Pediatric Emergency Medicine Associates
Eastern Virginia Medical School
University of St. Augustine for Health Sciences
Grand Strand Medical Center
Wright State University
University of Chicago
Rappahannock Community College
Medical University of Innsbruck, Austria
Head Injury In Older Adults: To Scan Or Not To Scan? Ten Tips To Make The Best Decision,
2023
Faculté de médecine familiale et de médecine d'urgence, Université de Sherbrooke
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. …
Abc's Of Geriatric Trauma,
2023
University of Chicago
Abc's Of Geriatric Trauma, Teresita Hogan
Journal of Geriatric Emergency Medicine
The ABC's approach to geriatric trauma alerts clinicians to specific important factors in emergency evaluation of an injured older adult.
Evaluation Of Discharge Antibiotic Prescribing For Community Acquired Pneumonia At A Pediatric Emergency Department,
2023
St Christopher's Hospital for Children
Evaluation Of Discharge Antibiotic Prescribing For Community Acquired Pneumonia At A Pediatric Emergency Department, Priya Vyas, Catherine Cheng, Janet Chen, Jean Marie Rinnan, Emily Souder
St. Chris Research Day
No abstract provided.
Common Misperceptions Of Child Abuse In Toddler Femur Fractures,
2023
University of Kansas Medical Center
Common Misperceptions Of Child Abuse In Toddler Femur Fractures, Olivia Pruss, Jonathan Warren, Vincent Staggs, Grace Tideman, Collin Erickson, William L. Hennrikus, Richard M. Schwend
Research Days
Background: Current AAOS guidelines recommend that all children younger than thirty-six months with a femur fracture be evaluated for child abuse. However, the chance for abuse in walking-age children is highly unlikely at less than 20%.
Objectives/Goal: The purpose of this study is to identify how a patient’s age and femur fracture morphology impact the likelihood that providers assess a fracture as non-accidental and their decision to pursue further investigation of possible child abuse.
Methods/Design: This was a questionnaire study completed by clinicians from multiple specialties. There were 5 subgroup populations (6, 12, 18, 24, 35 months old) combined with …
“There’S A Difference In Practice When You Have To Make The Decision”: Autonomy In Pediatric Emergency Medicine Fellowship,
2023
Children's Mercy Kansas City
“There’S A Difference In Practice When You Have To Make The Decision”: Autonomy In Pediatric Emergency Medicine Fellowship, Katherine Dunne, Vivek Dubey, Sarkan Toy, Camryn Martinez, Kelsey Gavin, Christopher S. Kennedy
Research Days
Background: The Accreditation Council for Graduate Medical Education allows individual training programs to define appropriate supervision and autonomy commensurate with the trainees’ knowledge, clinical competence, and patient complexity and acuity. In pediatric emergency medicine (PEM), supervision is not standardized and subject to supervisor discretion, creating variability in trainee autonomy.
Objectives/Goal: To explore the concept of autonomy from the perspectives of PEM fellows and faculty.
Methods/Design: We conducted a qualitative study consisting of semi-structured interviews of PEM fellows and faculty from a large, single-center pediatric emergency medicine fellowship program. A trained interviewer conducted the interviews over an electronic interview platform. Audio …
Pediatric Educational Outreach To A Community Based Emergency Department: Clinical Management Of The Febrile Infant,
2023
Children's Mercy Kansas City
Pediatric Educational Outreach To A Community Based Emergency Department: Clinical Management Of The Febrile Infant, Jess Parker, Frances Turcotte Benedict, Emily Hillman, Ryan C. Jacobsen, Ashley K. Sherman, Arjun Sarin
Research Days
Background: Multiple studies have shown variability in the approach to treatment of febrile infants ≤ 60 days of age in community emergency departments (EDs), and the American Academy of Pediatrics (AAP) recently published new guidelines on management of febrile infants. Therefore, an opportunity exists to provide evidence-based recommendations for the care of this patient population to providers in community EDs.
