Medical Specialties Commons^™

Effectiveness Of The Novel Ventilation System In The Ambulance For Airborne Particle Reduction, Dhanadol Rojanasarntikul

Chulalongkorn Medical Journal

Background: During the Coronavirus disease (COVID-19) pandemic, emergency medical service (EMS) workers areexposed to infectious particles in closed spaces such as in the ambulance. Few studies have demonstrated the effectiveness of ambulance ventilation system in reducing airborne particles.

Objective: To assess the effectiveness of an ambulance ventilation system in reducing the volume density of airborne particles and return-to-background time.

Methods: Aerosol particles of various sizes were administered into the cabin via nebulization for one minute. The aerosol volume concentrations of particles at 0.5-1; 1-2.5; and 2.5-5 microns were measured with three different ventilation rates (switched off, medium and maximum) …

Perception Of Pediatric Readiness Across A Health System's Emergency Departments, Rebekah L. Sabo

Doctoral Dissertations & Projects

The recent pandemic and pediatric respiratory syncytial virus surge have reinvigorated pediatric care readiness conversations. National strategies and associations exist to guide health systems in improving the quality of emergency care offered to pediatric populations by first assessing readiness for care. These research strategies center on survey implementation and staff engagement in general emergency departments with the goal to improve staff readiness to care for pediatric patients that may present for treatment. What impact would developing a consolidated pediatric readiness program that includes: pediatric emergency care coordinator designation for each emergency department, pediatric readiness education and committee engagement have on …

Academic Detailing As A Health Information Technology Implementation Method: Supporting The Design And Implementation Of An Emergency Department-Based Clinical Decision Support Tool To Prevent Future Falls, Hanna J Barton, Apoorva Maru, Margaret A Leaf, Daniel J Hekman, Douglas A Wiegmann, Manish N Shah, Brian W Patterson

Faculty, Staff and Student Publications

BACKGROUND: Clinical decision support (CDS) tools that incorporate machine learning-derived content have the potential to transform clinical care by augmenting clinicians' expertise. To realize this potential, such tools must be designed to fit the dynamic work systems of the clinicians who use them. We propose the use of academic detailing-personal visits to clinicians by an expert in a specific health IT tool-as a method for both ensuring the correct understanding of that tool and its evidence base and identifying factors influencing the tool's implementation.

OBJECTIVE: This study aimed to assess academic detailing as a method for simultaneously ensuring the correct …

Testosterone Supplementation In Patients With Burn Hypermetabolism, Alexandra Dewitt, Anastasiya Ivanko, Jonathan E. Schoen, Aimee Keating, Herb A. Phelan Iii, Jeffrey E. Carter

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL

Old Dog, New Tricks? Applying The Causal Hazard Chain Model To Burn Prevention And Injuries, Randy D. Kearns, Jeffrey E. Carter, Ernest Grant, W.L. Hickerson

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL

The Inflammatory Response Of Patients With Major Burns And Traumatic Injuries, Jared M. Robinson, Sophia Trinh, Jenna Dennis, Cameron Fontenot, Jeffrey Hobden, Jonathan E. Schoen, Herb A. Phelan Iii, Jeffrey E. Carter, Alison A. Smith

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL

When Do Patients Arrive To The Burn Center? Business Hours Don't Apply To Burns, Rohit Mittal, Kathleen Hollowed, Jeffrey E. Carter, Steven A. Kahn

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL

When Educational Images Don’T Reflect The Population: Phlegmasia Cerulea Dolens, A Case Report, Kasha Bornstein, Elizabeth Larosa, Kelsey Byrd, Dan Laney, Hector Ferral, Heather Murphy-Lavoie

School of Medicine Faculty Publications

Introduction: Phlegmasia cerulea dolens (PCD) is an uncommon, potentially life-threatening complication of acute deep venous thromboses that requires a timely diagnosis. The name of the condition, the visual diagnostic criteria, and the preponderance of cases in the literature referencing findings exclusively in patients with lighter skin complexions means that PCD may not be on the differential diagnosis for the patient with more melanated skin who is experiencing this time-sensitive vascular emergency. Case Report: We describe one case of PCD in a patient with darker skin complexion and the importance of identifying clinical findings, regardless of skin color, given the paucity …

Using Implementation Science To Understand Barriers To Telemedicine Use For Burn Care During A Crisis, Amanda Bettencourt, Jeffrey E. Carter, Theresa M. Davis, Katherine R. Buhikire, Joseph Rhodes, Subhash Aryal, Gary Vercruysse, Deena Kelly-Costa, Colleen M. Ryan

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL

Influence Of Co-Morbid Modifiable Risk Factors On Adipose-Derived Stem Cell Paracrine Factors In Burn Patients, Jared M. Robinson, Jenna Dennis, Sophia Trinh, Cameron Fontenot, Herb A. Phelan Iii, Jeffrey E. Carter, Jonathan E. Schoen, Alison A. Smith

