelts are not only “more likely to use more hospital resources because they are more severely injured”, but also less likely to have health insurance, thus incurring more debt for the hospitals serving them¹. Conversely, restraint compliance has …

Parenteral Ascorbic Acid For Treatment Of Sepsis, Lindsey Hiatt

Physician Assistant Scholarly Project Posters

Sepsis kills nearly 1 million people each year in the United States and sepsis-related hospitalizations cost approximately $24 billion annually (Paoli, Reynolds, Sinha, Gitlin, & Crouser, 2018). Current treatment guidelines are limited to targeted antibiotics and hemodynamic support. While antibiotics are the definitive treatment to eradicate the infectious pathogen, there are currently no standard-of-care treatments that consistently and successfully attenuate the damage sustained to the body by its own inflammatory response to infection. Many different treatments have been trialed and failed to show improved outcomes. Vitamin C, or ascorbic acid, has long been associated with supporting immune function, and has …

What Does Anxiety Look Like? Prevalence Among Ed Patients, Justin B. Anderson

Scholarship in Medicine - All Papers

The prevalence of mental illness in the US population is common, with an estimated value of 8%. The emergency department patient population is especially vulnerable to mental illness. Previous studies from 2012 and 2017 estimated the rate of undiagnosed mental illness in the Emergency Department (ED) at 41-42%.1,2 According to the studies, only a minority of these were identified by the physician.

DSM-5 defines the criteria for generalized anxiety disorder (GAD) as “excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school …

The Relationship Between Generalized Anxiety Disorder And Self-Reported Pain Scores Among Emergency Department Patients, Nicholas Seitz

Scholarship in Medicine - All Papers

Anxiety is common among Emergency Department (ED) patients. Self-reported pain scores have been associated with a variety of physical and psychological factors. However, the relationship between pain and anxiety in ED patients has not been previously reported. This study aims to identify a relationship between self-reported pain scores and the diagnosis of generalized anxiety disorder among ED patients.

This prospective patient survey study was conducted at Miami Valley Hospital, an urban ED in Dayton, Ohio. Eligible participants included ED patients age 18 or over, with a self-reported pain score ranging from 1-10 on the verbal numeric rating pain scale (VNRS). …

Cannabis Use And Association With Pain, Anxiety, And Depression Among Emergency Department Patients, John Detherage

Scholarship in Medicine - All Papers

Introduction:

Cannabis use is increasing nationwide. Many states have legalized medical and recreational use of cannabis. This study was undertaken to identify any association between cannabis use and chronic pain among ED patients.

Methods:

This was a prospective survey study of Emergency Department (ED) patients at Miami Valley Hospital, a level 1 trauma center in Dayton, Ohio conducted during June – August 2018. The survey included data regarding the frequency of cannabis use, chronic pain, and current mental illness.

Results:

Three hundred and sixty patients participated in this study. The majority of respondents were white (55%) or African American (42%). …

Becoming A Washington Firefighter, Connor Ridgeway

Undergraduate Honors Theses

For this project, under direction of Judy Beard and Matthew Martinson, I have created a manual to further assist individuals in the process of fulfilling dreams to become a firefighter. I have researched the vast number steps it takes to become a firefighter and provided helpful suggestions that will aid individuals throughout the process. Becoming a firefighter is a demanding process with physical abilities that need to be taken into consideration when going through the elaborate process. This project includes background information on structure firefighting, volunteer firefighting, wildland firefighting, emergency medical technicians, paramedics, and what the role of each of …

Utility Of Point-Of-Care Beta-Hydroxybutyrate Testing For Predicting Diabetic Ketoacidosis In The Pediatric Emergency Department, Michelle Knoll, Kelsee Halpin, Ryan Mcdonough

Posters

The objective of our investigation was to describe the diagnostic characteristics of point-of-care capillary beta-hydroxybutyrate (BOHB) testing to predict diabetic ketoacidosis among pediatric patients presenting with hyperglycemia in the pediatric emergency department.

