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Emergency Medicine Commons™

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2023

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Articles 91 - 120 of 314

Full-Text Articles in Emergency Medicine

Previous Health Care Experiences’ Influence On Health Care Perceptions Among Residents In Six Homeless Shelters In Seattle, Washington, July–October 2021, Ashley A. Meehan, Sarah N. Cox, Nicholas B. Thuo, Julia H. Rogers, Amy C. Link, Miguel A. Martinez, Natalie K. Lo, Brian J. Manns, Melissa A. Rolfes, Eric J. Chow, Helen Y. Chu, Emily Mosites, Morhaf Al Achkar Jul 2023

Previous Health Care Experiences’ Influence On Health Care Perceptions Among Residents In Six Homeless Shelters In Seattle, Washington, July–October 2021, Ashley A. Meehan, Sarah N. Cox, Nicholas B. Thuo, Julia H. Rogers, Amy C. Link, Miguel A. Martinez, Natalie K. Lo, Brian J. Manns, Melissa A. Rolfes, Eric J. Chow, Helen Y. Chu, Emily Mosites, Morhaf Al Achkar

Journal of Patient-Centered Research and Reviews

Purpose: The study purpose was to learn and describe 1) where homeless shelter residents receive health care, 2) what contributes to positive or negative health care experiences among shelter residents, and 3) shelter resident perceptions toward health care.

Methods: Semi-structured interviews (SSIs) utilizing purposive sampling and focus group discussions (FGDs) utilizing convenience sampling were conducted at 6 homeless shelters in Seattle-King County, Washington, during July–October 2021. All residents (age ≥ 18) were eligible to participate. SSIs were conducted with 25 residents, and 8 FGDs were held. Thematic analysis was conducted using Dedoose.

Results: Participants received health care …


Long Covid Clinical Phenotypes Up To 6 Months After Infection Identified By Latent Class Analysis Of Self-Reported Symptoms, Michael Gottlieb, Erica S. Spatz, Huihui Yu, Lauren E Wisk, Joann G. Elmore, Nicole L. Gentile, Mandy Hill, Ryan M. Huebinger, Ahamed H. Idris, Efrat M. Kean, Katherine Koo, Shu-Xia Li, Samuel Mcdonald, Juan Carlos C Montoy, Graham Nichol, Kelli N. O'Laughlin, Ian D. Plumb, Kristin L. Rising, Michelle Santangelo, Sharon Saydah, Ralph C. Wang, Arjun Venkatesh, Kari A. Stephens, Robert A. Weinstein Jul 2023

Long Covid Clinical Phenotypes Up To 6 Months After Infection Identified By Latent Class Analysis Of Self-Reported Symptoms, Michael Gottlieb, Erica S. Spatz, Huihui Yu, Lauren E Wisk, Joann G. Elmore, Nicole L. Gentile, Mandy Hill, Ryan M. Huebinger, Ahamed H. Idris, Efrat M. Kean, Katherine Koo, Shu-Xia Li, Samuel Mcdonald, Juan Carlos C Montoy, Graham Nichol, Kelli N. O'Laughlin, Ian D. Plumb, Kristin L. Rising, Michelle Santangelo, Sharon Saydah, Ralph C. Wang, Arjun Venkatesh, Kari A. Stephens, Robert A. Weinstein

Department of Emergency Medicine Faculty Papers

BACKGROUND: The prevalence, incidence, and interrelationships of persistent symptoms after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection vary. There are limited data on specific phenotypes of persistent symptoms. Using latent class analysis (LCA) modeling, we sought to identify whether specific phenotypes of COVID-19 were present 3 months and 6 months post-infection.

METHODS: This was a multicenter study of symptomatic adults tested for SARS-CoV-2 with prospectively collected data on general symptoms and fatigue-related symptoms up to 6 months postdiagnosis. Using LCA, we identified symptomatically homogenous groups among COVID-positive and COVID-negative participants at each time period for both general and fatigue-related …


A Clinical Review Of Antibiotic Therapy Versus Appendectomy For Treatment Of Acute Uncomplicated Appendicitis, Taylor Mcclard Jul 2023

A Clinical Review Of Antibiotic Therapy Versus Appendectomy For Treatment Of Acute Uncomplicated Appendicitis, Taylor Mcclard

SIU Journal of Medical Science Scholarly Works

Purpose: The purpose of this manuscript is to review the efficacy of antibiotic therapy in the treatment of acute uncomplicated appendicitis versus standard appendectomy.

Method: A PubMed literature search was conducted with keywords of acute appendicitis, antibiotics, and appendectomy. The publication date was limited to the last five years. Sample size less than 100 people, patient population less than five years of age, and articles examining only acute complicated appendicitis were excluded. Pertinent articles reviewing the efficacy of antibiotics compared to appendectomy serve as the basis for this clinical review.

