Emergency Medicine Commons^™

Co-Location Of Substance Use Disorder Treatment And Hospital Emergency Departments, Leila Hasan

Honors College Theses

Patients with substance use disorder (SUD) rely heavily on the hospital emergency department (ED) for acute care and are often discharged from the ED without access to long-term recovery resources. This project explores the impact of co-located addiction treatment programs with hospital EDs on recovery outcomes of patients with SUD. A systematic literature review conducted on relevant studies indicates that co-located programs can be effective in increasing treatment initiation and maintenance, reducing ED revisits, and reducing repeated overdose in SUD patients. Programs that were most effective included three key elements: fast linkage of SUD patients to program staff in the …

Clinical Performance Of A Novel Point-Of-Care High-Sensitivity Cardiac Troponin I Assay, Alan H. B. Wu, Simon A. Mahler, Stacey L. House, Saeed A. Jortani, Michael H. Creer, Kristin L. Rising, Jason J. Bischof, Chad Crystal, Gary F. Headden, Fred S. Apple, Nicholas E. Harrison, Andrew C. Meltzer, Justin T. Baca, Brian Tiffany, Mark Sochor, Grace U. Pentecostes, Katrina P. Di Tullio, Manish S. Gupta, Adam J. Singer, James L. Januzzi

Department of Emergency Medicine Faculty Papers

BACKGROUND: High-sensitivity cardiac troponin (hs-cTn) assays performed in the central laboratory have long turnaround times. This study evaluates the clinical performance of a novel bedside point-of-care (POC) hs-cTnI assay (i-STAT® hs-TnI) to aid in the diagnosis of myocardial infarction (MI).

METHODS: A prospective multisite cohort study involving emergency department (ED) patients with symptoms suggestive of acute coronary syndrome was conducted at 28 sites across the United States. Serial whole blood samples were collected at 0-1 h and >1-3 h from ED presentation. Primary outcome was MI or non-MI. Sensitivity, specificity, and negative predictive value (NPV) for MI were calculated with …

Patients Requiring Mechanical Ventilation Reported To The North American Snakebite Registry, Joshua Unger, Spencer Greene

Gulf Coast Division GME Research Day 2026

No abstract provided.

Seconds Matter: Rapid Pocus Diagnosis Of Ruptured Type B Aortic Dissection With Left Hemothorax, Jeby Kalathoor, Derrick Huang

Gulf Coast Division GME Research Day 2026

No abstract provided.

Tylenol Or Toradol? Iv Acetaminophen Vs. Parenteral Ketorolac For Prehospital Analgesia, Conrad Stallings, Kevin Crocker, Michael Wells, Nick Smith, Casey Patrick

Gulf Coast Division GME Research Day 2026

No abstract provided.

Beware Of Bears: Severe Hydronephrosis & Urinary Retention Hidden Behind A Uti, Bjorn Sorensen, Victoria Jackson, Carissa Ford

Gulf Coast Division GME Research Day 2026

No abstract provided.

Use Of Ultrasound In The Pre-Hospital Setting To Differentiate Acute Dyspnea, Kenith D'Souza, Michael Cabebe, Taryn Hoffman, Martin Wegman, Justin Deaton, Christopher Carney

South Atlantic Division GME Research Days 2026

No abstract provided.

Breaking The Pain Cycle: Ultrasound-Guided Sciatic Nerve Blocks For Acute Sciatica In The Ed, Pranav Bommineni, Taryn Hoffman

South Atlantic Division GME Research Days 2026

No abstract provided.

Utility Of Pocus In Expediting Time To Diagnosis In Two Separate Presentations Of Fournier's Gangrene, Arjavon Talebzadeh, Charles Budzyn, Taryn Hoffman, Mark Attlesey

South Atlantic Division GME Research Days 2026

No abstract provided.

A Multidisciplinary Approach To Acute-On-Chronic Pain Management In The Emergency Department, Lisa Persaud, Cameron Burr, Ursula Des Bordes, Noah Novembre, Abhishek Desai, Kaitlyn Phelps, Desiree Aird

South Atlantic Division GME Research Days 2026

No abstract provided.

