Emergency Medicine Commons^™

Rapid Response Team Codes Following Transition-Of-Care From The Emergency Department To An Inpatient Medicine Unit, Kerrin Bersani, Brett Todd

Posters

Transitions-of-care from the emergency department (ED) to an inpatient unit have been identified as a high-risk period for medical error due to multiple causes, such as communication mishaps, excessive workload, variability in patient flow, and unclear assignment of responsibility. Patients who experience a diagnostic error are also at increased risk for poor outcomes, including increased length-of-stay and mortality. Rapid Response Teams (RRTs) are frequently utilized by hospitals to address a sudden deterioration in clinical status, often after a transition-of-care. We investigated the occurrence of RRT in patients shortly after a transition-of-care from the ED to a medicine unit. Further, we …

Evaluation Of Online Patient Information Regarding Emergency Center Utilization, Rachel Truland, Steven Joseph

Posters

The decision a patient makes when seeking emergency medical care comes with risks and ambiguity if the right decision is not made. The internet is increasingly accessible to patients, and they often consult an internet search prior to seeking healthcare. The aim of this study is to assess the readability and reliability of online information regarding a patient’s decision to seek emergency care.

Atomic Habits In Meded: Tiny Changes, Remarkable Results, Eric Shappell, Sreeja Natesan, Brett Todd

Website/Multimedia Contributions

No abstract provided.

Pilot Study Of The Association Between Microbiome And The Development Of Adverse Posttraumatic Neuropsychiatric Sequelae After Traumatic Stress Exposure, Abigail L. Zeamer, Marie-Claire Salive, Xinming An, Stacey L. House, Francesca L. Beaudoin, Jennifer S. Stevens, Donglin Zeng, Thomas C. Neylan, Gari D. Clifford, Robert A. Swor

Articles

Background Patients exposed to trauma often experience high rates of adverse post-traumatic neuropsychiatric sequelae (APNS). The biologic mechanisms promoting APNS are currently unknown, but the microbiota-gut-brain axis offers an avenue to understanding mechanisms as well as possibilities for intervention. Microbiome composition at the time of trauma exposure has been poorly examined regarding neuropsychiatric outcomes. We aimed to determine whether baseline the gut microbiomes of trauma-exposed emergency department patients who later develop APNS have dysfunctional gut microbiome profiles and discover potential associated mechanisms.

Methods We performed metagenomic analysis on stool samples (n=51) from a subset of adults enrolled in the Advancing …

Updated Documentation Requirements, Michael Gratson

Website/Multimedia Contributions

No abstract provided.

The Impact Of Medical Scribes On Emergency Physician Diagnostic Testing And Diagnosis Charting, Lucas Nelson, Brett R. Todd

Posters

INTRODUCTION
Since the widespread adoption of electronic medical records (EMRs), medical scribes have been increasingly utilized in emergency department (ED) settings to offload the documentation burden of emergency physicians (EPs). Scribes have been shown to increase EP productivity and satisfaction; however, little is known about their effects on the EP’s diagnostic process. We aimed to assess what effect, if any, scribes have on EP diagnostic test ordering and their documentation of differential diagnoses.

Differences Within A Health System: Imaging Use For Suspected Pediatric Appendicitis, Nafisa Bhuiyan, Ryan Nierstedt, Michelle Jankowski, Shanna Jones, Aveh Bastani

Posters

INTRODUCTION
Ultrasound (US) is the first line imaging used for suspected pediatric appendicitis. However, following equivocal US findings and its lower negative predictive value for ruling out appendicitis, Computed Tomography (CT) imaging is often performed in children. This study investigates the differences in imaging utilization between a community hospital (Beaumont Troy) and a children’s ED hospital (Beaumont Royal Oak), making it the first study to evaluate suspected pediatric appendicitis in Beaumont Health System. It also aims to further characterize differences in patient outcomes such as surgery, length of hospital stay, complications of appendicitis, and highlight the need to reduce unnecessary …

Differences In Small Bowel Obstruction Outcomes In An Academic Vs Community Hospital., Kelly Fahey, Aveh Bastani, Shanna Jones, Philip Kilanowski-Doroh

Posters

Small bowel obstruction: blockage in small intestine. Adhesions are the most common cause. Accounts for 300,000 hospitalizations in the US annually, and 20% of emergency surgical procedures in patients with abdominal pain. High morbidity and mortality. Average hospital stay of 8 days. 30-day readmission rate of 16%. In-hospital mortality rate of 3%. Costly diagnosis: more than $2 billion spent on admissions for adhesion-related disease in the United States. Clinical presentation: variable, includes abdominal pain, vomiting, constipation, nausea, and abdominal distention. Management. Operative: important if signs of ischemia, peritonitis, or strangulation. Conservative: includes bowel rest, nasogastric decompression, serial examinations, and a …

Cardiac Arrest Patient Length Of Stay And Survival In Michigan Hospitals, Jaemin Song, David A. Berger, James H. Paxton, Joseph B. Miller, Joshua Reynolds, Nai-Wei Chen, Robert Swor

Posters

INTRODUCTION
Current guidelines recommend deferring prognostic decisions for at least 72 hours following admission after Out of Hospital cardiac arrest (OHCA). Most non-survivors experience withdrawal of life-sustaining therapy (WLST), and early WLST may adversely impact survival. We sought to characterize the hospital length of stay (LOS) and timing of Do Not Resuscitate (DNR) orders (as surrogates for WLST) to assess their relationship to survival following cardiac arrest.