Results: Antibiotic therapy alone could be a …


Oxygen Therapy Education To Improve Oxygen Safety In The Emergency Department: A Quality Improvement Project, Latania Wolfe Jul 2023

Oxygen Therapy Education To Improve Oxygen Safety In The Emergency Department: A Quality Improvement Project, Latania Wolfe

DNP Projects

Background and Significance: Oxygen is often administered in emergency departments (ED) in US without the nurses and other healthcare staff inputting orders for this medication. This gap in placing orders poses a risk to patient safety and poses a regulation issue.

Purpose: The goal of this quality improvement project is to increase the rate of orders placed for patients using oxygen in ED staff by 12% from March 1, 2023 to May 31, 2023.

Methods: The Model for Improvement guided this quality improvement project. Two PDSA cycles were completed.

Results: PDSA #1 Completed SWOT analysis and used information to …


Implementation Of A Patient Care Specialist Role To Enhance The Patient Experience In A Pediatric Emergency Department, Jillian Brodeur Jul 2023

Implementation Of A Patient Care Specialist Role To Enhance The Patient Experience In A Pediatric Emergency Department, Jillian Brodeur

Doctor of Nursing Practice Projects

Background: Patient-centered care (PCC) has been an emerging trend in healthcare for the past two decades (Walsh et al., 2022). PCC and the patient experience have become essential measures of the quality of care provided and are linked to reimbursement dollars and improved patient outcomes (Rapport et al., 2019).

Purpose: The purpose of the Doctor of Nursing Practice (DNP) project was to improve the patient experience in the Emergency Department (ED) of a metropolitan hospital. The DNP project focused on the benefit of a patient advocate in the ED to improve the patient experience. The project sought to improve …


Satisfaction Of Older Patients With Emergency Department Care: Psychometric Properties And Construct Validity Of The Consumer Emergency Care Satisfaction Scale, Peter L T Hoonakker, Pascale Carayon, Roger L Brown, Rebecca Schwei, Rebecca K Green, Mackenzie Rabas, Ly Hoang, Kathryn L Wust, Rachel Rutkowski, Megan E Salwei, Hanna J Barton, Manish N Shah, Michael S Pulia, Brian W Patterson, Paula V W Dail, Sheryl Krause, Denise Buckley, Jennifer Hankwitz, Nicole E Werner Jul 2023

Satisfaction Of Older Patients With Emergency Department Care: Psychometric Properties And Construct Validity Of The Consumer Emergency Care Satisfaction Scale, Peter L T Hoonakker, Pascale Carayon, Roger L Brown, Rebecca Schwei, Rebecca K Green, Mackenzie Rabas, Ly Hoang, Kathryn L Wust, Rachel Rutkowski, Megan E Salwei, Hanna J Barton, Manish N Shah, Michael S Pulia, Brian W Patterson, Paula V W Dail, Sheryl Krause, Denise Buckley, Jennifer Hankwitz, Nicole E Werner

Faculty, Staff and Student Publications

BACKGROUND: Patient satisfaction is an important indicator of quality of care, but its measurement remains challenging. The Consumer Emergency Care Satisfaction Scale (CECSS) was developed to measure patient satisfaction in the emergency department (ED). Although this is a valid and reliable tool, several aspects of the CECSS need to be improved, including the definition, dimension, and scoring of scales.

PURPOSE: The purpose of this study was to examine the construct validity of the CECSS and make suggestions on how to improve the tool to measure overall satisfaction with ED care.

METHODS: We administered 2 surveys to older adults who presented …


Association Between Sars-Cov-2 Variants And Frequency Of Acute Symptoms: Analysis Of A Multi-Institutional Prospective Cohort Study-December 20, 2020-June 20, 2022., Ralph C, Wang, Michael Gottlieb, Juan Carlos C. Montoy, Robert M. Rodriguez, Huihui Yu, Erica S. Spatz, Christopher W. Chandler, Joann G. Elmore, Paavali A. Hannikainen, Anna Marie Chang, Mandy Hill, Ryan M. Huebinger, Ahamed H. Idris, Katherine Koo, Shu-Xia Li, Samuel Mcdonald, Graham Nichol, Kelli N. O'Laughlin, Ian D. Plumb, Michelle Santangelo, Sharon Saydah, Kari A. Stephens, Arjun K. Venkatesh, Robert A. Weinstein Jul 2023

Association Between Sars-Cov-2 Variants And Frequency Of Acute Symptoms: Analysis Of A Multi-Institutional Prospective Cohort Study-December 20, 2020-June 20, 2022., Ralph C, Wang, Michael Gottlieb, Juan Carlos C. Montoy, Robert M. Rodriguez, Huihui Yu, Erica S. Spatz, Christopher W. Chandler, Joann G. Elmore, Paavali A. Hannikainen, Anna Marie Chang, Mandy Hill, Ryan M. Huebinger, Ahamed H. Idris, Katherine Koo, Shu-Xia Li, Samuel Mcdonald, Graham Nichol, Kelli N. O'Laughlin, Ian D. Plumb, Michelle Santangelo, Sharon Saydah, Kari A. Stephens, Arjun K. Venkatesh, Robert A. Weinstein

Department of Emergency Medicine Faculty Papers

Background: While prior work examining severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern focused on hospitalization and death, less is known about differences in clinical presentation. We compared the prevalence of acute symptoms across pre-Delta, Delta, and Omicron.