Acute Aortic Dissection Masquerading As Testicular Torsion: A Case Report, Bruce M. Lo, Megyn K. Christensen, Coral E. Byrns, Benjamin Chidester

Department of Emergency Medicine Faculty Publications

Introduction: Aortic dissection is a rare but life-threatening condition with a high mortality rate if diagnosis is delayed. Aortic dissection classically presents with sudden-onset, sharp pain in the chest or back. However, atypical presentations can also occur, which could lead to a delay in diagnosis.

Case Report: A patient initially presented to the emergency department (ED) with left testicular pain ongoing for several hours. On examination, he had tenderness in the left lower quadrant abdomen and left testicle. A testicular ultrasound revealed decreased blood flow to the left testicle, raising concern for testicular torsion. The patient was taken to the …

Diagnostic Yield Of Head Ct For Headache In The Emergency Department: A Systematic Literature Review, Jennifer Y. Cho, Bassel Zein, Hannah Wells, Dennis Besong

South Atlantic Division GME Research Days 2026

No abstract provided.

Case Report: Wellens Syndrome In The Emergency Department, Johnathan Abdool, John Robinson, Daniel Regino

South Atlantic Division GME Research Days 2026

No abstract provided.

Gross Findings With Point-Of-Care Ultrasound In Median Arcuate Ligament Syndrome: A Case Report, Justin Stanziola, Yelena Pecheny, Casey Wilson

South Atlantic Division GME Research Days 2026

No abstract provided.

A New Conceptual Framework For The Approach To The Emergency Department Patient, Christopher Houston

North Texas GME Research Forum 2026

Background

The Emergency Department (ED) is an often chaotic environment where you have little information, little time, and must evaluate for multiple serious conditions. This can be overwhelming for trainees and young physicians. Having a thought process specifically tailored to the ED could be helpful organizing priorities and diagnostic pathways. There are several disease specific core measures that are time sensitive in the ED. Specifically; STEMI, stroke, sepsis, and trauma. Each of these conditions must be rapidly identified, and appropriate pathways initiated.

Trainees are traditionally taught to approach a patient with a wide differential diagnosis for each chief complaint and …

A Rare Cause Of Pelvic Pain: Emergency Department Diagnosis Of Hematometra Using Point-Of-Care Ultrasound, Casey Wilson, Lena O'Field, Hannah Chotiner

South Atlantic Division GME Research Days 2026

No abstract provided.

Retrospective Analysis Of High Flow Nasal Cannula Use In The Emergency Department: Association With Intensive Care Unit Admissions And Emergency Department Throughput, Raj Patel, Jesus Tamayo, James Duong, Nathaniel Banet, Hengameh Pajer, Anita Datta, Jake Valentine

Gulf Coast Division GME Research Day 2026

No abstract provided.

Rapid Diagnosis Of Hemorrhagic Shock Due To Upper Gi Bleeding With Point-Of-Care Ultrasound In The Emergency Department, Tamari Ronen, Derrick Huang

Gulf Coast Division GME Research Day 2026

No abstract provided.

Nitrous Oxide Vs. Ketamine: Impacts On Pediatric Emergency Department Length Of Stay, Tabitha Brock, Anna Suessman

North Texas GME Research Forum 2026

Background Nitrous oxide (N₂O) is a well-established analgesic and anxiolytic agent, widely used for procedural sedation in pediatric dentistry. Despite its demonstrated safety and efficacy, its use in Pediatric Emergency Departments (PEDs) remains limited and underexplored. To address this gap, we implemented a comprehensive training program for PED providers and introduced N₂O as an alternative sedation agent.

Objective We hypothesized that using N₂O for procedural sedation would significantly reduce patient length of stay (LOS) without compromising safety or outcomes.

Methods We conducted a retrospective chart review of pediatric patients who underwent painful procedures in a tertiary children’s hospital emergency department. …

Positive Efast—Not So Fast, Barry J. Knapp, Mitchell Vallone, Megan Duggins, Matt Jones, Jacob Knapp, Lily Kauffman, Alexander Dornstauder

Department of Emergency Medicine Faculty Publications

[Patient presentation] A 68-year-old man presented via emergency medical services (EMS) with right hip pain following a traumatic fall from his bicycle. On arrival at the emergency department, he was alert and oriented. Physical examination revealed only tenderness over the greater trochanter of the left femur, with no significant pain on passive range of motion of the left hip. Plain radiography demonstrated a left acetabular fracture (Fig 1).

