Emergency Medicine Commons^™

One Year Outcomes Of A Pre-Hospital Myocardial Infarction Alert 3 Process, Gerald Coleman Do, Andrew C. Miller Do, David Richardson Md, David A. Cox Md, Nainesh Patel Md, J Patrick Kleaveland Md, Bruce Feldman Do, Ron Freudenberger Md, Richard S. Mackenzie Md

Department of Emergency Medicine

No abstract provided.

Impact Of Pre-Hospital Myocardial Infarction Alert Process Education On Door To Balloon Times At Sites Within A Regional Heart Center, Gerald Coleman Do, Andrew C. Miller Do, David Richardson Md, David Cox Md, Nainesh C. Patel Md, J Patrick Kleaveland Md, Bruce Feldman Do, Ron Freudenberger Md, Richard S. Mackenzie Md

Department of Emergency Medicine

No abstract provided.

Losartan Associated Anaphylaxis And Angioneurotic Oedema, Syed Faraz Kazim, Muhammad Shahid

Section of General Surgery

A case of anaphylaxis and angioedema induced by angiotensin II receptor blocker (ARB), losartan is reported. A 37 years old hypertensive female presented to the Emergency Department with swelling over the face especially the lips, urticarial rash all over the body, and dyspnoea within an hour of losartan administration. She did not have any previous history of drug allergies. The patient was managed with epinephrine. Although angioneurotic oedema and anaphylaxis are well documented adverse effects of angiotensin converting enzyme (ACE) inhibitors, very few cases of these adverse reactions with ARBs have been reported in medical literature.

Failure Of Intimate Partner Violence Screening Among Patients With Substance Use Disorders, Esther K. Choo, Christina Nicolaidis, Robert H. Jenkinson, Jessi M. Cox, Kenneth J. Mcconnell

School of Social Work Faculty Publications and Presentations

Objectives: This study examined the relationship between substance use disorder (SUD) and intimate partner violence screening (IPV) and management practices in the emergency department (ED). Methods: This was a retrospective cohort study of adult ED patients presenting to an urban, tertiary care teaching hospital over a 4-month period. An automated electronic data abstraction process identified consecutive patients and retrieved visit characteristics, including results of three violence screening questions, demographic data, triage acuity, time of visit, and ICD-9 diagnosis codes. Data on management were collected using a standardized abstraction tool by two reviewers masked to the study question. Multivariate logistic regression …

Methylglyoxal Increases Cardiomyocyte Ischemia-Reperfusion Injury Via Glycative Inhibition Of Thioredoxin Activity., Xiaoliang Wang, Wayne B. Lau, Yue-Xing Yuan, Ya-Jing Wang, Wei Yi, Theodore A. Christopher, Bernard L. Lopez, Hui-Rong Liu, Xin-Liang Ma

Department of Emergency Medicine Faculty Papers

Diabetes mellitus (DM) is closely related to cardiovascular morbidity and mortality, but the specific molecular basis linking DM with increased vulnerability to cardiovascular injury remains incompletely understood. Methylglyoxal (MG), a precursor to advanced glycation end products (AGEs), is increased in diabetic patient plasma, but its role in diabetic cardiovascular complications is unclear. Thioredoxin (Trx), a cytoprotective molecule with antiapoptotic function, has been demonstrated to be vulnerable to glycative inhibition, but whether Trx is glycatively inhibited by MG, thus contributing to increased cardiac injury, has never been investigated. Cultured H9c2 cardiomyocytes were treated with MG (200 muM) for 6 days. The …

Telemedicine And Advanced Technology Research Center: Quarterly Report, April 18, 2010 To July 17, 2010, Bea Babbitt

Telemedicine & Advanced Technology Research Center

Development of a P.O.I. and a Blended Learning Ecology for use in Combat Lifesaver Skills Training for the Army.

Development Of A P.O.I. And A Blended Learning Ecology For Use In Combat Lifesaver Skills Training For The Army, Bea Babbitt

Telemedicine & Advanced Technology Research Center

The primary purpose of the project, as originally conceived, was to design and implement a series of applied research studies to validate the effectiveness of a blended learning ecology in the teaching of life saving medical skills to US Army combat military personnel. The project has undergone several changes to include changing the focus to the development of a Program of Instruction (POI) for Combat Lifesaver Skills (CLS). The new scope of work which has been followed for the past year includes the completion of the POI as well as the integration of the Personal Response System (PRS) into the …

Emergency Department Staff Adherence To Bad News Delivery Recommendations, Kristen R. Myers

Loma Linda University Electronic Theses, Dissertations & Projects

Emergency department (ED) staff is responsible for giving bad news regarding death, diagnoses, and other traumatic losses to patients and loved ones. Individuals receiving traumatic and sudden bad news are at increased risk of serious psychological and physiological consequences of disrupted grief. Despite published recommended practices for providers to help prevent maladaptive grief responses, little research is available on actual bad news delivery practices and factors promoting or hindering adherence to recommendations, and no study specifically explored the ED context.