Objectives/Goal: To assess 1) alignment of community ED provider practices with an AAPinformed Clinical practice guideline (CPG) for management of febrile infants ≤ 60 days of age. 2) change in comfort level and degree of alignment after targeted education.
Methods/Design: …
Foley Catheter Algorithm,
2023
Southern Illinois University Edwardsville
Foley Catheter Algorithm, Chary Mathew
Doctor of Nursing Practice Projects
Urinary catheterization, indwelling and intermittent are simple and common procedures performed in hospitals, emergency rooms, nursing homes, and clinics to ensure adequate urinary output in patients who cannot void efficiently or closely monitor fluid intake and output. Though simple and straightforward in most cases, catheterization can become a challenging procedure with complications in the absence of a standardized protocol for difficult catheterization (Ghaffary et al., 2013). This Quality Improvement Project aimed to develop a standardized Foley catheter algorithm/ flow chart available in our institution's intranet and laminated charts in nursing stations and procedure rooms with Foley catheter insertion indications, types, …
Focused Pocus: Cardiopulmonary Curriculum For Internal Medicine Residents,
2023
Rowan University
Focused Pocus: Cardiopulmonary Curriculum For Internal Medicine Residents, Daniel Tran, Krunalkumar Patel, Shivani Dalal, Umang Patel, Troy Randle
Stratford Campus Research Day
Problem Statement: Point-of-care ultrasound (POCUS) is currently not a required core competency in internal medicine (IM) residency despite its inherent benefits, and many hospitalists are not equipped to confidently acquire nor interpret basic ultrasound images.
Background: POCUS is used at the bedside by physicians to answer directed clinical questions to help guide patient management. During the COVID-19 pandemic, the use of ultrasound for quick, accurate diagnosis of life-threatening pathology has been instrumental in early detection of acute cardiopulmonary failure, monitoring treatment response, and minimizing nosocomial spread. We aimed to determine interest in learning POCUS, confidence level, self-rated proficiency, and perceived …
Bedside Teaching In Emergency Medicine Brief Review And Practical Suggestions,
2023
Rowan University
Bedside Teaching In Emergency Medicine Brief Review And Practical Suggestions, James Espinosa, Alan Lucerna, Frank Wheeler, Sergey Medlenov, Robin Lahr, James Lee
Stratford Campus Research Day
Bedside teaching has been a tradtional practice and value in medicine. There is literature attesting the positive role of bedside teaching in medicine in general---and in emergency medicine in particular. The value proposition is centered around teaching overall clinical skills, communication skills and procedural skills. There is very little actual data concerning the outcomes of various bedside teaching approaches in EM. There are a number of very interesting suggestions In this review, we will discuss practical strategies to support bedside teaching in the speciality of emergency medicine.
Obstructive Hydrocephalus Caused By A Colloid Cyst Presenting As A Transient Ischemic Attack (Tia),
2023
Rowan University
Obstructive Hydrocephalus Caused By A Colloid Cyst Presenting As A Transient Ischemic Attack (Tia), Muhammad Nadeem
Stratford Campus Research Day
Colloid cysts are benign growths commonly found in the third ventricle or at the Foramen of Monroe. They are composed of epithelial lining filled with gelatinous material that contain cholesterol, mucin, old blood and ions. Most colloid cysts are asymptomatic but can present with a variety of symptoms that range from headaches, diplopia, memory problems, and vertigo. They can also present as an obstructive hydrocephalus with the classic “Wet, wacky and wobbly” triad. Rarely colloid cysts have been reported to cause sudden death. They can present to the ED with any spectrum of these symptoms.
