Emergency Medicine Commons^™

Reducing Substance Use By An Emergency Department Intervention, Matthew D. Marschall Do, Smeet Bhimani Do, Rachel Fieman Md, Derek J. Fikse Do, Paige Roth Lsw, Jennifer Stephens Do, Manuel F. Colón Bs, Kevin Weaver D.O.,Facoep, David M. Richardson Md, Marna R. Greenberg Do, Mph, Facep, Robert D. Cannon Do

Department of Emergency Medicine

No abstract provided.

Sex Specific Outcomes In A Substance Use Intervention Program, Alexandra M. Amaducci Do, Ryan A. Anderson Do, Aaron S. Frey Do, Andrew W. Sheen Do, Manuel F. Colón Bs, Paige Roth Msw, Lsw, Crs, Jennifer Stephens Do, Facp, Kevin R. Weaver D.O.,Facoep, David B. Burmeister Do, Mba, Cpe, Facep, Marna R. Greenberg Do, Mph, Facep, Robert D. Cannon Do

Department of Emergency Medicine

No abstract provided.

Sex Differences In Poisonings Among Older Adults: An Analysis Of The Toxicology Investigators Consortium (Toxic) Registry, 2010 To 2016., Gillian A. Beauchamp Md, Jennifer L. Carey Md, Tyler Adams Bs, Amy Wier, Manuel F. Colón Bs, Matthew D. Cook Do, Robert D. Cannon Do, Kenneth D. Katz Md, Marna R. Greenberg Do, Mph, Facep

Department of Emergency Medicine

PURPOSE: Adults aged >65 years are susceptible to intentional and unintentional poisoning, with contributing factors that include polypharmacy, comorbidity, susceptibility to medication error, and gaps in research. Although toxicologists are often tasked with managing and preventing poisoning among older adults, little is known about sex differences in these poisonings. The aim of this study was to review sex differences in poisonings among older adults managed at the bedside by medical toxicologists.

METHODS: All case subjects aged >65 years in the Toxicology Investigators Consortium (ToxIC) registry between January 2010 and December 2016 were reviewed. Data included reasons for exposure and consultation, …

Neonatal Purpura Fulminans, A Rare Genetic Disorder Due To Protein C Deficiency: A Case Report., Ghazala Irfan Kazi, Emaduddin Siddiqui, Saadia Tabassum, Badar Afzal, Irum Qamar Khan

Department of Emergency Medicine

Neonatal Purpura Fulminans is a rare and fatal disorder associated with perivascular haemorrhage and disseminated intravascular coagulation. Early clinical recognition, timely investigation and treatment is utmost important. A 6 days old baby boy was brought to emergency with blackish ulcers all over the body. Initially these were over the feet and scalp but later appeared on the abdomen. On examination, child was vitally stable, mildly icteric and had multiple erythematous large bullous blackish lesions on scalp, lower abdomen, perineum, back and soles. Neonatal reflexes and systemic examination was normal. Laboratory investigations showed normal CBC, PT/APTT and Protein S level while …

Prognostic Significance Of Optic Nerve Sheath Diameter On Computed Tomography Scan With Severity Of Blunt Traumatic Brain Injury In The Emergency Department., Shahan Waheed, Muhamamd Akbar Baig, Emaduddin Siddiqui, Danyal Jamil, Asher Feroze

Department of Emergency Medicine

Optic nerve sheath diameter measurement (ONSD) has been associated with identifying the prognosis of traumatic brain injury (TBI) patients. The study was planned to evaluate the prognostic value of ONSD measured on the initial brain computed tomography (CT) scan performed on patients with blunt TBI in the emergency department(ED). This retrospective cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of moderate and severe TBI patients from January to December 2014. ONSD for each eye on the initial CT scan and Glasgow Coma Scale (GCS) was measured upon patient presentation. Correlation between presentation GCS and …

Teaching Children Road Safety Through Storybooks: An Approach To Child Health Literacy In Pakistan, Haris Ahmad, Rubaba Naeem, Nukhba Zia, Asher Feroze, Amarah Shakoor, Uzma R. Khan, Asad Mian

Department of Emergency Medicine

Background: Road traffic injuries (RTIs) commonly affect the younger population in low- and-middle-income countries. School children may be educated about road safety using storybooks with colorful pictures, which tends to increase the child’s interest in the text. Therefore, this study assessed the use of bilingual pictorial storybooks to improve RTI prevention knowledge among school children.
Methods: This pretest-posttest study was conducted in eight public and nine private schools of Karachi, Pakistan, between February to May 2015. Children in grades four and five were enrolled at baseline (n = 410). The intervention was an interactive discussion about RTI prevention using a …

Sex Differences In Prevalence Of Emergency Department Patient Substance Use, Robert D. Cannon Do, Gillian A. Beauchamp Md, Paige Roth Lsw, Jennifer Stephens Do, David B. Burmeister Do, Facep, Cpe, David M. Richardson Md, Alanna Balbi Bs, Tennessee Park Ba, Stephen W. Dusza Drph, Marna R. Greenberg Do, Mph, Facep

Department of Emergency Medicine

Purpose

Substance use and misuse is prevalent in emergency department (ED) populations. While the prevalence of substance use and misuse is reported, sex-specific trends in ED populations have not been documented. We set out to determine the sex-specific prevalence of ED patient substance use during this current epidemic.