A Multimodal Approach To Reducing Opioid Administration In The Emergency Department, Eddie Ford, Vito Rocco, Shanna Jones, Patrick Karabon

Posters

INTRODUCTION
The United States is battling a deadly epidemic against opioid abuse and misuse, which began as a result of pharmaceutical companies purposely downplaying the addictive potential of their opioid medications. In 2016, a Colorado health care system developed a groundbreaking alternative to opioids (ALTO) protocol for acute pain relief in the Emergency Department (ED). This protocol was adapted and implemented in the Beaumont Troy ED and is the focus of this current study. The primary goal of this study is to characterize the impact of the ALTO protocol on the rate of opioid and non-opioid administration in the ED …

The Current State Of Diagnostic Error Education In U.S. Medical Schools, Dakota Hall, Sandra Lablance, Brett Todd

Posters

Diagnostic error has been identified by the Institute of Medicine as a major cause of patient harm. Despite recent focus on the importance of diagnostic error, little is known about how medical schools are educating future physicians, specifically, the extent to which it is taught. We aimed to investigate the current state of diagnostic error education in U.S. medical schools.

Outcomes For Patients With Congestive Heart Failure And Chronic Kidney Disease Receiving Fluid Resuscitation For Severe Sepsis Or Septic Shock, Melany Wiczorek, Ronny Otero, Steven Knight, Kaitlin Ziadeh, James Blumline, Zachary Rollins

Posters

INTRODUCTION
Sepsis core measures are an integral part of sepsis treatment. Current fluid administration guidelines consist of administering at least 30cc/kg of intravenous fluids (IVF) per ideal body weight (IBW) within the first three hours of sepsis diagnosis regardless of pre-existing comorbidities at risk for fluid overload. This study aims to evaluate the outcomes of patients with a history of congestive heart failure (CHF) and/or chronic kidney disease (CKD) who receive fluid resuscitation for the management of severe sepsis or septic shock.

Journal Club In The Pre-Clinical Years During Medical School, Kristin Cuadra, Steven Joseph

Posters

INTRODUCTION
Traditionally, journal clubs have been conducted within graduate medical programs to help integrate evidence-based learning. This study will be focused on beginning to integrate journal club into the pre-clinical years while implementing successful techniques used in past journal clubs. Our hypothesis is that, with a structured review instrument in place to help students analyze clinical articles, students will be able to benefit from monthly journal clubs and fully grasp concepts taught in these pre-clinical years. Overall, the results will contribute significantly in determining the efficacy of journal club and whether or not it can be a valuable tool in …

The Current State Of Diagnostic Error Education In Us Medical Schools, Dakota Hall, Brett R. Todd, Sandra Lablance

Conference Presentation Abstracts

Background: Diagnostic error has been identified by the Institute of Medicine as a major cause of patient harm. Despite this recent focus on the importance of diagnostic error, little is known about how medical schools are educating future physicians on diagnostic error, specifically if diagnostic error is taught, when in the curriculum it is taught, and the format for teaching. We aimed to investigate the current state of education on diagnostic error in US medical schools. Methods: We conducted an anonymous survey of deans of medical education at US MD and DO medical schools utilizing Qualtrics. The study was distributed …

What You Need To Know About Em Administration Fellowships, Michael Muradian

Articles

No abstract provided.

Impact Of Urgent Care Centers And Telehealth In The Ed, Javed Osmani, Michael Muradian, Christina Brown, Nicholas Stark

Articles

No abstract provided.

What's In Your Box? Dental Trauma Management, Amy Smark

Website/Multimedia Contributions

No abstract provided.

Going Off The Deep End - The Life And Controversies Of Henry Heimlich, Md, Bradford L. Walters, Matthew Drogowski

Articles

No abstract provided.

Geriatric Emergency Medicine Assessment In The Emergency Department Results In Yearly Savings Of $3 Million, Sarah Keene, Lauren Cameron-Comasco

Conference Presentation Abstracts

Background and Objectives: Older adult patients admitted to the hospital from the Emergency Department (ED) have a longer length of stay in the hospital on average compared to younger patients. Geriatric patients make up an increasing percentage of the patient population, and almost all health care for geriatric patients in the United States is paid for by Medicare. The cost of the inpatient care of geriatric patients is a significant contributor to the total cost of health care in the United States. Methods: We conducted a case-control study looking at the impact of a Geriatric Emergency Medicine Assessment (GEMA) team …

Identifying Predictors Of Peripheral Intravenous Catheter Failure Using A Novel Combination Of Clinical And Ultrasonographic Assessments, Amit Bahl, Steven Johnson, Nicholas Mielke, Patrick Karabon

Articles

No abstract provided.