Handheld Bedside Pocus In The Evaluation Of Neck Swelling: A Case Of Ludwig's Angina,
2023
Rowan University
Handheld Bedside Pocus In The Evaluation Of Neck Swelling: A Case Of Ludwig's Angina, Alex Gechlik, Frank Wheeler, James Espinosa, Alan Lucerna, Henry Schuitema
Stratford Campus Research Day
Ludwig's angina is a rare and life threatening cellulitic infection, first described by German physician, Wilhelm Frederick Von Ludwig in 1836, as a gangrenous infection of the soft tissue floor of the mouth and neck. The potential to spread rapidly to contiguous tissues surrounding the upper airways, notably the glottis, resulted in Ludwig's angina carrying a high mortality rate near 50% in the pre- antibiotic era. It necessitates rapid detection and management to assure respiratory compromise does not occur. This case study is novel as it illustrates handheld bedside POCUS utilization in diagnosing Ludwig’s Angina.
Development Of Schizophrenia In A Genetically Predisposed Individual Following Covid-19,
2023
Rowan University
Development Of Schizophrenia In A Genetically Predisposed Individual Following Covid-19, Sung Kang, Jonathan Yuh, Timothy Wong
Stratford Campus Research Day
We present a patient who is a 56-year-old female with a psychiatric history of anxiety disorder and a medical history of hypercholesterolemia and hyperthyroidism, who was admitted to the hospital after a witnessed seizure at an inpatient psychiatric facility. This patient’s family history is significant for her mother experiencing unspecified psychotic disorder that required psychiatric hospitalization. Our patient was first admitted to the psychiatric hospital after exhibiting worsening paranoid delusions and hallucinations that began several months prior. The patient had reportedly begun locking herself in the restroom and screaming “get out, they’re spying on me”, referring to her next-door neighbors …
Analysis Of Implementing Best Practices For Co-Prescribing Naloxone In Your Agency Online Cme Training Module Via Pre- And Post- Knowledge Assessment.,
2023
Rowan University
Analysis Of Implementing Best Practices For Co-Prescribing Naloxone In Your Agency Online Cme Training Module Via Pre- And Post- Knowledge Assessment., Alicia Podwojniak, Arvind Venkataraman, Richard Jermyn
Stratford Campus Research Day
The opioid epidemic poses substantial risk to society. Providers must ensure that their patients understand the uses and risks of both opioids and naloxone. One way to analyze this concept is via metacognition. This refers to a person’s knowledge about cognitive phenomena, and thus it regulates self-awareness abilities in decision making, such as planning and evaluating. It is not only important for providers to have knowledge on best practices, but also to have self-awareness, and confidence in their decision making to ensure optimal patient outcomes. True-false confidence weighted scoring can be utilized, whereby various levels of confidence are assessed from …
Trends In Opioid Usage And The Covid-19 Pandemic,
2023
Rowan University
Trends In Opioid Usage And The Covid-19 Pandemic, Priya Brahmbhatt, Jeffery Powers
Stratford Campus Research Day
The opioid epidemic and the COVID-19 pandemic have affected individuals in the United States in various capacities, and new avenues to reduce the harmful effects of both public health crises must be explored. It has been found that those with substance use disorders have an increased risk for COVID-19 (Wang 2021). There have been more visits to emergency rooms for substance overdose during the COVID-19 pandemic compared to before the COVID-19 pandemic (Holland 2021). This research project attempted to understand the trends amongst opioid users during the COVID-19 pandemic compared to before the COVID-19 pandemic in the United States, in …
A Rare Case Of Left Main Vasospasm Resulting In Sudden Cardiac Death,
2023
Rowan University
A Rare Case Of Left Main Vasospasm Resulting In Sudden Cardiac Death, Trinava Roy, Anjeli Patel, Tania Maheshwari, Vasu Palli
Stratford Campus Research Day
Background: Coronary artery vasospasm (CAV) is transient spasm of a coronary artery that can lead to cardiac ischemia. We present a case with left main (LM) CAV identified on electrocardiogram (ECG) and cardiac catheterization resulting in appropriate therapy.