Methods: We conducted an analysis of the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE), a cohort study enrolling symptomatic SARS-CoV-2-positive participants. We determined the association between the pre-Delta, Delta, and Omicron time periods and the prevalence of 21 coronavirus disease 2019 (COVID-19) acute symptoms.

Results: We enrolled 4113 participants from December 2020 to June 2022. Pre-Delta vs Delta …


Achieving Equity In Emergency Medicine Quality Measures Requires A Sex And Gender Lens, Ynhi T Thomas, Angela F Jarman, Nina G Faynshtayn, Greg B Buehler, Sara Andrabi, Alyson J Mcgregor Jul 2023

Achieving Equity In Emergency Medicine Quality Measures Requires A Sex And Gender Lens, Ynhi T Thomas, Angela F Jarman, Nina G Faynshtayn, Greg B Buehler, Sara Andrabi, Alyson J Mcgregor

Faculty, Staff and Students Publications

BACKGROUND: Quality measures within Emergency Medicine (EM) were developed to standardize and improve care. Their development has been limited by lack of consideration of sex- and gender-based differences. Research has suggested that sex and gender can impact clinical care and treatment. Inclusion of sex and gender differences is needed to create EM quality measures that are equitable to all.

OBJECTIVE: The aim of the review is to provide a brief history of EM quality measures and the value of considering sex- and gender-based evidence in their development to ensure equity, using acute myocardial infarction (AMI) as an example.

DISCUSSION: Current …


Rethinking Resilience Using The R-Factor: Neurobiological Mechanisms Of Static And Dynamic Components Of Resilience Following Trauma, Sanne Van Rooij, Justin Santos, Cecilia A. Hinojosa, Timothy Ely, Nathaniel Harnett, Vishnu P. Murty, Lauren Lebois, Tanja Jovanovic, Stacey House, Robert A. Swor Jun 2023

Rethinking Resilience Using The R-Factor: Neurobiological Mechanisms Of Static And Dynamic Components Of Resilience Following Trauma, Sanne Van Rooij, Justin Santos, Cecilia A. Hinojosa, Timothy Ely, Nathaniel Harnett, Vishnu P. Murty, Lauren Lebois, Tanja Jovanovic, Stacey House, Robert A. Swor

Articles

Resilience is a dynamic process of recovery after trauma, but in most studies it is conceptualized as the absence of specific psychopathology following trauma. Using the large emergency department AURORA study (n=1,865, 63% women), we took a longitudinal, dynamic and transdiagnostic approach to define a static resilience (r) factor, that could explain >50% of variance in mental wellbeing 6-months following trauma, and a dynamic r-factor, which represented recovery from initial symptoms. We assessed its neurobiological profile across threat, inhibition, and reward processes using fMRI collected 2-weeks post-trauma. Our neuroimaging results suggest that resilience is promoted by activation of higher-level cognitive …


Geriatric Emergency Medicine Fellowship Journal Club: Screening For High-Risk Alcohol Use Among Older Adults In The Emergency Department, Kira Gossack-Keenan Jun 2023

Geriatric Emergency Medicine Fellowship Journal Club: Screening For High-Risk Alcohol Use Among Older Adults In The Emergency Department, Kira Gossack-Keenan

Journal of Geriatric Emergency Medicine

Alcohol use in older adults is a growing and under-recognized issue. Older adults are at higher risk of alcohol-related complications due to underlying comorbidities, frailty, and polypharmacy. High-risk alcohol use and alcohol use disorder (AUD) are often missed among older patients. We present two recent studies on screening older patients for alcohol use. Older adults have unique needs and require a specialized approach to screening.


