Medical Specialties Commons^™

Er Referral Models Summary, American Dental Association

Action for Dental Health

No abstract provided.

Effectiveness Of Helmets In Preventing Severe Injuries In A Setting With Poorly Enforced Quality Standards, Junaid Ahmad Bhatti, Junaid A. Razzak, Rashid Jooma

Department of Emergency Medicine

Helmets save lives, yet many countries do not have laws about their quality assessment or how they should be worn. We assessed the effectiveness of helmet use in preventing injuries in such a setting. The data were extracted from a large road traffic injury surveillance study in Karachi, Pakistan. We assessed the association of wearing helmets with several injury outcomes including deaths, injury severity (via New Injury Severity Score, NISS ≥ 9) and moderate or severe injury (via Abbreviated Injury Score, AIS ≥ 2) to head, face, or other regions of the body. The data about helmet use was available …

Unforgiving Heat Wave Deaths In The Largest Metropolitan City Of Pakistan: Lessons Learned, Muhammad Akbar Baig, Shahan Waheed, Asad Mian, Erfaan Hussain

Department of Emergency Medicine

Heat stroke is a deadly condition that needs astute care and timely management. Recently, the city of Karachi in Pakistan has been the victim of an intense heat wave, which has resulted in an insurmountable loss of life. We observed various deficiencies in dealing with this national threat that provides us with a valuable lesson regarding the measures that can be undertaken to avoid such a disaster from occurring again.

Prehospital Emergency Medical Services Treatment Protocols: Aligning With National Best Practices, Zachary Ryan Charest

Online Theses and Dissertations

Many variances in prehospital Paramedic treatment protocols exist amongst Emergency Medical Service (EMS) Providers in the State of Kentucky. These differences lead to inconsistencies in quality of patient care delivered, reduce ease of mobility of providers and result in a decreased oversight from the Kentucky Board of EMS (KBEMS). To investigate the impact of protocol variances on patient care, a mixed methods study consisting of a convenience sample of Kentucky EMS prehospital Paramedic treatment protocols was collected and compared to the Kentucky state-wide treatment protocols. A literature review of best practices regarding EMS protocols was conducted. Of all protocols 81.9% …

Community-Based Perceptions Of Emergency Care In Kenya, Morgan C. Broccoli, Emilie J.B Calvello, Alexander P. Skog, Benjamin W. Wachira, Lee A. Wallis

Emergency Medicine, East Africa

Access to quality emergency services is an essential component of the human right to health, but barriers to emergency care are found throughout Africa and the wider world. Data to support the development of emergency care are essential to improve access to care and further infrastructure development. We undertook this study to understand the community's emergency care needs and the barriers they face when trying to access care and to engage community members with developing high impact solutions to expand access to essential emergency services.

To accomplish this, we used a qualitative research methodology to conduct 59 focus groups with …

Intraosseous Vascular Access In The Emergency Department, Nicole M. Helsper Devoe

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Current guidelines and recommendations from the American College of Surgeons Advanced Trauma Life Support and the American Heart Association (AHA) include intraosseous (IO) access as a second-line alternative when delayed or failed peripheral vascular access occurs in emergent or trauma situations. IO access is underutilized in the emergency department (ED) due to registered nurses’ knowledge deficit, lack of training and education, and lack of supplies (Cheung, Rosenberg, & Vaillancourt, 2014). The National Association of EMS Physicians (NAEMSP) supports the use of IO access and describes IOs as a significant time saving intervention in achieving vascular access and decreasing the time …

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

All Publications

No abstract provided.

Decreasing Blood Culture Contamination In The Ed, Bettina Laier

All Publications

No abstract provided.

Pediatric Emergency Department Rapid Care Model, Netonua Reyes, Rene Bascoy, Rosa Rousseau, Francisco A. Medina Mejia, Julian Diavanti, Pedro Marin, Tanisha R. Jones, Sandra Young, Andrea Gibson

All Publications

No abstract provided.

