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Validation Of The Termination Of Resuscitation Rules In Detroit, Arqam Husain, Adam D. Chalek, Robert Dunne 2022 Wayne State University School Of Medicine

Validation Of The Termination Of Resuscitation Rules In Detroit, Arqam Husain, Adam D. Chalek, Robert Dunne

Medical Student Research Symposium

Introduction: 326,000 patients suffer from an out of hospital cardiac arrest (OHCA) each year. The Termination of Resuscitation (TOR) criteria guides physicians in determining the futility of continuing CPR and transporting patients to the hospital. We examined compliance with current BLS TOR rules and assessed an alternate set of rules to derive improved TOR guidelines for OHCAs in Detroit.

Methods: A retrospective study was conducted utilizing non-traumatic OHCA cases in Detroit from January 1, 2017 to December 31, 2019, which includes time before and after BLS TOR guidelines were implemented. Patients younger than 18 and arrests of traumatic origin ...


Language Preference Impact On The Outcomes Of Those Lost To Follow-Up After A Diagnosis Of Pregnancy Of Unknown Location, Erin A. Leestma, Mayra A. Shafique, Megan McNitt, Annmarie Vilkins 2022 Wayne State University School of Medicine

Language Preference Impact On The Outcomes Of Those Lost To Follow-Up After A Diagnosis Of Pregnancy Of Unknown Location, Erin A. Leestma, Mayra A. Shafique, Megan Mcnitt, Annmarie Vilkins

Medical Student Research Symposium

Pregnancy of unknown location (PUL) is a temporary diagnosis when there is a positive pregnancy test but an intrauterine gestational sac and/or fetal pole are not visualized with ultrasonography. The three potential outcomes for such a pregnancy are failed pregnancy, an early intrauterine pregnancy or an ectopic/abnormal pregnancy. Given the serious associated morbidity of ectopic pregnancy, these PUL require strict follow up of bHCG levels to help the clinician determine the likely outcome of the PUL (failed vs early vs ectopic) and choose the best intervention (expectant management, surgical management or medical management). One potential barrier to follow-up ...


Emergency Medicine Journal Club, Dave M. Gibbs, Dylan Norton, Kyle Barbour 2022 Rochester Regional Health System

Emergency Medicine Journal Club, Dave M. Gibbs, Dylan Norton, Kyle Barbour

Advances in Clinical Medical Research and Healthcare Delivery

In this column, we provide a brief review of important papers recently published that relate to the field of Emergency Medicine. The goal is to provide the busy clinician a bullet-like summary of the study, focusing on the research question, methods, results, limitations and bottom line interpretation.


Hemoglobin As A Predictor For Covid-19 Disease Severity, Nicholas Sarcia, Dan Thai, Andrea M. Bodine MD 2022 University of New England College of Osteopathic Medicine

Hemoglobin As A Predictor For Covid-19 Disease Severity, Nicholas Sarcia, Dan Thai, Andrea M. Bodine Md

Advances in Clinical Medical Research and Healthcare Delivery

Background: The dilemma of who is at highest risk for COVID-19 severe disease and death persists. Hemoglobin levels may be an indicator of COVID-19 disease severity. There is inconsistent data on Emergency Department (ED) hemoglobin levels and severity of disease. Our objective was to examine if COVID-19 patients presenting with abnormal hemoglobin levels have an increased risk of severe disease and in-hospital mortality.

Methods: We conducted a retrospective cohort study at Berkshire Medical Center in Pittsfield, MA to investigate the relationship of COVID-19 disease severity with hemoglobin level. Inclusion criteria consisted of ED patients over 18 years with a COVID-19 ...


Disease Severity In Covid-19 Breakthrough Cases, Dan Thai, Nicholas Sarcia, Andrea M. Bodine MD 2022 University of New England College of Osteopathic Medicine

Disease Severity In Covid-19 Breakthrough Cases, Dan Thai, Nicholas Sarcia, Andrea M. Bodine Md

Advances in Clinical Medical Research and Healthcare Delivery

Background

Vaccine breakthrough is a phenomenon wherein vaccinated individuals become infected with disease despite adequate protection. During this study period, the Centers for Disease Control (CDC) reported 66.6% of US people have been fully vaccinated. Any measures to improve trust would increase vaccination rates. This study aims to understand vaccine breakthrough cases in COVID-19 by comparing their severity to unvaccinated cases. Our objective is to compare disease severity based on the worst initial vital signs (temperature, respiratory rate, oxygen saturation), length of stay (LOS), and age between vaccinated and unvaccinated COVID-19 cases.

Methods

We conducted a retrospective cohort study ...