Patient Experience After Geriatric Emergency Medicine Assessment, Jessica Kuxhause, Natalie Liogas, Sarah Keene, Rebecca Fisher, Lauren Cameron Comasco Jun 2023

Patient Experience After Geriatric Emergency Medicine Assessment, Jessica Kuxhause, Natalie Liogas, Sarah Keene, Rebecca Fisher, Lauren Cameron Comasco

Journal of Geriatric Emergency Medicine

Study Objectives

The geriatric population is increasing in size and expected to represent 20% of the United States population by 2030 per US census data estimates, with expectant increase in geriatric emergency department (ED) visits.1 Prior research has demonstrated older adults evaluated in the ED are more likely to have an increased length of stay, more diagnostic tests, and higher overall costs than their younger counterparts, but despite consuming greater resources and staff time, older adults are still more likely to be dissatisfied with their treatment outcomes and less likely to feel that their presenting complaint has been resolved. …


Shared Disposition Decision Making In The Emergency Department For Persons Living With Dementia, Justine Seidenfeld, Fernanda Bellolio, Anita Vashi, Courtney Van Houtven, Susan Hastings Jun 2023

Shared Disposition Decision Making In The Emergency Department For Persons Living With Dementia, Justine Seidenfeld, Fernanda Bellolio, Anita Vashi, Courtney Van Houtven, Susan Hastings

Journal of Geriatric Emergency Medicine

N/A


Comparative Outcomes Of Interventions For Femoropopliteal Chronic Total Occlusion Versus Non-Chronic Total Occlusion Lesions From The Multicenter Xlpad Registry, Shirling Tsai, Yulun Liu, Lawrence Hoang, Michael Vu, Hua Lu, Bala Ramanan, David Fernandez Vazquez, Zachary Rosol, Sameh Sayfo, Mohamad Amer Alaiti, Panagiotis Koutakis, Emmanouil S Brilakis, Mehdi H Shishehbor, Subhash Banerjee Jun 2023

Comparative Outcomes Of Interventions For Femoropopliteal Chronic Total Occlusion Versus Non-Chronic Total Occlusion Lesions From The Multicenter Xlpad Registry, Shirling Tsai, Yulun Liu, Lawrence Hoang, Michael Vu, Hua Lu, Bala Ramanan, David Fernandez Vazquez, Zachary Rosol, Sameh Sayfo, Mohamad Amer Alaiti, Panagiotis Koutakis, Emmanouil S Brilakis, Mehdi H Shishehbor, Subhash Banerjee

Faculty, Staff and Student Publications

Background Endovascular intervention of femoropopliteal chronic total occlusions (CTOs) is technically more complex. However, there is lack of comparative analysis between CTO and non-CTO femoropopliteal interventions. Methods and Results We report procedural details and outcomes of patients treated for femoropopliteal CTO and non-CTO lesions in the XLPAD (Excellence in Peripheral Artery Disease) registry (NCT01904851) between 2006 and 2019. Primary outcomes were procedural success and 1-year major adverse limb events, a composite of all-cause death, target limb revascularization, or major amputation. Analysis included 2895 patients (CTO: n=1516 patients; non-CTO: n=1379 patients) with 3658 lesions (CTO: n=1998 lesions; non-CTO: n=1660 lesions). Conventional …


Current Best Practice In Pelvic And Hip Fracture Management In The Older Adult Population, Anthony P. Joseph Jun 2023

Current Best Practice In Pelvic And Hip Fracture Management In The Older Adult Population, Anthony P. Joseph

Journal of Geriatric Emergency Medicine

Fractures of the pelvis and hip are a relatively frequent occurrence in the older population. Pelvic fractures in older patients usually occur after a fall from standing height. CT scan is the investigation of choice. There are several classifications available which are useful in risk stratification and predicting surgical treatment. Haemorrhage is a major complication and can usually be treated by interventional radiology. An Orthopedic opinion should be sought promptly, and surgical stabilisation (if indicated) should be completed as early as possible to enable early mobilisation and the avoidance of complications such as deep vein thrombosis or pneumonia.

Hip fractures …


Top 10 Things To Know About Falls In Older Adults, Alexander W. Zirulnik, Shan Liu Jun 2023

Top 10 Things To Know About Falls In Older Adults, Alexander W. Zirulnik, Shan Liu

Journal of Geriatric Emergency Medicine

No abstract provided.


Geriatric Trauma Triage - The Scope Of The Problem, Mya Cubitt, Rachel Key Jun 2023

Geriatric Trauma Triage - The Scope Of The Problem, Mya Cubitt, Rachel Key

Journal of Geriatric Emergency Medicine

n/a


Patiromer Utility As An Adjunct Treatment In Patients Needing Urgent Hyperkalaemia Management (Platinum): Design Of A Multicentre, Randomised, Double-Blind, Placebo-Controlled, Parallel-Group Study, Zubaid Rafique, Jeffrey Budden, Carol Moreno Quinn, Youyou Duanmu, Basmah Safdar, Jason J Bischof, Brian E Driver, Charles A Herzog, Matthew R Weir, Adam J Singer, Stephen Boone, Karina M Soto-Ruiz, W Frank Peacock Jun 2023