Lamotrigine Odt-Induced Seizure In A 3-Year-Old Child After Accidental Ingestion, Ashley Griswold Do, Briana Tully, Kenneth D. Katz Md, Gillian A. Beauchamp Md, Matthew D. Cook Do, Robert D. Cannon Do

Department of Emergency Medicine

Lamotrigine is a new generation antiepileptic which blocks sodium channels and can cause significant toxicity in overdose. A case of a three-year-old child who suffered a seizure and required endotracheal intubation after accidental lamotrigine ingestion is presented. The lamotrigine concentration measured 23.2 mcg/mL which is the highest reported after accidental pediatric exposure. A review of the literature regarding pediatric lamotrigine poisoning is also included.

Consent For Emergency Treatment: Emergency Department Patient Recall And Understanding, Ashley Lafountain

Scholarship in Medicine - All Papers

Informed consent is an important ethical and legal requirement that underlies the concept of patient autonomy. This prospective survey study was conducted to assess patient recall and understanding of consent for treatment in adult emergency department (ED) patients at an urban level 1 trauma center with annual volume of 95,000, Miami Valley Hospital. Out of a total 293 patients, most individuals reported only receiving a verbal explanation of the consent document (45%) or not reading the document at all (36%). About half of the patients recalled consenting to treatment (N=144, 49%) and over one third of patients could not recall …

Risk Factors For Pneumonia Following Rib Fractures, Brittany Bowers

Scholarship in Medicine - All Papers

Objective: Pneumonia is a known complication following rib fractures. The purpose of this study is to identify factors associated with the development of pneumonia following rib fractures. Methods: In this retrospective chart review, eligible participants included trauma patients with one or more rib fractures who were admitted to Miami Valley Hospital during 2012 through 2017. Variables studied included age, gender, injury severity score (ISS), mechanism of injury, smoking status, alcohol use, administration of influenza and pneumococcal vaccine, number and side of rib fracture(s), spirometer use, blood transfusion, and intravenous fluid administration.

Results: Among 78 cases and 74 controls, matched for …

Factors Contributing To The Negative And Unhealthy Psychological Conditions In The Ed Rn, Ariana M. Nieves

Honors Undergraduate Theses

The emergency department is a stressful environment. Emergency department registered nurses (ED RNs) are at an increased risk of development of negative and unhealthy psychological conditions due to their frequent exposure to stress and traumatic events. These conditions include post-traumatic stress disorder, compassion fatigue, and burnout syndrome, which are already known to be common in the emergency department registered nurse population. It is important to understand the factors that influence the development of these psychological conditions in order to provide better education to nurses regarding prevention of the development of these psychological conditions. This literature review aimed to identify articles …

Evaluating The Impact Of An Intervention To Promote Empathy For Patients With Substance Use Disorder In A Rural Emergency Department, Theresa Poling

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background

Negative attitudes of health professionals towards patients with SUD are common and contribute to suboptimal health care for this marginalized group of patients (Van-Boekel, Brouwers, Van-Weeghel & Garretson, 2013).

Objectives

Promoting empathy in the Emergency Department (ED) has the potential to increase nursing staff’s awareness of their attitudes and perceptions toward patients with SUD, thereby decreasing the stigma associated with addiction and improving patient care and patient outcomes. The rationale for implementing this project was to evaluate a tool to promote empathy. This tool was developed by the student researcher based on a literature search and analysis.

Design

This …

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 …

Assessment Of Patient-Centered Approaches To Collect Sexual Orientation And Gender Identity Information In The Emergency Department: The Equality Study, Adil H. Haider, Rachel R. Adler, Eric Schneider, Tarsicio Uribe Leitz, Anju Ranjit, Christina Ta, Adele Levine, Omar Harfouch, Danielle Pelaez, Lisa Kodadek

Section of General Surgery

Importance: Health care and government organizations call for routine collection of sexual orientation and gender identity (SOGI) information in the clinical setting, yet patient preferences for collection methods remain unknown.
Objective: To assess of the optimal patient-centered approach for SOGI collection in the emergency department (ED) setting.
Design, setting, and participants: This matched cohort study (Emergency Department Query for Patient-Centered Approaches to Sexual Orientation and Gender Identity [EQUALITY] Study) of 4 EDs on the east coast of the United States sequentially tested 2 different SOGI collection approaches between February 2016 and March 2017. Multivariable ordered logistic regression was used to …