Implementation Of Delirium Bundle On A Hospital Medical/Surgical Unit To Help Decrease The Prevalence Of Delirium, Sanusi Mohammed 2022 University of Massachusetts Boston

Implementation Of Delirium Bundle On A Hospital Medical/Surgical Unit To Help Decrease The Prevalence Of Delirium, Sanusi Mohammed

Doctor of Nursing Practice Scholarly Projects

Description of the Problem: Delirium is defined as a constellation of symptoms that includes disturbance in attention or awareness, change in cognition, language and perceptual disturbances that develops over a short period of time. Delirium mostly affects adult patients with risk factors including history of dementia, early cognitive impairment, dehydration, and infections. This quality improvement project was implemented on one hospital unit at a large tertiary hospital in the Boston area. This unit has one highest rate of delirium in the entire hospital system. Delirium is associated with high rate of morbidity and mortality. Also, this syndrome leads to longer ...


Strategies To Combat Ageism In Emergency Medicine, Anita N. Chary, Lauren Cameron Comasco, Anita Rohra, Shan Lliu 2022 Baylor College of Medicine

Strategies To Combat Ageism In Emergency Medicine, Anita N. Chary, Lauren Cameron Comasco, Anita Rohra, Shan Lliu

Journal of Geriatric Emergency Medicine

N/a


Factors Affecting Emergency Department Mental Health Visits, Logan Daul 2022 University of South Dakota

Factors Affecting Emergency Department Mental Health Visits, Logan Daul

Honors Thesis

Research has shown that current quantities of emergency department visits for mental health and substance use are increasing at a startling rate. These increases are acknowledged in quantitative studies and some important information can be gathered from qualitative studies however determining specific causes for these emergent visits are difficult. The purpose of this study is to derive findings from statistical analyses focusing on quantities of emergency department visits for mental health and substance use disorders. Comparisons will be drawn at the state level between the per capita quantity of emergency department visits and poverty rate, climate, psychiatric healthcare infrastructure, urban ...


A Puzzling Case Of Normal Pressure Hydrocephalus In The Outpatient Setting, Shadi Shams, Asim Shafique, Marym Khan, James Bailey 2022 Rowan University

A Puzzling Case Of Normal Pressure Hydrocephalus In The Outpatient Setting, Shadi Shams, Asim Shafique, Marym Khan, James Bailey

Stratford Campus Research Day

Normal Pressure Hydrocephalus (NPH) is a disease of adulthood characterized by the triad of gait disturbance, dementia, and urinary incontinence. Since NPH shares a lot of characteristics with other disorders including neurodegenerative disorders and degenerative-dystrophic spine, it is usually underdiagnosed and undertreated. Combination of ventriculomegaly seen on a computerized tomography (CT) scan or magnetic resonance imaging (MRI) with clinical findings could be used in diagnosis of NPH. However, improvement of symptoms post spinal tap procedure would be a better indication of diagnosis. Currently, shunt placement is the best available modality of treatment for NPH. Here we present a case of ...


A Ruptured Mycotic Aortic Aneurysm In A Patient With Urinary Retention: A Case Report., Samantha L. Gaetani MD, Jerome C. Deutsch DO, Mila H. Ju MD 2022 Lehigh Valley Health Network

A Ruptured Mycotic Aortic Aneurysm In A Patient With Urinary Retention: A Case Report., Samantha L. Gaetani Md, Jerome C. Deutsch Do, Mila H. Ju Md

Department of Emergency Medicine

Symptomatic abdominal aortic aneurysm (AAA) is a diagnosis that is a true emergency. Since AAAs are typically asymptomatic prior to rupturing, they can easily be missed. When an abdominal aortic aneurysm becomes symptomatic and ruptures, the ramifications can be catastrophic for the patient. We present a case of a 55-year-old male who presented with urinary retention and suprapubic pain. Computerized tomography demonstrated a rapidly expanding AAA and signs of impending rupture. Emergent vascular surgical repair was performed successfully. There was concern for mycotic nature of the AAA with recent COVID-19 infection and possible bacteremia. This case demonstrates the need for ...


A Review Of The Clinical And Cost Effectiveness Of Intravenous And Intramuscular Pharmacological Treatment On Acute Agitation In Patients Admitted To The Emergency Department, Ryan Ferris, Carol Keller 2022 Providence

A Review Of The Clinical And Cost Effectiveness Of Intravenous And Intramuscular Pharmacological Treatment On Acute Agitation In Patients Admitted To The Emergency Department, Ryan Ferris, Carol Keller

Providence Pharmacy PGY1 Program at Providence Milwaukie and Providence Newberg Medical Centers 2022

No abstract provided.