Patiromer Utility As An Adjunct Treatment In Patients Needing Urgent Hyperkalaemia Management (Platinum): Design Of A Multicentre, Randomised, Double-Blind, Placebo-Controlled, Parallel-Group Study, Zubaid Rafique, Jeffrey Budden, Carol Moreno Quinn, Youyou Duanmu, Basmah Safdar, Jason J Bischof, Brian E Driver, Charles A Herzog, Matthew R Weir, Adam J Singer, Stephen Boone, Karina M Soto-Ruiz, W Frank Peacock

Faculty, Staff and Students Publications

INTRODUCTION: Hyperkalaemia is common, life-threatening and often requires emergency department (ED) management; however, no standardised ED treatment protocol exists. Common treatments transiently reducing serum potassium (K

METHODS AND ANALYSIS: PLATINUM is a Phase 4, multicentre, randomised, double-blind, placebo-controlled study in participants who present to the ED at approximately 30 US sites. Approximately 300 adult participants with hyperkalaemia (K

ETHICS AND DISSEMINATION: A central Institutional Review Board (IRB) and Ethics Committee provided protocol approval (#20201569), with subsequent approval by local IRBs at each site, and participants will provide written consent. Primary results will be published in peer-reviewed manuscripts promptly following study …


Preparation And Immunofluorescence Staining Of Bundles And Single Fiber Cells From The Cortex And Nucleus Of The Eye Lens, Michael P Vu, Catherine Cheng Jun 2023

Preparation And Immunofluorescence Staining Of Bundles And Single Fiber Cells From The Cortex And Nucleus Of The Eye Lens, Michael P Vu, Catherine Cheng

Faculty, Staff and Student Publications

The lens is a transparent and ellipsoid organ in the anterior chamber of the eye that changes shape to finely focus light onto the retina to form a clear image. The bulk of this tissue comprises specialized, differentiated fiber cells that have a hexagonal cross section and extend from the anterior to the posterior poles of the lens. These long and skinny cells are tightly opposed to neighboring cells and have complex interdigitations along the length of the cell. The specialized interlocking structures are required for normal biomechanical properties of the lens and have been extensively described using electron microscopy …


End-Of-Life Care In The Trauma Bay: Six Key Points, Louis Christie Dr Jun 2023

End-Of-Life Care In The Trauma Bay: Six Key Points, Louis Christie Dr

Journal of Geriatric Emergency Medicine

The dominant culture across North America, Europe and Australia has been characterized by workers in hospice and palliative care as ‘death denying’ or ‘death phobic’. The last two decades have seen a significant increase in the number of trauma patients with complex background co-morbidities due to advanced age. Effective end-of-life care in trauma requires physicians to begin careful, balanced and sensitive conversations encompassing goals of care and expectation-setting, in the trauma bay. These pointers will help the reader communicate the principles of these clinical decisions clearly to patients and their families.


Using Medicare Claims To Estimate Risk-Adjusted Performance Of Pennsylvania Trauma Centers, Alexis M Zebrowski, Phillipe Loher, David G Buckler, Isidore Rigoutsos, Brendan G Carr, Douglas J Wiebe Jun 2023

Using Medicare Claims To Estimate Risk-Adjusted Performance Of Pennsylvania Trauma Centers, Alexis M Zebrowski, Phillipe Loher, David G Buckler, Isidore Rigoutsos, Brendan G Carr, Douglas J Wiebe

Computational Medicine Center Faculty Papers

Trauma centers use registry data to benchmark performance using a standardized risk adjustment model. Our objective was to utilize national claims to develop a risk adjustment model applicable across all hospitals, regardless of designation or registry participation. Patients from 2013-14 Pennsylvania Trauma Outcomes Study (PTOS) registry data were probabilistically matched to Medicare claims using demographic and injury characteristics. Pairwise comparisons established facility linkages and matching was then repeated within facilities to link records. Registry models were estimated using GLM and compared with five claims-based LASSO models: demographics, clinical characteristics, diagnosis codes, procedures codes, and combined demographics/clinical characteristics. Area under the …


Reduced Heart Failure-Related Healthcare Costs With Furoscix Versus In-Hospital Intravenous Diuresis In Heart Failure Patients: The Freedom-Hf Study, Daniel Bensimhon, William S. Weintraub, William Frank Peacock, Tamas Alexy, Dalton Mclean, Donald C. Haas, Kathleen L. Deering, Stefanie J. Millar, Matthew M. Goodwin, John F. Mohr Jun 2023

Reduced Heart Failure-Related Healthcare Costs With Furoscix Versus In-Hospital Intravenous Diuresis In Heart Failure Patients: The Freedom-Hf Study, Daniel Bensimhon, William S. Weintraub, William Frank Peacock, Tamas Alexy, Dalton Mclean, Donald C. Haas, Kathleen L. Deering, Stefanie J. Millar, Matthew M. Goodwin, John F. Mohr

Abington Jefferson Health Papers

Aim: Compare heart failure (HF) costs of Furoscix use at home compared with inpatient intravenous (IV) diuresis.