The study used a qualitative design to explore bad news delivery practices, awareness of recommendations, factors perceived to hinder or …

Telemedicine And Advanced Technology Research Center: Quarterly Report, January 18, 2010 To April 17, 2010, Bea Babbitt

Telemedicine & Advanced Technology Research Center

Development of a P.O.I. and a Blended Learning Ecology for use in Combat Lifesaver Skills Training for the Army.

Standardized Performance Measurement And Reporting In Emergency Departments (Eds), Gw Urgent Matters Learning Network Ii

Health Workforce Research Center Publications

The drive to maximize emergency department (ED) efficiency while also ensuring the quality of care they deliver has been the focus of experts in the United States for decades. Access to patient-centered and equitable emergency care is critical to a community, and EDs are the safety net that must provide that care whenever it is needed, to whomever needs it. A wellmanaged ED increases the quality and safety of patient care and strengthens the health care infrastructure.

Post-Prandial Vomiting And Abdominal Pain: A Case Report, Hilary F. Basham Do, Kathleen Kane Md

Department of Emergency Medicine

No abstract provided.

Diagnosis Of Enteric Fever In The Emergency Department: A Retrospective Study From Pakistan., Uzma R. Khan, J. Razzak, Ali Faisal Saleem Dr, Adnan Ahmed, Sabeena Jalal

Department of Emergency Medicine

Background:Enteric fever is one of the top differential diagnoses of fever in many parts of the world. Generally, the diagnosis is suspected and treatment is initiated based on clinical and basic laboratory parameters.
Aims: The present study identifies the clinical and laboratory parameters predicting enteric fever in Patients visiting the emergency department of a tertiary care hospital in Pakistan.
Methods:This is a retrospective chart review of all adult Patients with clinically suspected enteric fever admitted to the hospital through the emergency department during a 5-year period (2000-2005).
Results:A total of 421 emergency department Patients were admitted to …

Needle Stick Injuries Among Health Care Workers Of Public Sector Tertiary Care Hospitals Of Karachi, Mubashir Aslam, Tahir Taj, Arif Ali, Waseem Mirza, Hammad Ali, Mudassir Iqbal Dar, Nasira Badar

Community Health Sciences

OBJECTIVE: To estimate the frequency of needle stick injuries (NSI) among health care workers (nurses, student nurses and paramedical staff) in public hospitals of Karachi.STUDY DESIGN: Cross sectional, observational.PLACE AND DURATION OF STUDY: This study was conducted in three public tertiary care hospitals of Karachi, from November 2007 to January 2008.METHODOLOGY: Data was collected by structured interview-based questionnaires in Urdu and English language. Questionnaire was designed to obtain information regarding demography, work experience, hepatitis vaccination status, and occurrence of needle stick injuries with associated factors. Needle stick injury that occurred in the previous month was the defined outcome. Data was …

Cardiomyocyte-Derived Adiponectin Is Biologically Active In Protecting Against Myocardial Ischemia-Reperfusion Injury., Yajing Wang, Wayne Bond Lau, Erhe Gao, Ling Tao, Yuexing Yuan, Rong Li, Xiaoliang Wang, Walter J. Koch, Xin-Liang Ma

Department of Emergency Medicine Faculty Papers

Adiponectin (APN) has traditionally been viewed as an adipocyte-specific endocrine molecule with cardioprotective effects. Recent studies suggest that APN is also expressed in cardiomyocytes. However, biological significances of this locally produced APN remain completely unknown. The aim of this study was to investigate the pathological and pharmacological significance of cardiac-derived APN in cardiomyocyte pathology. Adult cardiomyocytes from wild-type littermates (WT) or gene-deficient mice were pretreated with vehicle (V) or rosiglitazone (RSG) for 6 h followed by simulated ischemia-reperfusion (SI/R, 3 h/12 h). Compared with WT cardiomyocytes, myocytes from APN knockout (APN-KO) mice sustained greater SI/R injury, evidenced by greater oxidative/nitrative …

Impact Study Of A Central Lines Simulation Training Program Using Kirkpatrick’S Four-Level Evaluation Model, James P. Orlando Edd, Andrew C. Miller Do, William Bond Md, Ms, Valerie A. Rupp Rn, Bsn, Bryan G. Kane Md, Cindy Umbrell Rn, Msn, Michael Pasquale Md

Department of Emergency Medicine

No abstract provided.