Enhancing Depression Screening For The Adolescent Population In The Pediatric Emergency Department By Utilizing The Patient Health Questionnaire: A Quality Improvement Project, Chelsea Alvarez 2022 Sacred Heart University

Enhancing Depression Screening For The Adolescent Population In The Pediatric Emergency Department By Utilizing The Patient Health Questionnaire: A Quality Improvement Project, Chelsea Alvarez

DNP Projects

Background:

Mental health disparities make up 16% of the global burden of disease and injury in people ages 10-19. Many cases of mental health are unidentified and left untreated. Failure to address mental health disorders in children can lead to poor outcomes of health and well-being. Evidence-based practice supports the utilization of screening tools such as the Patient Health Questionnaire-9 (PHQ-9) for depression screening in adolescents ages 12-18 years.

Objectives:

By implementing the PHQ-9 in the pediatric emergency department, the goals for this quality improvement project were to increase staff knowledge on the PHQ-9, improve staff screening compliance, and to ...


Decreasing Time To Antibiotic Administration In Febrile Neutropenic Adult Oncology Patients In The Emergency Department: An Evidence-Based Quality Improvement Project, Kristin Murray 2022 Sacred Heart University

Decreasing Time To Antibiotic Administration In Febrile Neutropenic Adult Oncology Patients In The Emergency Department: An Evidence-Based Quality Improvement Project, Kristin Murray

DNP Projects

Introduction—Significance and Background: Febrile Neutropenia (FN) is the most common and serious complication of hematopoietic cancers and in patients receiving chemotherapy. Patients in this immunocompromised state have weakened immunity to fight off infection and a mortality rate of almost 10%. Thus, Infectious Diseases Society of America has identified the single most important determining factor of outcomes is the timing of antibiotic (TTA) administration and has identified the gold standard to be 60 minutes. Current practice does not follow guidelines and the current policy does not address the urgency of antibiotic administration.

Purpose: The purpose of this project is to ...


An Exploration Of Covid-19 Impact On Healthcare Workers’ Mental Health In China, Jenny Yang 2022 Dominican University of California

An Exploration Of Covid-19 Impact On Healthcare Workers’ Mental Health In China, Jenny Yang

Nursing | Senior Theses

Background

In December 2019, the first confirmed human case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 occurred in Wuhan, China. By March 2020, the World Health Organization (WHO) had classified the COVID-19 outbreak as a pandemic due to the rapid spread of the virus to other countries. Many people have been affected by the COVID-19 pandemic in various aspects, especially front-line healthcare workers. Hospital working conditions are constantly changing to cope with the problems that arise from the pandemic. These problems can result in an unsafe patient-to-nurse ratio, understaffed healthcare workers in hospitals, equipment shortage, and increased ...


The Current State Of Diagnostic Error Education In Us Medical Schools, Dakota Hall, Brett R. Todd, Sandra LaBlance 2022 Oakland University William Beaumont School of Medicine Medical Student

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 ...


Analyzing The Effect Of Interview Time And Day On Emergency Medicine Residency Interview Scores, Alanna O'Connell, Sean Greco, Tingting Zhan, Tracy Brader, Megan Crossman, Robin Naples, Anthony Sielicki, Megan Stobart Gallagher, Peter Tomaselli, Dimitrios Papanagnou 2022 Thomas Jefferson University

Analyzing The Effect Of Interview Time And Day On Emergency Medicine Residency Interview Scores, Alanna O'Connell, Sean Greco, Tingting Zhan, Tracy Brader, Megan Crossman, Robin Naples, Anthony Sielicki, Megan Stobart Gallagher, Peter Tomaselli, Dimitrios Papanagnou

Department of Medicine Faculty Papers

Background: When it comes to scheduling interviews, medical students may wonder if they need a strategy to increase their likelihood of matching. Previous studies examined the temporal effects of the residency interview on overall match rate; however, there are additional factors that affect the match process, including board examination scores and letters of recommendation. Only few studies have examined the effect interview time of day has on match success. The current study examines the impact date and time of interview during the interview season have on candidates' respective interview scores.

Methods: Interview data over a three-year period (i.e., three ...