Methods

A retrospective electronic data abstraction tool, developed for quality-improvement purposes, was used to assess ED visits in 3 hospitals in northeastern Pennsylvania. All patients with ED diagnosis codes for substance use F10.000 through F 19.999 (excluding F17 codes for nicotine) were abstracted for network ED visits at all 3 hospitals. Data …

Women And The Experience Of Pain And Opioid Use Disorder: A Literature-Based Commentary, Andrew L. Koons, Marna R. Greenberg Do, Mph, Facep, Robert D. Cannon Do, Gillian A. Beauchamp Md

Department of Emergency Medicine

It is generally understood that pain experience and opioid abuse have relied on male-dominated models. However, sex and gender play a role in both pain experience and opioid use disorder.

Using the previously validated Texas Tech University Health Sciences Center Sex and Gender Specific Health PubMed Advanced Search Tool, the authors used pertinent literature to develop this literature-based commentary on sex and gender differences in pain experience and opioid use disorder. Women report their experience of pain more frequently, have increased rates of diagnoses related to pain, have increased pain sensitivity, and have a variable response to pain and analgesia. …

Perception And Practice Among Emergency Medicine Health Care Providers Regarding Discharging Patients After Opioid Administration, Ryan M. Surmaitis Do, Alexandra Amaducci Do, Kathryn Henry Do, Michael Jong Md, Emily A. Kiernan Do, Hope Kincaid Mph, Cph, Lindsa Houck Msn, Rn, Nea-Bc, Cen, Cpen, Phrn, Sandra Sabbatini Bsn, Rn, Marna R. Greenberg Do, Mph, Facep, Kenneth D. Katz Md

Department of Emergency Medicine

Abstract

Purpose

This study aimed to determine the current attitudes, perceptions, and practices of emergency medicine providers and nurses (RNs) regarding the discharge of adult patients from the emergency department (ED) after administration of opioid analgesics.

Methods

A cross-sectional survey was administered at 3 hospital sites with a combined annual ED census of >180,000 visits per year. All 59 attending emergency physicians (EPs), 233 RNs, and 23 advanced practice clinicians (APCs) who worked at these sites were eligible to participate.

Findings

Thirty-five EPs (59.3%), 88 RNs (37.8%), and 14 APCs (60.9%) completed the survey for an overall response rate of …

Methanol Poisoning: 27 Years Experience At A Tertiary Care Hospital, Fareed Ahmed, Nadeem Ullah Khan, Noman Ali, Asher Feroze

Department of Emergency Medicine

Methanol toxicity can result in serious morbidity and mortality without timely diagnosis and treatment. Many cases of methanol poisoning outbreaks have been noted in our population but no study has been performed to estimate methanol exposure and its outcomes and complications. A retrospective study was conducted to review all the cases of methanol poisoning admitted from January 1988 to December 2015 at the Aga Khan University Hospital. A total of 35 methanol poisoning cases were reported. All the patients were male, and the mean age was 36.2±8.6 years. The mean Glasgow Coma Scale score on presentation in the emergency was …

A Resident's Note, Syed Muhammad Mustahsan

Department of Emergency Medicine

No abstract provided.

Sex Differences In Pediatric Exploratory Exposures: A Retrospective Review Of National Poison Data System (Npds) Exposures 2007-2016, Gillian A. Beauchamp Md, B Zane Horowitz Md, Esther K. Choo Md, Mph, Marna R. Greenberg Do, Mph, Facep, Daniel A. Spyker Md, Phd

Department of Emergency Medicine

No abstract provided.

Sex Differences In Intentional Exposures Among Adolescents And Adults: A Retrospective Review Of National Poison Data System (Npds) Pharmaceutical Exposures 2007-2016, Gillian A. Beauchamp Md, B Zane Horowitz Md, Esther K. Choo Md, Mph, Marna R. Greenberg Do, Mph, Facep, Daniel A. Spyker Md, Phd

Department of Emergency Medicine

No abstract provided.