A Scoping Review Of The Associations Between Mental Health And Factors Related To Hiv Acquisition And Disease Progression In Conflict-Affected Populations, Erica Koegler, Erica Koegler, Caitlin Kennedy

Social Work Faculty Works

The association between poor mental health and factors related to HIV acquisition and disease progression (also referred to as HIV-related factors) may be stronger among conflict-affected populations given elevated rates of mental health disorders. We conducted a scoping review of the literature to identify evidence-based associations between mental health (depression, anxiety, and post-traumatic stress disorder [PTSD]) and factors related to HIV acquisition and progression in conflict-affected populations. Five electronic databases were searched on October 10, 2014 and updated on March 7, 2017 to identify peer-reviewed publications presenting primary data from January 1, 1994 to March 7, 2017. Articles were included …

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

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. …

Challenging Hazards Amidst Observational Simulation In The Emergency Department: Advancing Gamification In Simulation Education Through A Novel Resident-Led Skills Competition., Nicholas Salerno, Dimitrios Papanagnou, Md, Priyha Mahesh, Kaitlin M Bowers, Scott H Pasichow, Sara Paradise, Xiao Chi Zhang

Department of Emergency Medicine Faculty Papers

Medical simulation competitions have become an increasingly popular method to provide a hands-on "gamified" approach to education and training in the health professions. The most well-known competition, SimWars, consists of well-coordinated teams that are tasked with completing a series of mind-bending clinical scenarios in front of a live audience through 'bracket-style' elimination rounds. Similarly, challenging hazards amidst observational simulation (CHAOS) in the emergency department (ED) is another novel approach to gamification in both its structure and feel. Conducted at the Council of Emergency Medicine Resident Directors (CORD) 2018 National Assembly in San Antonio, Texas, instead of assigning premeditated teams, it …

A Three-Dimensional Printed Low-Cost Anterior Shoulder Dislocation Model For Ultrasound-Guided Injection Training., Zachary Risler, Mark A. Magee, Jacob M. Mazza, Kelly Goodsell, Arthur K. Au, Resa E. Lewiss, Robert S. Pugliese, Bon Ku

Department of Emergency Medicine Faculty Papers

Anterior shoulder dislocations are the most common, large joint dislocations that present to the emergency department (ED). Numerous studies support the use of intraarticular local anesthetic injections for the safe, effective, and time-saving reduction of these dislocations. Simulation training is an alternative and effective method for training compared to bedside learning. There are no commercially available ultrasound-compatible shoulder dislocation models. We utilized a three-dimensional (3D) printer to print a model that allows the visualization of the ultrasound anatomy (sonoanatomy) of an anterior shoulder dislocation. We utilized an open-source file of a shoulder, available from embodi3D® (Bellevue, WA, US). After …

Impact Of Legalizing Recreational Cannabis Sales On Cannabis Exposure Calls To Poison Centers 2008-2017, Gillian A. Beauchamp Md, Robert G. Hendrickson Md, B. Zane Horowitz Md, Daniel A. Spyker Md, Phd

Department of Emergency Medicine

No abstract provided.

"It's A Precious Gift, Not To Waste": Is Routine Cross Matching Necessary In Orthopedics Surgery?: Retrospective Study Of 699 Patients In 9 Different Procedures, Obada Hasan, Eraj Khurshid Khan, Moiz Ali, Sadaf Sheikh, Anum Fatima, Haroon Ur Rashid

Section of Orthopaedic Surgery

Background: Orthopedic surgeries are usually associated with excessive blood loss which leads surgeons to overestimate need for blood transfusions and over ordering of blood. The cross matched blood, when not used, leads to the wastage of blood bank resources in terms of time, money and manpower. The objective of this study was to investigate the compliance to previously proposed MSBOS and to provide updated recommendations for all orthopedic procedures.
Methods: A retrospective analysis was conducted between 1st June 2015 and 31st May 2016. Patients admitted to the orthopedic surgery service for whom blood products were requested were included. Cross Match/Transfusion …