Promotion Of Covid-19 Va(X)Ccination In The Emergency Department-Procovaxed: Study Protocol For A Cluster Randomized Controlled Trial., Robert M Rodriguez, Kelli O'Laughlin, Stephanie A Eucker, Anna Marie Chang, Kristin L. Rising, Graham Nichol, Alena Pauley, Hemal Kanzaria, Alexzandra Gentsch, Cindy Li, Herbie Duber, Jonathan Butler, Vidya Eswaran, Dave Glidden 2022 University of California

Promotion Of Covid-19 Va(X)Ccination In The Emergency Department-Procovaxed: Study Protocol For A Cluster Randomized Controlled Trial., Robert M Rodriguez, Kelli O'Laughlin, Stephanie A Eucker, Anna Marie Chang, Kristin L. Rising, Graham Nichol, Alena Pauley, Hemal Kanzaria, Alexzandra Gentsch, Cindy Li, Herbie Duber, Jonathan Butler, Vidya Eswaran, Dave Glidden

Department of Emergency Medicine Faculty Papers

Background: We conducted in-depth interviews to characterize reasons for COVID-19 vaccine hesitancy in emergency department (ED) patients and developed messaging platforms that may address their concerns. In this trial, we seek to determine whether provision of these COVID-19 vaccine messaging platforms in EDs will be associated with greater COVID-19 vaccine acceptance and uptake in unvaccinated ED patients.

Methods: This is a cluster-randomized controlled trial (RCT) evaluating our COVID-19 vaccine messaging platforms in seven hospital EDs (mix of academic, community, and safety-net EDs) in four US cities. Within each study site, we randomized 30 1-week periods to the intervention and 30 ...


Outcomes Of Covid-19 Infection In Patients With Hematological Malignancies- A Multicenter Analysis From Pakistan, Adeeba Zaki, Salman Muhammad Soomar, Danish Hasan Khan, Hasan Shaharyar Sheikh, Raheel Iftikhar, Ayaz Mir, Zeba Aziz, Khadija Bano, Hafsa Naseer, Qamar Un-Nisa Chaudhry 2022 Aga Khan University

Outcomes Of Covid-19 Infection In Patients With Hematological Malignancies- A Multicenter Analysis From Pakistan, Adeeba Zaki, Salman Muhammad Soomar, Danish Hasan Khan, Hasan Shaharyar Sheikh, Raheel Iftikhar, Ayaz Mir, Zeba Aziz, Khadija Bano, Hafsa Naseer, Qamar Un-Nisa Chaudhry

Section of Haematology/Oncology

Purpose: COVID-19 infection resulting from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began to spread across the globe in early 2020. Patients with hematologic malignancies are supposed to have an increased risk of mortality from coronavirus disease of 2019 (COVID-19) infection. From Pakistan, we report the analysis of the outcome and interaction between patient demographics and tumor subtype and COVID-19 infection and hematological malignancy.
Patients and methods: This multicenter, retrospective study included adult patients with a history of histologically proven hematological malignancies who were tested positive for COVID-19 via PCR presented at the oncology department of 5 tertiary care hospitals ...


Individuals With Sickle Cell Disease Using Sbar As A Communication Tool: Secondary Data Analysis, Deborah M. Jean-Baptiste 2022 UMass Chan Medical School

Individuals With Sickle Cell Disease Using Sbar As A Communication Tool: Secondary Data Analysis, Deborah M. Jean-Baptiste

Tan Chingfen Graduate School of Nursing Dissertations

Purpose: The purpose of this study was to determine the usefulness of SBAR-cued web-based communication skills training and address study participants' perceptions of the training.

Specific Aims:

  1. Evaluate the usefulness and accuracy of participants to answer prompts of SBAR-cued communication responses.
  2. Describe individuals' perspectives of the acceptability of using SBAR patient-HCP communication simulation to better prepare for ED visits during a SCC.

Framework: This study was guided by The Theory of Self-Care Management for Sickle Cell Disease (SCMSCD).

Design: A secondary analysis was conducted using a qualitative descriptive approach. Inter-rater reliability (IRR) of qualitative data was used to evaluate the ...


Cpr-Directive Conversations In The Emergency Department: The Opinion Of Elderly Patients, Kelvin H. Kramp Dr., Rutger de Hond, Mirwais Mehrab, Martijn Van Hooft, Roger A.P.A. Hessels 2022 Elisabeth-Tweesteden Ziekenhuis

Cpr-Directive Conversations In The Emergency Department: The Opinion Of Elderly Patients, Kelvin H. Kramp Dr., Rutger De Hond, Mirwais Mehrab, Martijn Van Hooft, Roger A.P.A. Hessels

Journal of Geriatric Emergency Medicine

Background: The average age of patients admitted to the emergency department (ED) continues to rise. Many face difficult discussions about cardiopulmonary resuscitation (CPR) and end-of-life decisions.

Objectives: This study aimed to determine which healthcare professionals elderly patients admitted via the ED preferred to discuss their CPR-directive with and their opinion about the ED as a setting for discussing their CPR-directive.

Methods: A mixed-methods study with an explanatory sequential design was conducted. A questionnaire was administered to 100 patients >65 years of age admitted to nursing wards via the ED that had a CPR-directive conversation during admission 24-48 hours earlier. Patients ...


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