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL

Patient's Perception Of Likelihood To Attend Follow-Up In Burn Surgery Clinic, Alexandra Coward, Megan Gilbert, Anastasiya Ivanko, Jason Heard, Soman Sen, Tina L. Palmieri, David G. Greenhalgh, Kathleen S. Romanowski

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL

The Burden Of Burns: An Analysis Of Public Health Measures, Anastasiya Ivanko, Anna Garbuzov, Jonathan E. Schoen, Randy S. Kearns, Denise Danos, Erica Murata, Bart D. Phillips, Herb A. Phelan Iii, Jeffrey D. Carter

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL

The Consequences Of A Career In Burn Surgery: An Economic Analysis To Aid Prospective Clinicians, Jeffrey E. Carter, Anastasiya Ivanko, Jonathan E. Schoen, Herb A. Phelan Iii, William L. Hickerson, Randy D. Kearns

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL

An Analysis Of Burn Icu Days From The National Injury Resource Database, Anastasiya Ivanko, Jonathan E. Schoen, William L. Hickerson, Herb A. Phelan Iii, Bart D. Phillips, Jeffery E. Carter, Denise Danos

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL

Use Of The Burn Care Quality Platform (Bcqp) For Modern Burn Care Benchmarking, Madeline G. Lechtenberg, Jeffrey E. Carter, Denise Danos, Bart D. Phillips, Erica Murata, Jonathan E. Schoen, Herb A. Phelan Iii

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL

Empowering Emergency Responders To Treat On Scene Alleviates Hospital Strain During Disaster Events, Anastasiya Ivanko, Jonathan E. Schoen, Elizabeth Lacy, Carl A. Flores, Randy D. Kearns, Herb A. Phelan Iii, Jeffrey E. Carter

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL

Ems Versus Attending Physician Opinion On The Destination Of Patients Presenting To The Emergency Department By Ambulance, Patrick Boyle, Nikki Rimlinger, Traci Deaner, Adam Sigal

Tower Health Research Day

No abstract provided.

Uti With A New Renal Mass: Chicken Or The Egg?, Grant Nugent, Adam Sigal, Courtney Cassella

Tower Health Research Day

No abstract provided.

Investigating Markers For Intracranial Hemorrhage Severity: Insights From Cbc Changes And Beyond, Mckenzie Locker, Kasey Chelemedos, Nataly Apollonsky

Tower Health Research Day

No abstract provided.

Opioid Prescribing Habits Of Emergency Department Providers In Response To An Educational Intervention, Tory A. Makela, Benjamin Aaker

Aesculapius Journal (Health Sciences & Medicine)

Opioid prescribing habits of Emergency Department providers in response to an educational intervention

Tory Makela, MS4; Benjamin Aaker, MD

Introduction: Prescription opioid misuse and dependency has been a rising cause for concern in the United States in recent years, and many of these cases began with an initial prescription in the Emergency Department (ED). Prior studies found that patients seen by “high intensity” prescribers, who prescribe greater quantities of opioids than 75% of other ED physicians within the same hospital, are significantly more likely to suffer from long-term opioid use. Other studies have shown that educational interventions on appropriate opioid …

Comparison Of Prehospital Finger Thoracostomy And Needle Thoracostomy Performed By Ground Emergency Medical Services, Angelo Ciaraglia, Alison Smith, Benjamin Axtman, Brian Eastridge, Ronald Stewart, Susannah Nicholson, Donald Jenkins

School of Medicine Faculty Publications

Introduction: Tension pneumothorax related to chest trauma is a rapidly lethal condition that requires immediate treatment, often prior to arrival at definitive ca.re. Recent concerns regarding the safety and efficacy of needle thoracostomy (NT) have led to alternatives. Finger thoracostomy (FT) is a potential life-sav­ing treatment performed by prehospital providers as an alternative to NT. We hypothesize that FT has improved rates of prehospital thoracic decompression and is a safe alternative to NT. Materials and Methods: Retrospective cohort study of consecutive adult trauma patients presenting to a Level 1 trauma center who sustained chest trauma. A matched cohort of patients …

Pods: A Team-Based Approached To Reduce The Left Without Being Seen Rate In An Urban, High-Volume Emergency Department, Charis Keane Md, Daryn Brauner Msn, Amy Bobbit Rn, Nikki Campbell Bsn, April Alfano Ms

Posters

The purpose of this QI project is to evaluate the impact of the Patient-Oriented Discharge System (PODS) model, a registered nurse-provider team-based approach, on reducing the rate of LWBS in a high-volume, urban ED

Preventing And Responding To Workplace Violence In The Emergency Department, Janina La Porte, Stefanie Lai, Alicia Rodriguez

Articles, Abstracts, and Reports

No abstract provided.

Improving Emergency Department Belongings Inventory Electronic Medical Record Documentation, Shanekia Garrett, Stefanie Lai, Jairo Pagan, Wendy Lu, Katie Whitehead

Articles, Abstracts, and Reports

No abstract provided.