Descriptive Study Of Prescriptions For Opioids From A Suburban Academic Emergency Department Before New York's I-Stop Act., Lyncean Ung, Ronald Dvorkin, Steven Sattler, David P. Yens

The School of Health Sciences Publications and Research

Introduction: Controlled prescription opioid use is perceived as a national problem attributed to all specialties. Our objective was to provide a descriptive analysis of prescriptions written for controlled opioids from a database of emergency department (ED) visits prior to the enactment of the I-STOP law, which requires New York prescribers to consult the Prescription Monitoring Program (PMP) prior to prescribing Schedule II, III, and IV controlled substances for prescriptions of greater than five days duration.

Methods: We conducted a retrospective medical record review of patients 21 years of age and older, who presented to the ED between July …

Er Referral Models: Dental Intercept “Pay It Forward” Model — Calhoun County, Michigan, American Dental Association, Samanta Pearl

Action for Dental Health

No abstract provided.

The Impact Of Disability: A Comparative Approach To Medical Resource Allocation In Public Health Emergencies, Katie Hanschke, Leslie E. Wolf, Wendy F. Hensel

Faculty Publications By Year

It is a matter of time before the next widespread pandemic or natural disaster hits the United States (U.S.). The international response to the 2009 H1N1 influenza stands as a cautionary tale about how prepared the world is for such an emergency. Although the pandemic fortunately proved to be less severe than initially anticipated, it nevertheless resulted in shortages of medical equipment, overburdened hospitals, and preventable patient deaths, particularly among young people.

A pandemic will inevitably lead to difficult decisions about the allocation of medical resources, such as who will have priority access to ventilators and critical care beds when …

10 Steps To An Er Dental Referral Program — Wisconsin Case Study, American Dental Association

Action for Dental Health

No abstract provided.

Geropsychiatric Medical Problems, Daniel Giorgio

Williams Honors College, Honors Research Projects

With a growing elderly population in the United States, the development of

efficient methods to ensure high-quality care for geriatric patients is more important than

ever. In the emergency department (ED), geriatric patients account for up to 24% of

stays. Many of these patients come to the ED for neuropsychiatric reasons and some are

admitted to geropsychiatric units. These patients require medical screening to identify

issues that may in part account for their mental state. The purpose of this study was to

characterize the patients who were admitted from the Summa Health System ED to

geropsychiatric units. It was hypothesized …

Uchunguzi (Journal Watch/Montre De Journal) September 2015, Benjamin Wachira

Internal 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.

Uchunguzi (Journal Watch/Montre De Journal) June 2015, Benjamin Wachira

Internal 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.

Outcomes Associated With Blood Component Transfusion In Adult Trauma Patients, Allison R. Jones

Theses and Dissertations--Nursing

The purpose of this dissertation was to evaluate outcomes associated with blood component (BC) transfusion in adult trauma patients. Specific aims were to: 1) explore the relationship between traumatic injury, hemorrhage, and BC transfusion, focusing on consequences of the component storage lesion through presentation of a conceptual model; 2) systematically review research literature comparing outcomes of massively transfused major trauma patients based on ratios of BCs received; 3) evaluating the relationship between type of blood transfusion trauma patients received (whole blood versus BCs) and mortality likelihood after controlling for demographic and clinical variables; 4) evaluating the relationship between volume and …

Best Practices For Improving Flow And Care Of Pediatric Patients In The Emergency Department., Isabel Barata, Kathleen M. Brown, Laura Fitzmaurice, Elizabeth Stone Griffin, Sally K. Snow, American College Of Emergency Physicians Pediatric Emergency Medicine Committee, Emergency Nurses Association Pediatric Committee, Gregory P. Conners, American Academy Of Pediatrics Committee On Pediatric Emergency Medicine

Manuscripts, Articles, Book Chapters and Other Papers

This report provides a summary of best practices for improving flow, reducing waiting times, and improving the quality of care of pediatric patients in the emergency department.