Effect Of Implementing Safety Nursing Measures For Maintaining Fluid And Electrolyte Balance Among Critically Ill Patients With Acute Pancreatitis, Marwa Abdo

Nursing

Acute pancreatitis is a severe inflammatory condition that affects the pancreas and causes multiple organ failure. High rates of morbidity and mortality are caused by acute pancreatitis. Early fluid resuscitation, within the first 48 hrs., remains the hallmark for acute pancreatitis management. It lowers the incidence of pancreatic necrosis. Therefore, the foundation of treating acute pancreatitis in its early stages is safe fluid resuscitation. Aim: This study aims to evaluate the effect of implementing safety nursing measures for maintaining fluid and electrolyte balance among patients. Study design: A quasi-experimental research design was utilized in this study. Setting: This study was …

Does Cognitive Frame Affect Clinical Reasoning Among Medical Students? A Cross-Sectional Study, Xiao C. Zhang, Sara A. Belko, Andrew J Monick

Department of Emergency Medicine Faculty Papers

Background Diagnostic errors affect patient safety and lead to high costs. Cognitive bias is a key source of diagnostic error, and the framing effect poses a particular clinical challenge. The extent to which individual factors affect susceptibility to the framing bias is unclear, and the role of expertise in particular is contested across the literature. Objectives This study investigated the effects of framing bias on diagnostic reasoning among medical students. We hypothesised that the effects attributable to framing would be mediated by the number of years of medical education completed. Methods Participants were randomly assigned on an automated basis with …

Differences In Emergency Department Imaging Modalities For Femur Fractures Based On Insurance And Demographics, Patrick De La Torre Schutz, Bryce M. Bellon, Daniel Salinas, Kelsey Baker, Hamaad Gohar

Research Colloquium

Insurance status and race have been significant predictors of delayed care and reduced imaging utilization in emergency settings, particularly among minority and Medicaid-insured populations (Moser, Shan). The reasoning for the disparities in treatment for these underserved populations is still not well understood. To further analyze these claims, this study examined whether demographic factors such as ethnicity, sex, age, insurance type, and fracture classification were associated with differences in imaging modality among patients with femur fractures. Data from the Texas Department of State Health Services Trauma Registry (2018–2022) was analyzed using logistic regression to determine the odds ratios of receiving CT, …

Fatal Facial Necrotizing Fasciitis: A Case Report Highlighting Diagnostic And Therapeutic Challenges, Muhammad Sheraz Hameed, Syed Rafay Hussain Zaidi, Ali Iqbal, Muhammad Ahsan, Austin Mitchell, Azka Asad Mirza, Joshiah Gordon, Rahmat Gul Omarzai

Department of Medicine Faculty Papers

BACKGROUND: Facial Necrotizing Fasciitis (FNF) is a rare but aggressive, life-threatening infection involving the face's subcutaneous tissues and underlying musculature. It can rapidly progress to septic shock and multi-organ failure if not promptly recognized and treated. The clinical course, including severe pain, disproportionate tenderness, and systemic signs, is often the most crucial factor in diagnosis. While computed tomography (CT) can aid in identifying early signs such as soft tissue swelling and gas formation, clinical suspicion remains paramount and should not be delayed by reliance on imaging alone. Without early intervention, FNF may lead to devastating outcomes, including disfigurement, blindness, or …

Implementation Of A Triage System For The Residents At A Residential Facility To Improve Triage Assessment Skills Of The Staff As Well As Improve The Level And Timeliness Of Care, Andrew J. Choi Rn, Neha Gopal Rn, Andres N. Padilla Rn, Dana Son

Master's Projects and Capstones

Triage is an integral part of the clinical process which involves assessing patients and determining their level of care in order to get them appropriate, timely treatment. Several countries utilize a standardized triage system with established criteria to aid staff in their decision-making during assessments (Peta et al., 2023). The Nursing and Residential Triage (NaRT) tool, from the Manchester Triage System (MTS), was shown to enhance staff clinical assessment skills and help avoid inappropriate ED transfers during a study among older adults in a residential facility (Markey et al., 2024). For this project, the main issue identified at the residential …