Patients & methods: Prospective, case control study of chronic HF patients presenting to emergency department (ED) with worsening congestion discharged to receive Furoscix 80 mg/10 ml 5-h subcutaneous infusion for ≤7 days. 30-day HF-related costs in Furoscix group derived from commercial claims database compared with matched historical patients hospitalized for <72 h.

Results: Of 24 Furoscix patients, 1 (4.2%) was hospitalized in 30-day period. 66 control patients identified and were well-matched for age, sex, ejection fraction (EF), renal function and other comorbidities. Furoscix patients had …


Head Injury In Older Adults: To Scan Or Not To Scan? Ten Tips To Make The Best Decision, Audrey-Anne Brousseau, Éric Mercier Jun 2023

Head Injury In Older Adults: To Scan Or Not To Scan? Ten Tips To Make The Best Decision, Audrey-Anne Brousseau, Éric Mercier

Journal of Geriatric Emergency Medicine

Ground-level falls are a leading cause of emergency department (ED) visits by older adults. In addition to understanding the cause of the fall, the assessment of potential fall-induced injuries such as traumatic intracranial hemorrhage, can be highly challenging for emergency clinicians. Premorbid conditions, medications and concomitant injuries can all interfere with the physical examination and impact the prevalence of signs traditionally associated with traumatic brain injury (TBI). When it comes to the decision to potentially investigate for a traumatic intracranial hemorrhage with a brain imaging such as a head computed tomography (CT), many potential predictors and factors will be considered. …


Older Person Fracture Presentation And Management Including Tips For Pain Management, Timothy D W Arnold Jun 2023

Older Person Fracture Presentation And Management Including Tips For Pain Management, Timothy D W Arnold

Journal of Geriatric Emergency Medicine

Fractures in older adults occur in patients who commonly carry chronic, complex multi-system disease. Nuanced management for these injuries is required in this patient group to reduce mortality, morbidity and improve outcomes.


Differential Effects Of An Ed-To-Home Care Transitions Intervention In An Older Adult Population: A Latent Class Analysis, Rebecca K Green, Kenneth J Nieser, Gwen C Jacobsohn, Amy L Cochran, Thomas V Caprio, Jeremy T Cushman, Amy J H Kind, Michael Lohmeier, Manish N Shah Jun 2023

Differential Effects Of An Ed-To-Home Care Transitions Intervention In An Older Adult Population: A Latent Class Analysis, Rebecca K Green, Kenneth J Nieser, Gwen C Jacobsohn, Amy L Cochran, Thomas V Caprio, Jeremy T Cushman, Amy J H Kind, Michael Lohmeier, Manish N Shah

Faculty, Staff and Student Publications

BACKGROUND: Older adults frequently return to the emergency department (ED) within 30 days of a visit. High-risk patients can differentially benefit from transitional care interventions. Latent class analysis (LCA) is a model-based method used to segment the population and test intervention effects by subgroup.

OBJECTIVES: We aimed to identify latent classes within an older adult population from a randomized controlled trial evaluating the effectiveness of an ED-to-home transitional care program and test whether class membership modified the intervention effect.

RESEARCH DESIGN: Participants were randomized to receive the Care Transitions Intervention or usual care. Study staff collected outcomes data through medical …


Artificial Intelligence Cad Tools In Trauma Imaging: A Scoping Review From The American Society Of Emergency Radiology (Aser) Ai/Ml Expert Panel, David Dreizin, Pedro V Staziaki, Garvit D Khatri, Nicholas M Beckmann, Zhaoyong Feng, Yuanyuan Liang, Zachary S Delproposto, Maximiliano Klug, J Stephen Spann, Nathan Sarkar, Yunting Fu Jun 2023

Artificial Intelligence Cad Tools In Trauma Imaging: A Scoping Review From The American Society Of Emergency Radiology (Aser) Ai/Ml Expert Panel, David Dreizin, Pedro V Staziaki, Garvit D Khatri, Nicholas M Beckmann, Zhaoyong Feng, Yuanyuan Liang, Zachary S Delproposto, Maximiliano Klug, J Stephen Spann, Nathan Sarkar, Yunting Fu

Faculty, Staff and Student Publications

BACKGROUND: AI/ML CAD tools can potentially improve outcomes in the high-stakes, high-volume model of trauma radiology. No prior scoping review has been undertaken to comprehensively assess tools in this subspecialty.

PURPOSE: To map the evolution and current state of trauma radiology CAD tools along key dimensions of technology readiness.

METHODS: Following a search of databases, abstract screening, and full-text document review, CAD tool maturity was charted using elements of data curation, performance validation, outcomes research, explainability, user acceptance, and funding patterns. Descriptive statistics were used to illustrate key trends.