Patient- And Family-Centered Care Of Children In The Emergency Department., Nanette Dudley, Alice Ackerman, Kathleen M. Brown, Sally K. Snow, American Academy Of Pediatrics Committee On Pediatric Emergency Medicine, American College Of Emergency Physicians Pediatric Emergency Medicine Committee, Emergency Nurses Association Pediatric Committee., Gregory P. Conners

Manuscripts, Articles, Book Chapters and Other Papers

Patient- and family-centered care is an approach to the planning, delivery, and evaluation of health care that is grounded in a mutually beneficial partnership among patients, families, and health care professionals. Providing patient- and family-centered care to children in the emergency department setting presents many opportunities and challenges. This revised technical report draws on previously published policy statements and reports, reviews the current literature, and describes the present state of practice and research regarding patient- and family-centered care for children in the emergency department setting as well as some of the complexities of providing such care.

Use Of Low-Dose Ketamine For Pain Management In An Emergency Department, Joseph Ladd, Winifred Pardo

All Publications

Background/Purpose: In the emergency department (ED), many barriers exist to pain management. Non-steroidal anti-inflammatory drugs and acetaminophen often cannot provide enough relief, while opioid analgesics are hindered by side effects, dependency, and tolerance. A non-competitive NMDA receptor antagonist, ketamine has historically been used for sedation and anesthesia in rural settings or in those with limited resources. Ketamine's unique safety profile and variety of dosage forms indicate its potential role in pain management. An evaluation was conducted of ketamine's use in low doses to treat pain in an emergency department with the third-greatest annual census in Miami-Dade county.

Methodology: A retroactive …

Tactical Medicine: An Examination Of Medical Training In Law Enforcement, Brian J. Woods Jr.

Williams Honors College, Honors Research Projects

In recent years, there has been a trend towards making law enforcement officers more well-rounded first responders by increasing their required medical competencies. The required medical competencies of six law enforcement agencies of varying sizes in Northeast Ohio were examined by interviews conducted with a representative from each agency. Interview question topics included information on current training requirements and the types of medical equipment issued to officers. The study found that all six of the agencies surveyed offered medical training to officers as part of required continuing education, and all six agencies currently issued, or planned to issue in the …

Adiponectin Protects Against Paraquat-Induced Lung Injury By Attenuating Oxidative/Nitrative Stress., Rong Yao, Yaxiong Zhou, Yarong He, Yaowen Jiang, Peng Liu, Lei Ye, Zhijie Zheng, Wayne Bond Lau, Yu Cao, Zhi Zeng

Department of Emergency Medicine Faculty Papers

The specific mechanisms underlying paraquat (PQ)-induced lung injury remain unknown, which limits understanding of its cytotoxic potential. Although oxidative stress has been established as an important mechanism underlying PQ toxicity, multiple antioxidants have proven ineffective in attenuating the deleterious effects of PQ. Adiponectin, which shows anti-oxidative and antinitrative effects, may have the potential to reduce PQ-mediated injury. The present study determined the protective action of globular domain adiponectin (gAd) on PQ-induced lung injury, and attempted to elucidate the underlying mechanism or mechanisms of action. BALB/c mice were administered PQ, with and without 12 or 36 h of gAd pre-treatment. The …

Subdural Hematoma As A Consequence Of Epidural Anesthesia., Tracy M Bishop Do, Kareem S. Elsayed Ms, Kathleen E. Kane Md

Department of Emergency Medicine

Regional spinal and epidural anesthesia are used commonly in operative procedures. While the most frequent complication, postdural puncture headache (PDPH), is a clinically diagnosed positional headache that is usually self-limited, subdural hemorrhage (SDH) is a potentially fatal complication that cannot be missed. We report a case of an otherwise healthy female who presented with persistent positional headache and was ultimately found to have a large subdural hematoma with midline shift requiring surgical evacuation.

Quantification Of Opportunities For Early-Stage Paramedicine Students To Practice Clinical Skills During Clinical Placements Compared With An Equal Dose Of Simulation-Based Workshops, Brennen W. Mills, Owen B. Carter, Cobie Rudd, Jodie Mills, Nathan Ross, Joanne D. Ruck

Research outputs 2014 to 2021

Introduction A reported advantage of simulation-based learning environments (SLE) over clinical placements (CPs) is that the former can provide a greater number and breadth of opportunities to practice level-appropriate clinical skills compared with the random patient presentations provided during the latter. Although logical and widely accepted as fact, we find no published evidence to demonstrate the magnitude, nor indeed veracity, of this assumption. We therefore sought to quantify the clinical skills practiced by entry-level paramedicine students attending a well-selected CP compared with an equal dosage of SLE.