Sustained Impact: Long-Term Application Of Diagnostic Uncertainty Communication Training, Danielle M. Mccarthy, Jethel Hernandez, Dimitrios Papanagnou, Kenzie A. Cameron, David H, Salzman, Andrew W. Long, Alexandra D. Franiek, Kristin L. Rising

Department of Emergency Medicine Faculty Papers

OBJECTIVES: More than one-third of discharged emergency department (ED) patients leave without a clear diagnosis for their symptoms. In 2019-2020, we implemented a simulation-based mastery learning curriculum across two academic medical centers to train emergency medicine residents to discuss diagnostic uncertainty during ED discharge, guided by the Uncertainty Communication Checklist (UCC). We sought to assess if this cohort continues to apply skills learned and to obtain trainee insights into the most valuable checklist items.

METHODS: A survey was emailed to all 109 participants who completed the training in 2019-2020. Questions assessed how often participants currently encountered uncertainty and used the …

Urgent Implementation Of Point-Of-Care Testing For Group A Streptococcal Infection In A Uk Children’S Emergency Department, Ruth Shorrocks, Philip J. Turner, Thomas Fanshawe, Umasha Ukwatte, Jim Gray, James Taylor, Liliana Graveto, Gail Hayward, Chris Bird

Journal of Pediatric Infectious Diseases

Objective: In late 2022, Western Europe and the United States experienced increased incidences of scarlet fever and life-threatening invasive group A strepto- coccal (iGAS) infections, especially among children. The outbreak was widely reported in the media in the United Kingdom, leading to increased emergency department (ED) attendances and threatened supplies of antibiotics. Our ED rapidly introduced point-of-care testing for GAS pharyngitis with the aim of rationalizing antibiotic prescribing.

Methods: We rapidly implemented the use of a molecular-based (polymerase chain reaction) point-of-care test for all children scoring 3 or higher on the McIsaac clinical prediction rule for GAS pharyngitis in children …

Checklists To Improve Emergency Medicine Resident Confidence In Airway Management, Tiara Paul, Bs, Elizabeth Glowacki, Md, Sean Mcgann, Md

Health Equity and Quality Improvement (HEQI) Summit

Objectives

• Determine the level of confidence regarding airway management among TJUH emergency medicine residents
• Implement education based on identifiable knowledge gaps
• Assess for improvement in resident confidence and discover avenues to optimize the education program

A New Approach: Evaluating The Effectiveness Of Artificial Intelligence Developments For Trauma Triage In The Emergency Department, William C. Anoka

2025 Spring Honors Capstone Projects - Archive

Triage in emergent situations occurs when patients are assigned to areas of the hospital with different levels of care according to the perceived risks determined by their signs and symptoms. The variability of current triage protocols substantially increases the proportion of lower acuity patients who die unexpectedly due to improper risk stratification. However, recent artificial intelligence (AI) developments have been applied to trauma triage situations to improve accuracy and patient outcomes. To further evaluate the effectiveness of this new tool, this study used various AI models to assess the presenting assessments of multiple situations and determine the appropriate level of …

Enhancing Diagnostic Accuracy In Dyspnea: The Role Of Ai-Enhanced Ecg Interpretation, Sami Asif, Ayesha Mushtaq

Rowan-Virtua Research Day

Dyspnea is a frequent and diagnostically challenging presentation in emergency departments, requiring rapid distinction between cardiac and non-cardiac causes. Traditional approaches, including NT-proBNP testing and clinical assessment, often lack optimal sensitivity and specificity. Recent advancements in artificial intelligence (AI) have introduced AI-enhanced electrocardiogram (ECG) analysis as a promising diagnostic tool capable of identifying cardiac dysfunction with high accuracy.

A structured literature review was performed using PubMed to identify randomized controlled trials, prospective validations, and systematic reviews published between 2018 and 2024. Studies evaluating AI-ECG performance, NT-proBNP testing, and clinical assessment in adult patients presenting with dyspnea were included. Data extracted …