Sex Differences In Adverse Drug Reactions And Adverse Drug Events In Older Adults: A Retrospective Review Of National Poison Data System Cases 2007-2016., Gillian A. Beauchamp Md, B Zane Horowitz Md, Esther K. Choo Md, Mph, Marna R. Greenberg Do, Mph, Facep, Daniel A. Spyker Md, Phd

Department of Emergency Medicine

No abstract provided.

Abruptio Placentae With Type Ii Respiratory Failure Secondary To Acute Interstitial Pneumonia Responsive To Steroids., Muhammad Umer Salim, Syed Muhammad Mustahsan, Anum Fatima

Department of Emergency Medicine

Acute Interstitial Pneumonia (AIP) is categorized as Idiopathic Interstitial Pneumonia (IIP), in which the cause is unknown. Ayoung female of 22 years presented in 34 weeks gestation with abruptio placentae (AP) and underwent Lower Segment Caesarian Section (LSCS) for AP. It progressed to type II respiratory failure secondary to AIPon 4th day post-surgery. It remained unresponsive when treated with noninvasive ventilation (NIV-BiPAP) along with antibiotics. Later, a trial treatment of pulse therapy of Methylprednisolone was executed on 7th day post-surgery which resulted in dramatic improvement in symptoms. It is uncommon to have type II respiratory failure secondary to AIP, and …

Sex And Gender In Emergency Medicine: An Innovative Elective And Toolkit For Incorporation Into Trainee Education., Lauren Walter Md, Gillian A. Beauchamp Md, Rebecca Barron Md, Mph, Tracy E. Madsen Md, Scm, Marna R. Greenberg Do, Mph, Facep, Alyson J. Mcgregor Md, Ma

Department of Emergency Medicine

No abstract provided.

Gender Differences In Effectiveness Of The "Timed Up And Go" (Tug) Test As A Screening Tool For Geriatric Fall Risk Assessment., Richard Chow Do, Marna R. Greenberg Do, Mph, Facep, Jeanne L. Jacoby Md, Robert D. Barraco Md, Mph, Bryan G. Kane Md

Department of Emergency Medicine

No abstract provided.

Gender Differences In Emergency Medicine Resident Self-Assessment Of Clinical Teaching, Alan R. Cherney Md, Amy B. Smith Phd, Charles C. Worrilow Md, Kevin Weaver D.O.,Facoep, Dawn M. Yenser, Jennifer E. Macfarlan Mph, Marna R. Greenberg Do, Mph, Facep, Bryan G. Kane Md

Department of Emergency Medicine

No abstract provided.

Incorporating Sex And Gender Into Culturally Competent Simulation In Medical Education (Poster)., Gillian A. Beauchamp Md, Alyson J. Mcgregor Md, Ma, Esther K. Choo Md, Mph, Basmah Safdar Md, Alexander M. Rosenau Do, Marna R. Greenberg Do, Mph, Facep

Department of Emergency Medicine

No abstract provided.

Sex Specific Analysis Of The Vulnerable Elders Survey As A Predictor Of Falls., Rebecca Brown Md, Marna R. Greenberg Do, Mph, Facep, Bryan G. Kane Md, Robert D. Barraco Md, Mph, Jeanne L. Jacoby Md

Department of Emergency Medicine

No abstract provided.

No Sex-Specific Differences In Preference Of Management Options To Prevent Elderly Falls, Marna R. Greenberg Do, Mph, Facep, Jeanne L. Jacoby Md, Robert D. Barraco Md, Mph, Bernadette Glenn-Porter Bs, Kyle Durics Bs, Ryan Day Md, Victoria Goodheart Do, Danielle Mills Md, Alexander Youngdahl Do, Bryan G. Kane Md

Department of Emergency Medicine

No abstract provided.

A Retrospective Review Of Paediatric Head Injuries In Asia - A Pan Asian Trauma Outcomes Study (Patos) Collaboration, Shu-Ling Chong, Uzma R. Khan, Indumathy Santhanam, Jun Seok Seo, Quan Wang, Sabariah Faizah Jamaluddin,, Quoc Ai Hoang Quoc, Su Yah Chew, Marcus Eng Hock Ong

Department of Emergency Medicine

Objective: We aim to examine the mechanisms of head-injured children presenting to participating centres in the Pan Asian Trauma Outcomes Study (PATOS) and to evaluate the association between mechanism of injury and severe outcomes.
Design and Setting: We performed a retrospective review of medical records among emergency departments (EDs) of eight PATOS centres, from September 2014 - August 2015.
Participants: We included children <16 years old who presented within 24 hours of head injury and were admitted for observation or required a computed tomography (CT) of the brain from the ED. We excluded children with known coagulopathies, neurological co-morbidities or prior neurosurgery. We reviewed the mechanism, intent, location and object involved in each injury, and the patients' physical findings on presentation.
Outcomes: Primary outcomes were death, endotracheal intubation or neurosurgical intervention. Secondary outcomes included hospital and ED length of stay.
Results: 1438 children were analysed. 953 children (66.3%) were male and the median age was 5.0 years (IQR …