Case Of Human Orthohantavirus Infection, Michigan, Usa, 2021, Samuel M Goodfellow, Robert A Nofchissey, Dustin Arsnoe, Chunyan Ye, Seonghyeon Lee, Jieun Park, Won-Keun Kim, Kartik Chandran, Shannon L M Whitmer, John D Klena, Jonathan W Dyal, Trevor Shoemaker, Diana Riner, Mary Grace Stobierski, Kimberly Signs, Steven B Bradfute

Faculty, Staff and Student Publications

Orthohantaviruses cause hantavirus cardiopulmonary syndrome; most cases occur in the southwest region of the United States. We discuss a clinical case of orthohantavirus infection in a 65-year-old woman in Michigan and the phylogeographic link of partial viral fragments from the patient and rodents captured near the presumed site of infection.

S100a8/A9 As A Prognostic Biomarker With Causal Effects For Post-Acute Myocardial Infarction Heart Failure, Jie Ma, Yang Li, Ping Li, Xinying Yang, Shuolin Zhu, Ke Ma, Fei Gao, Hai Gao, Hui Zhang, Xin-Liang Ma, Jie Du, Yulin Li

Department of Emergency Medicine Faculty Papers

Heart failure is the prevalent complication of acute myocardial infarction. We aim to identify a biomarker for heart failure post-acute myocardial infarction. This observational study includes 1062 and 1043 patients with acute myocardial infarction in the discovery and validation cohorts, respectively. The outcomes are in-hospital and long-term heart failure events. S100A8/A9 is screened out through proteomic analysis, and elevated circulating S100A8/A9 is independently associated with heart failure in discovery and validation cohorts. Furthermore, the predictive value of S100A8/A9 is superior to the traditional biomarkers, and the addition of S100A8/A9 improves the risk estimation using traditional risk factors. We finally report …

Development Of A Follow-Up Measure To Ensure Complete Screening For Colorectal Cancer, Elizabeth L Ciemins, Jeff T Mohl, Carlos A Moreno, Francis Colangelo, Robert A Smith, Mary Barton

Faculty, Staff and Student Publications

IMPORTANCE: The current quality performance measure for colorectal cancer (CRC) screening is limited to initial screening. Despite low rates, there is no measure for appropriate follow-up with colonoscopy after receipt of an abnormal result of a stool-based screening test (SBT) for CRC. A quality performance measure is needed.

OBJECTIVE: To develop and test a quality performance measure for follow-up colonoscopy within 6 months of an abnormal result of an SBT for CRC.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective quality improvement study examined data from January 1, 2016, to December 31, 2020, with 2018 plus 6 months of follow-up as the …

Improving Emergency Department Belongings Inventory Electronic Medical Record Documentation Rates, Stefanie Lai

Providence Nursing Research Conference 2023 – Present

Background: Electronic Medical Record (EMR) education and training for RNs should be multifaceted and targeted to the RN clinical workflow. Input from direct care RNs is essential to ensure EMR education is relevant and effective. Shared Governance at a community hospital identified quality and safety concerns among inpatient RNs. RNs reported that belongings inventories were not consistently documented in the EMR for Emergency Department (ED) admissions. Hospital policy requires belongings inventory EMR documentation for all admitted patients. An audit of charts for ED admissions over three months revealed only 5% compliance with this policy.

Purpose: The purpose of this project …

The Utility Of Non-Specific Ecg Findings In The Setting Of Low High-Sensitivity Cardiac Troponin Levels, Arqam Husain, Nathan Klausner, Emily Schwab, Joseph Miller, Kaab Husain

Medical Student Research Symposium

Objective: Our objective was to assess the relationship between non-specific ischemic electrocardiogram (nsi-ECG) findings and the occurrence of major adverse cardiac events (MACE) within a 30-day timeframe among patients in the Emergency Department (ED) with low high-sensitivity cardiac troponin (hs-cTnI) levels.

Methods: We conducted a secondary analysis of the RACE-IT trial, a randomized trial performed across 9 EDs from July 2020 through March 2021 that looked at the effectiveness of hs-cTnI in evaluating the risk for acute myocardial infarction (AMI). Our study assessed the association between nsi-ECG findings (left bundle branch block, ST-segment changes, or T-wave inversions) and 30-day MACE …

Characterizing Cold Water Drownings In The Great Lakes, Elizabeth T. Helfrich, Anthony Lagina

Medical Student Research Symposium

Since the COVID-19 outbreak in 2020, Great Lakes drownings have increased. The Great Lakes are a unique and understudied environment due to being cold, fresh water, and resuscitation protocols and guidelines being derived from warm, primarily salt water environments. We analyzed open sources materials to find records of Great Lakes drownings from 2021-2023 and analyze the data looking for trends in cold and warm water drownings.

We found 80.0-85.0% of the included drowning victims were male and had an average age of 38.0-39.0 years old. 40.0%-57.7% of Great Lakes drowning deaths were in cold water; of those, Lake Michigan had …