Case: A 52 year old female with months of spontaneously resolving episodic neck pain, flushing, and diaphoresis presented to the emergency department after a resuscitated cardiac arrest. Initial ECG was without evidence of ischemia, however high-sensitivity troponin (522) was elevated. Telemetry monitoring and ECG showed transient ST elevations in V1 and diffuse ST depressions with left bundle branch block. LV Function was …
Case Study: Posterior Reversible Encephalopathy Syndrome (Pres) In A Stroke Patient With Seizures,
2023
Rowan University
Case Study: Posterior Reversible Encephalopathy Syndrome (Pres) In A Stroke Patient With Seizures, Akhmad Ernazarov, Shikhar Manchanda, Yvette Wang
Stratford Campus Research Day
Posterior Reversible Encephalopathy Syndrome (PRES) is a condition in which patients present with visual disturbances, headaches, seizures, and impaired consciousness. It can affect a wide variety of patients ranging from infants to elderly, but young and middle aged adults are most commonly affected; females are more likely to be affected by PRES than males. Risk factors such as hypertension, pre-eclampsia/eclampsia, renal failure, cytotoxic conditions and autoimmune conditions predispose patients to PRES. In this unique case, a 63 female patient was admitted to Jefferson Washington Hospital exhibiting classic stroke like symptoms. Patient also began seizing in the ED which was unusual …
Brief Review: Patient Pill Splitting. What Is The Appropriate Advice To Provide Patients In The Emergency Department?,
2023
Rowan University
Brief Review: Patient Pill Splitting. What Is The Appropriate Advice To Provide Patients In The Emergency Department?, Mohammad Rattu, James Espinosa, Gabriel Meister, Alan Lucerna
Stratford Campus Research Day
A number of patients have inquired about the practice of pill splitting. Cutting or splitting of pills can be used by patients to create an intermediate dose or to save on money where a higher dose is priced at relatively the same cost as a lower dose. In this review we discuss a number of issues related to medication safety and table splitting.
Case Report: Uterine Torsion – A Rare Cause Of Right Lower Quadrant Pain,
2023
Rowan University
Case Report: Uterine Torsion – A Rare Cause Of Right Lower Quadrant Pain, David Ho, James Jung Lee, James Espinosa
Stratford Campus Research Day
Uterine torsions are very rare. In an article by Matsumoto et al published in 2021, only 25 cases have been documented on PubMed in non-gravid females in the past 20 years. Uterine torsion is defined as rotation of the uterus greater than 45 degrees in the long axis. Rotation can occur anywhere between 45 degrees to 180 degrees. The torsion can be due to a congenital anomaly or an obstetrics emergency such as with an ovarian torsion. Uterine torsions presenting as an obstetrics emergency carries the potential for irreversible ischemic damage to the uterus, and just as in ovarian torsion, …
Case Report: Use Of Bedside Handheld Ultrasound To Diagnose Finger Dislocation,
2023
Jefferson Health
Case Report: Use Of Bedside Handheld Ultrasound To Diagnose Finger Dislocation, Frank Wheeler, Philip Carhart, James Espinosa, Alan Lucerna, Henry Schuitema
Stratford Campus Research Day
Here we present the case of a 37-year-old male with a finger injury in which finger dislocation was suspected clinically. A bedside pocket ultrasound was performed using a water submersion technique, which identified a posterior dislocated right 2nd digit at the PIP joint. This finding was confirmed with an x-ray. This case report demonstrates that ultrasonography can be utilized to correctly identify finger dislocation. Although larger studies need to be performed to validate the accuracy of this imaging technique, the implications may improve care of the patient. It would also be particularly beneficial for this technique to be applied to …
Case Report And Brief Review: Co-Infection Covid-19 Virus And Influenza A Virus,
2023
Rowan University
Case Report And Brief Review: Co-Infection Covid-19 Virus And Influenza A Virus, James Espinosa, Umar Sannoh, Alan Lucerna
Stratford Campus Research Day
We report the case of a 45 year old male who presented to the an emergency department with a complaint of myalgias, chills and sore throat of a two day duration. The patient tested positive for COVID-19 virus as well as Influenza A virus. The purpose of this brief review is to discuss what is known about co-infection of COVID-19 and influenza A.