Hydrogen Sulfide Gas Poisoning In Fish Garbage Room: A Report Of A Fisherman, Sadaf Sheikh, Muhammad Akbar Baig, Noman Ali, Nadeemullah Khan

Department of Emergency Medicine

We report the case of a fisherman who was exposed to high concentrations of hydrogen sulfide (H2S) gas from the fish garbage room. The patient survived and was discharged with full recovery from the hospital. H2S is a colourless, foul smelling and highly toxic gas next to carbon monoxide, which causes inhalation death. It is a by-product of various industrial processes particularly involves exposure from agriculture, petrochemical industry and organic matter decomposition from sewage processing. It is a by-product of H2S has been referred as the "knock down gas" because inhalation of high concentrations can cause immediate loss of consciousness …

A Unique Cause Of Anion Gap Metabolic Acidosis: Euglycemia Dka., Ross Cohen Do, Pgy-4, Kevin Weaver D.O.,Facoep

Department of Emergency Medicine

No abstract provided.

Mental Illness And Injuries: Emerging Health Challenges Of Urbanisation In South Asia, Devaki Nambiar, Junaid Razzak, Kaosar Afsana, Alayne M. Adams, Arif Hasan, Dinesh Mohan, Vikram Patel

Department of Emergency Medicine

No abstract provided.

Does A Brief Educational Intervention Allow For Greater Prehospital Recognition Of Acute Stroke By Paramedics?., Tara K. Henry-Morrow Emt-P, Bryan D. Nelson Mba, Nr-P, Erin M. Conahan Rn, Cnrn, Claranne Mathiesen Rn, Msn, Cnrn, Bernadette Glenn-Porter Bs, Matthew Niehaus Do, Lauren M. Porter, Mitchell Gesell Do, Gregory Monaghan Md, Jeanne L. Jacoby Md

Department of Emergency Medicine

No abstract provided.

Loperamide-Induced Torsades De Pointes: A Case Series, Kenneth D. Katz Md, Robert D. Cannon Do, Matthew D. Cook Do, Alexandra Amaducci, Ryan Day, Joshua Enyart Do, Glenn Burket, Jennifer Janssen Ms, Karl E. Williams Md, Mph

Department of Emergency Medicine

Background: Loperamide (Imodium™) is an antidiarrheal opioid acting at the μ receptor agonist in high concentrations. Due to the US opioid epidemic, loperamide abuse and ensuing life-threatening toxicity have surfaced.

Hypothesis: The timing and duration of Torsades de Pointes (TdP) from loperamide toxicity is unpredictable and should be heeded with caution, even in asymptomatic patients and drug discontinuance.

Methods: Two patients presenting with life-threatening TdP requiring lengthy hospital admissions for confirmed loperamide toxicity are discussed. Patient data were retrieved from the hospital’s EMR system.

Loperamide-Induced Torsades De Pointes: A Case Series (Poster)., Kenneth D. Katz Md, Robert D. Cannon Do, Matthew D. Cook Do, Alexandra Amaducci, Ryan Day, Joshua Enyart Do, Glenn Burket, Jennifer Janssen Ms, Karl E. Williams Md, Mph

Department of Emergency Medicine

No abstract provided.

Gender Disparity In Clinical Trials: Research Professionals’ Perspective Regarding Their Own Female Patient's Barriers, V1, 2015, Anita Kurt Phd, Rn, Lauren Semler Ms, Matthew Meyers Bs, Samantha Myles Rn, Bernadette Glenn-Porter Bs, Tyler Adams Bs, Micaela Wilson Ba, Jeanne L. Jacoby Md, John C. Smulian Md, Mph

Department of Emergency Medicine

No abstract provided.

Development Of A Health Care Systems Curriculum., Zachary Pruitt, Rahul Mhaskar, Bryan G. Kane Md, Robert D. Barraco Md, Mph, Deborah J Dewaay, Alexander M. Rosenau Do, Kristin A. Bresnan Md, Marna R. Greenberg Do, Mph, Facep

Department of Emergency Medicine

Background: There is currently no gold standard for delivery of systems-based practice in medical education, and it is challenging to incorporate into medical education. Health systems competence requires physicians to understand patient care within the broader health care system and is vital to improving the quality of care clinicians provide. We describe a health systems curriculum that utilizes problem-based learning across 4 years of systems-based practice medical education at a single institution.

Methods: This case study describes the application of a problem-based learning approach to system-based practice medical education. A series of behavioral statements, called entrustable professional activities, was created …