Methods N=37 first-year paramedicine students completed activity diaries during 3 days of CP …

Impact Of Improving Throughput In The Emergency Department, Katherine J. Edrington

Doctor of Nursing Practice (DNP) Projects

The purpose of this project was to evaluate the patient experience in the emergency department (ED) and in the inpatient setting while correlating increased throughput and patient outcomes at a suburban Acute Care facility in Ohio. The culture in the organization has lacked accountability and ownership of the patients. The ED admitted length of stay (ALOS) was 358 minutes in the beginning of 2013. For the first time in the organization’s history, the ED ALOS is now typically less than the recommended benchmark of 300 minutes. A report of findings among ED’s surveyed showed the ALOS best practice is 244 …

La Cesárea Y El Parto Natural: Las Opiniones De Profesionales De La Salud En La Provincia De Buenos Aires / Cesarean Section And Natural Birth: The Opinions Of Health Provinces In The Province Of Buenos Aires, Jacqueline Chipkin

Independent Study Project (ISP) Collection

Introduction: The ways in which women of society give birth have the power to influence maternal-infant health and shape the economy of the healthcare system. Today, the rates of cesarean sections are increasing throughout the world. In Argentina, on average, more than 35% of pregnant women received cesarean sections in 2008, with large differences observed in the rates between the public and private health sectors. The World Health Organization (WHO) has established that healthcare systems should only employ a cesarean section if labor cannot progress safely. According to this standard, the organization estimates that cesarean sections should only be utilized …

Pediatric Emergency Medical Care In Yerevan, Armenia: A Knowledge And Attitudes Survey Of Out-Of-Hospital Emergency Physicians., Aline A. Baghdassarian, Ross I. Donaldson, Andrew D Depiero, Nancy L Chernett, Harsh P. Sule Md

Department of Emergency Medicine Faculty Papers

BACKGROUND: Out-of-hospital emergency care is at an early stage of development in Armenia, with the current emergency medical services (EMS) system having emergency physicians (EPs) work on ambulances along with nurses. While efforts are underway by the Ministry of Health and other organizations to reform the EMS system, little data exists on the status of pediatric emergency care (PEC) in the country. We designed this study to evaluate the knowledge and attitudes of out-of-hospital emergency physicians in pediatric rapid assessment and resuscitation, and identify areas for PEC improvement.

METHODS: We distributed an anonymous, self-administered Knowledge and Attitudes survey to a …

A Cross Sectional Study Of Medical Student Knowledge Of Evidence Based Medicine As Measured By The Fresno Test Of Evidence Based Medicine, Lauren Semler Ms, Elizabeth Rehman, Zachary Haddad Bs, Katie Ahmadzadeh Do, Steven J. Crellin Do, Katarzyna Falkowska Do, Kalif Kendig Do, Brent H. Steinweg Do, Amy B. Smith Phd, Bryan G. Kane Md

Department of Emergency Medicine

No abstract provided.

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

Department of Emergency Medicine

No abstract provided.

Wearable Technology In Obstetrical Emergency Simulation: A Pilot Study, Jami Goodwin, Rayan A. Elkattah, Martin Olsen

International Journal of Health Sciences Education

Background: Medical student involvement in clinical care of obstetrical emergencies is limited. Wearable technology, namely Google Glass, has been used to enhance the simulation experience for trainees at our institution. We present a pilot study that examines the utility of this technology in medical students’ education through remotely-conducted exercises in obstetric emergencies.

Materials & Methods: A total of thirteen medical students accepted the opportunity to participate in an obstetric emergencies training exercise with remote monitoring. Students wore the Google Glass device while participating in two simulated obstetrical emergencies: shoulder dystocia and vaginal breech delivery. A remote instructor monitored the students’ …