RESULTS: A total of 4052 records were screened, and 233 full-text …


Coronary Artery Disease As An Independent Predictor Of Cardiovascular Mortality In Covid-19 Patients, Hywel Soney, Nathan Deron, Lucas Wang, Lawrence Hoang, Mujahed Abualfoul, Yi Zhao, Kristopher Aten, Victor Canela, Sri Prathivada, Michael Vu, Manavjot Sidhu Jun 2023

Coronary Artery Disease As An Independent Predictor Of Cardiovascular Mortality In Covid-19 Patients, Hywel Soney, Nathan Deron, Lucas Wang, Lawrence Hoang, Mujahed Abualfoul, Yi Zhao, Kristopher Aten, Victor Canela, Sri Prathivada, Michael Vu, Manavjot Sidhu

Faculty, Staff and Student Publications

BACKGROUND: Coronavirus disease 2019 (COVID-19) is associated with increased risk of cardiovascular mortality. However, little is known about the combined effect of coronary artery disease (CAD) and COVID-19 on mortality. We aimed to investigate the incidence of cardiovascular and all-cause mortality in COVID-19 patients with CAD.

METHODS: This multicenter retrospective study identified 3,336 COVID-19 patients admitted between March and December 2020. Data points were manually reviewed in the patients' electronic health records. Multivariate logistic regression was used to assess whether CAD and its subtypes were associated with mortality.

RESULTS: This study shows that CAD was not an independent predictor of …


Sedation And Analgesia For Reduction Of Pediatric Ileocolic Intussusception, Naveen Poonai, Daniel M Cohen, Doug Macdowell, Rakesh D Mistry, Santiago Mintegi, Simon Craig, Damian Roland, Michael Miller, Itai Shavit, Paediatric Emergency Research Networks (Pern) Paint Study Group;, Yvette Wang, Alan Nager, Theodore Heyming, Rebekah Burns, Indi Trehan, Matthew Lipshaw, Carmen Sulton, Joyce Li, Aderonke Ojo, Susan Kelly, Matthew Thornton, Kerry Caperell, Iluonose Amoni, Anna Abrams, Myto Duong, Muhammad Wassem, Adrienne Davis, Jocelyn Gravel, Evelyne Doyon Trottier, Neta Bar Am, Graham Thompson, Vikram Sabhaney, Garth Meckler, Rini Jain, Samina Ali, Silvia Bressan, Tiziana Zangardi, Giovanna Villa, Martina Giacalone, Michelle Seiler, Cyril Sahyoun, Fabrizio Romano, Zsolt Bognar, Szofia Hajosi-Kalcakosz, Lisa Amir, Said Hachimi-Idrissi, Zanda Pucuka, Astra Zviedre, Emilija Zeltina, Natalie Phillips, Meredith Borland, Sharon O'Brien, Jeanette Marchant, Amit Kochar, Shane George, Victoria Pennington, Mark Lyttle, Jen Browning, Anna Mcloughlin, Stuart Hartshorn, Chaman Urooj, Lucy Johnston, Emily Walton, Deepika Subrahmanyam Puthucode, Phil Peacock, James Conroy, Rafael Marañon, Silvia Garcia, Nuria Cahís, Amaia Cámara-Otegui, Arantxa Gomez, Maria Carbonero, Carlos Angelats-Romero, Adriana Yock-Corrales, Gabriela Hualde, Fabian Spigariol, Alex Donas, Cinthia Gübeli Linné, Alessia Rocchi, Alessia Pedrazzini, Giorgio Cozzi, Dino Barbi, Laura Baggio, Giovana La Fauci, Angela Mauro, Matthew Steimle, Danilo Buonsenso, Irma Ugalde, Gaby Nieva, Charlotte Harper, Idanna Sforzi, Shobhit Jain Jun 2023

