Emergency Medicine Commons^™

Richmond Agitation-Sedation Scoring Implementation In A Critical Access Hospital, Jasmine A. Hobbs

Doctor of Nursing Practice Posters and Presentations

Mechanically ventilated patients who are boarding in rural emergency departments face an increased risk of inconsistent sedation management due to the lack of standardized protocols and the extended transfer times to higher levels of care. The variability in sedation practices can lead to both under- and over-sedation, which negatively affects patient comfort, safety, and clinical outcomes. Research suggests that sedation protocols incorporating the Richmond Agitation-Sedation Scale (RASS) can shorten mechanical ventilation duration and improve clinical outcomes. The purpose of this project was to evaluate the effectiveness of a targeted educational intervention on improving nursing knowledge and comfort with the RASS …

Exploring The Relationship Between Behavioral Health Early Prediction Model And Patient Outcomes In The Emergency Department, Karen M. Richendollar, Kathie M. Zimbro

Knowledge and Creativity Expo

Problem: Emergency departments (EDs) are increasingly utilized for mental health (MH) care, often resulting in overcrowding and delayed access to specialized services. A significant proportion of MH patients are discharged without a psychiatric consult, raising concerns about safety and readmission rates. This trend places additional strain on already limited behavioral health resources and contributes to care delays for patients in acute crisis. Moreover, the lack of standardized discharge criteria for MH patients increases variability in care and may compromise patient outcomes. Purpose: This study evaluates the effectiveness of the Behavioral Health Early Discharge Prediction Model (BHEDPM) in identifying MH patients …

Clinical Outcomes For Patients With Obstructive Shock With Pe In Octogenarians, Nonagenarians, And Centenarians: An Analysis Of The National Inpatient Sample, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Wasim Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

One of the most common causes of obstructive shock is massive pulmonary embolism. I these patients with compounded morbidities and limited filling of the heart we sought to sample databases to analyze the inpatient outcomes of the population.

Lower Extremity Weakness In The Setting Of Covid Myositis, Christopher Dellmyer, Frank Wheeler

Rowan-Virtua Research Day

Bilateral lower extremity weakness has numerable causes including stroke, peripheral neuropathy, deconditioning, Guillain-Barre, Multiple Sclerosis, anterior cord syndrome, trauma, spinal epidural abscess and many more. It is imperative however, that we investigate and understand more rare causes of lower extremity weakness. Here we present the case of a 74-year-old female presented to the ED with a complaint of lower extremity weakness due to Covid myositis causing significant bilateral lower extremity weakness.

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 …

Herniated Nucleus Pulposus Radiculopathy In Athletes, Elizabeth G. Massel

Capstone Showcase

Herniated nucleus pulposus (HNP), commonly referred to as intervertebral disc (IVD) herniation, is the second most common cause of neck and back pain, and most common cause of radiculopathy. The purpose of this CME article is to provide guidance on the medical management and secondary prevention of HNP in athletic populations, and highlight the pathophysiological process of mechanical overload putting athletes at a proportionately higher risk of the disease. It will address the unique pathophysiology of overuse-related HNP, as opposed to underuse, with the mechanical overload on vertebral discs associated with many sports. It will also review, with more emphasis …

Exploring Factors Contributing To Compassion Fatigue In Emergency Departments And Possible Interventions, Neggin Assadi

Capstone Showcase

The ED is a fast paced, busy, and unpredictable environment. Increased exposures to death, suffering, and trauma can make the ED a stressful environment and makes providers more susceptible to a phenomenon called compassion fatigue (CF), a diminished ability to feel compassion towards those they are tasked to care for. Three main contributors to CF in the ED are a poor workplace environment, workplace aggression/violence, and traumatic events. Exploring what contributes to these stressors and proposing ways to reduce them can help ED providers combat CF.

Diagnostic Imaging Read By Ai-Assisted Technology Within The Emergency Department, Joshua Leland

Capstone Showcase

Introduction: The emergency department (ED) has had an appreciable increase in volume over the past two decades with more individuals utilizing the ED now than a decade ago which has placed a strain on healthcare resources. Specifically adding to the rising costs in healthcare are diagnostics including chest x-rays. To combat this, institutions across the nation are developing deep-learning and artificial intelligence (AI) programs to assist in reading these diagnostics. Therefore, this systematic review analyzes the use of AI programs by clinicians in the ED to read diagnostic imaging compared to those who do not use these algorithms.