Differences In Reporting Of Violence And Deliberate Self Harm Related Injuries To Health And Police Authorities, Rawalpindi, Pakistan, Umar Farooq, Mudassir Majeed, Junaid Ahmad Bhatti, Jahangir Sarwar Khan, Junaid Razzak, Muhammad Mussadiq Khan

Department of Emergency Medicine

Background:

The aim of study was to assess differences in reporting of violence and deliberate self harm (DSH) related injuries to police and emergency department (ED) in an urban town of Pakistan.

Methods/Principal Findings:

Study setting was Rawalpindi city of 1.6 million inhabitants. Incidences of violence and DSH related injuries and deaths were estimated from record linkage of police and ED data. These were then compared to reported figures in both datasets. All persons reporting violence and DSH related injury to the police station, the public hospital's ED, or both in Rawalpindi city from July 1, 2007 to June 30, …

Telemedicine And Advanced Technology Research Center: Quarterly Report, October 18, 2009 To January 17, 2010, Bea Babbitt

Telemedicine & Advanced Technology Research Center

Development of a P.O.I. and a Blended Learning Ecology for use in Combat Lifesaver Skills Training for the Army.

Implementing The 2005 American Heart Association Guidelines, Including Use Of The Impedance Threshold Device, Improves Hospital Discharge Rate After In-Hospital Cardiac Arrest, Ken Thigpen, Scott Davis, Roberta Basol, Peggy Lange, Sandeep Jain, John Olsen, Bernard Erickson, Timothy Schuchard, Tom P. Aufderheide

Articles

OBJECTIVE:

To determine the impact of the 2005 American Heart Association cardiopulmonary resuscitation (CPR) guidelines, including use of an impedance threshold device (ITD), on survival after in-hospital cardiac arrest.

METHODS:

Two community hospitals that tracked outcomes after in-hospital cardiac arrest pooled and compared their hospital discharge rate before and after implementing the 2005 American Heart Association CPR guidelines (including ITD) in standardized protocols. In CPR we used the proper ventilation rate, allowed full chest-wall recoil, conducted continuous CPR following intubation, and used an ITD. We compared historical control data from a 12-month period at St Cloud Hospital, St Cloud, Minnesota, …

Essential Medicines Management During Emergencies In Pakistan, S. K. S. Bukhari, J.A.R. H. Qureshi, Rashid Jooma, K.M. Bile, G. N. Kazi, W. A. Zaibi, A. Zafar

Section of Neurosurgery

This paper illustrates the experiences of essential medicine management in providing cure and care to victims of Pakistan's 2005 earthquake in a safe, rational and effective mode. The health interventions assured access to essential medicine, sustained supply, inventory control through a computerized logistic support system and rational use of medicines. World Health Organization Pakistan outlined modalities for acceptance of donated medicines, assisted in speedy procurement of medicines and designed customized kits. Proper storage of medicines at controlled temperature was ensured in warehousing facilities in 12 locations. A steady supply of medicines and their consumption without stock-outs in the 56 first-level …

Knowledge Attitude And Practices Of Undergraduate Students Regarding First Aid Measures, Afrasyab Khan, Sumaira Shaikh, Fawad Shuaib, Ahsan Sattar, Saira Aziz Samani, Quratulain Shabbir, Ameer Zaighum Rasheed

Department of Emergency Medicine

OBJECTIVES: To assess knowledge, attitude and practices of first aid measures in undergraduate students of Karachi.

METHODS: A cross-sectional study was carried out at six colleges of Karachi, three of which were medical colleges and three non-medical colleges. Knowledge was assessed regarding various emergency situations with the help of a questionnaire. The target population size was 460, based on 50% prevalence and 95% confidence interval. The eventual sample size achieved was 446.

RESULTS: A total of 446 students were interviewed. Seventy eight students (17.5%) had formal First Aid (FA) training. The mean number of correct answers of students with FA …