Sedation And Analgesia For Reduction Of Pediatric Ileocolic Intussusception, Naveen Poonai, Daniel M Cohen, Doug Macdowell, Rakesh D Mistry, Santiago Mintegi, Simon Craig, Damian Roland, Michael Miller, Itai Shavit, Paediatric Emergency Research Networks (Pern) Paint Study Group;, Yvette Wang, Alan Nager, Theodore Heyming, Rebekah Burns, Indi Trehan, Matthew Lipshaw, Carmen Sulton, Joyce Li, Aderonke Ojo, Susan Kelly, Matthew Thornton, Kerry Caperell, Iluonose Amoni, Anna Abrams, Myto Duong, Muhammad Wassem, Adrienne Davis, Jocelyn Gravel, Evelyne Doyon Trottier, Neta Bar Am, Graham Thompson, Vikram Sabhaney, Garth Meckler, Rini Jain, Samina Ali, Silvia Bressan, Tiziana Zangardi, Giovanna Villa, Martina Giacalone, Michelle Seiler, Cyril Sahyoun, Fabrizio Romano, Zsolt Bognar, Szofia Hajosi-Kalcakosz, Lisa Amir, Said Hachimi-Idrissi, Zanda Pucuka, Astra Zviedre, Emilija Zeltina, Natalie Phillips, Meredith Borland, Sharon O'Brien, Jeanette Marchant, Amit Kochar, Shane George, Victoria Pennington, Mark Lyttle, Jen Browning, Anna Mcloughlin, Stuart Hartshorn, Chaman Urooj, Lucy Johnston, Emily Walton, Deepika Subrahmanyam Puthucode, Phil Peacock, James Conroy, Rafael Marañon, Silvia Garcia, Nuria Cahís, Amaia Cámara-Otegui, Arantxa Gomez, Maria Carbonero, Carlos Angelats-Romero, Adriana Yock-Corrales, Gabriela Hualde, Fabian Spigariol, Alex Donas, Cinthia Gübeli Linné, Alessia Rocchi, Alessia Pedrazzini, Giorgio Cozzi, Dino Barbi, Laura Baggio, Giovana La Fauci, Angela Mauro, Matthew Steimle, Danilo Buonsenso, Irma Ugalde, Gaby Nieva, Charlotte Harper, Idanna Sforzi, Shobhit Jain

Faculty, Staff and Student Publications

IMPORTANCE: Ileocolic intussusception is an important cause of intestinal obstruction in children. Reduction of ileocolic intussusception using air or fluid enema is the standard of care. This likely distressing procedure is usually performed without sedation or analgesia, but practice variation exists.

OBJECTIVE: To characterize the prevalence of opioid analgesia and sedation and assess their association with intestinal perforation and failed reduction.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study reviewed medical records of children aged 4 to 48 months with attempted reduction of ileocolic intussusception at 86 pediatric tertiary care institutions in 14 countries from January 2017 to December 2019. Of …


Adult Female With A Painful And Pruritic Lower Extremity Skin Lesion., Chase Silvers, Christopher Lloyd Jun 2023

Adult Female With A Painful And Pruritic Lower Extremity Skin Lesion., Chase Silvers, Christopher Lloyd

Ambulatory and Primary Care Articles

No abstract provided.


The Development Of An Educational Workshop To Reframe And Manage Professional Conflict Via A Sex And Gender Lens, Ynhi T Thomas, Anita N Chary, Michelle I Suh, Mehrnoosh Samaei, Valerie Dobiesz, Annahieta Kalantari, Greg Buehler, Devjani Das, Jeannette Wolfe Jun 2023

The Development Of An Educational Workshop To Reframe And Manage Professional Conflict Via A Sex And Gender Lens, Ynhi T Thomas, Anita N Chary, Michelle I Suh, Mehrnoosh Samaei, Valerie Dobiesz, Annahieta Kalantari, Greg Buehler, Devjani Das, Jeannette Wolfe

Faculty, Staff and Students Publications

BACKGROUND: Conflict is inevitable in the emergency department, and conflict resolution is an essential skill for emergency providers to master. Effective conflict management can optimize patient care and enhance professional satisfaction. To communicate effectively in high-stress, high-impact situations, sex- and gender-based differences need to be considered.

METHODS: Nine resident, fellow, junior, and senior faculty members of the Academy for Women in Academic Emergency Medicine collaborated to design a 4-h workshop. The focus was on professional communication and conflict resolution in emergency medicine (EM), with special attention on how sex and gender can influence these processes.

RESULTS: The final educational workshop …


Beyond Diversity And Inclusion: Developing A Research Agenda For Anti-Racism In Emergency Medicine Education, Edgardo Ordonez, Cassandra Bradby, Jennifer Carey, Sanjey Gupta, Katherine M Hiller, Danielle Miller, Ava Pierce, Kathryn Wiesendanger, Shannon Moffett Jun 2023

Beyond Diversity And Inclusion: Developing A Research Agenda For Anti-Racism In Emergency Medicine Education, Edgardo Ordonez, Cassandra Bradby, Jennifer Carey, Sanjey Gupta, Katherine M Hiller, Danielle Miller, Ava Pierce, Kathryn Wiesendanger, Shannon Moffett

Faculty, Staff and Students Publications

BACKGROUND: Addressing racism in emergency medicine education is vital for providing optimal training and assessment of physicians in the specialty, developing physicians with the skills necessary to advocate for their patients, and recruiting and retaining a diverse group of physicians. To form a prioritized research agenda, the Society of Academic Emergency Medicine (SAEM) conducted a consensus conference at the annual meeting in May 2022 on addressing racism in emergency medicine, which included a subgroup on education.

METHODS: The education workgroup worked on summarizing the current literature on addressing racism in emergency medicine education, identifying critical knowledge gaps, and creating a …