Methods: This …

Opioid Use Disorder: The Timeline For Medication Assisted Therapy, Alexander Cristofori

Capstone Showcase

Opioid Use Disorder is patterns of opioid use leading to withdrawal, giving up important life events in order to use opioids, and excessive time spent using opioids, to name a few diagnostic criteria. The clinical progression of the disorder involves periods of acute exacerbation and remission that are cyclic in nature. Treatment is most effective when it includes both pharmacological and psychosocial modalities, referred to as medication assisted therapy (MAT). Three drugs used commonly in MAT-based treatment for OUD from oldest to newest include Methadone, Buprenorphine-naloxone, and Naltrexone. Treatment program models that prioritize total abstinence from the addictive substance attached …

Family Presence During Resuscitation, Brittany Whistle

Scholars Week

Background:

Families want more involvement in their loved one’s care than they did just twenty years ago. Especially, in the matter of resuscitation efforts, this involvement remains controversial.

Evidence and Findings:

Based on research, theories, and multiple educated opinions, family presence during resuscitation (FPDR) needs to be implemented in hospitals. Theories by Kolcaba and Helvie demonstrate a need for comfort and positive energy around patients to enhance the healing process. Evidence has shown multiple benefits of FPDR. The patient receives a holistic approach of care, the family gains closure and feeling of participation of care, and provides a plan for …

Effect Of Epinephrine On Outcomes In Out-Of-Hospital Cardiac Arrest, Ian Lumsden

Capstone Showcase

Abstract

Introduction

Epinephrine administration during cardiac arrest has been the standard of care for decades. In the United States, epinephrine administration has been recommended by the American Heart Association since the first cardiac arrest guidelines were published in 1974. However, epinephrine use became the standard of care with strong medical rational but with limited data on outcomes. The intent of this research is to review available literature and determine if in (P) an adult population in non-traumatic out-of-hospital cardiac arrest (I) treatment with epinephrine administration (C) compared to cardiac care without the administration of epinephrine (O) results in improved survival …

An Exploration Of Why Healthcare Professionals Under-Report Observed Patient Aggression, Sydney Bonta

UNO Student Research and Creative Activity Fair

An Exploration of Why Healthcare Professionals Under-Report Observed Patient Aggression

Authors: Sydney Bonta & Lisa L. Scherer, Ph.D.

Advisor: Lisa L. Scherer, Ph.D.

According to the 2011 US Bureau of Justice Statistics report, medical professionals experienced the third highest proportion of workplace violence (WPV), with violence primarily emanating from patient. In a national survey of nurses employed in hospitals, 76% stated that they had encountered some sort of violence in their workplace (Speroni, Fitch, Dawson, Dugan, Atherton, & Leesburg, 2014). Similarly, patient aggression against physicians has long been a problem (Morrison, Lantos, Levinson, 1998). Despite this widespread exposure to WPV …

Transabdominal Versus Transvaginal, Kyla Camille Gray

Grace Peterson Nursing Research Colloquium

Background: In the United States, there has been a 21% increase in the occurrence of premature births within the last two decades. These children are also more likely to require lifelong therapies, assistive technologies, mobility devices, and more supportive services throughout their time in school. Globally, preterm births, and their preventions, have become a topic of interest. One method that has had significant success rates is placing a cerclage to prevent cervical dilation; while simultaneously treating prophylactically for early delivery.

Objectives: The purpose of this integrative literature review was to focus on which placement of cerclages, transabdominal or transvaginal, …

Teaching Outbreak Preparedness In The Emergency Medicine Clerkship: An Innovative Approach, Larissa S. May

E-Learning Modules

Clinicians should be competent at contagious disease outbreak detection and management. Given the threat of emerging infectious diseases and biowarfare, there is a need to develop instructional methods on these topics. We have created a case-based exercise addressing sentinel case recognition, reporting, and containment. The workshop, conducted for medical students during their emergency medicine clerkship, incorporates the core competencies of systems-based practice, practice-based learning, and patient care. The workshop is held in a hospital conference room with the availability of internet, telephone, and other resources, simulating "real life." A hypothetical case of Ebola presenting to an emergency department is outlined. …