Emergency Medicine Commons^™

Unlocking Prognostic Potential: Biomarker Predictors Of Admission And Length Of Stay In Pediatric Sickle Cell Vaso-Occlusive Pain Crisis, Jeffrey Hernandez, Abhishek Dutta, Jacob Lowry, Bruce Bernstein, Luis Gamboa, Nataly Apollonsky

Tower Health Research Day

No abstract provided.

Evaluating The Role Of Traditional And Nontraditional Educational Resources In Point-Of-Care Ultrasound Training: A Cross-Sectional Survey Of Educator Preferences And Practices, Arthur Broadstock, Annahieta Kalantari, Almaz S. Dessie, Al'ai Alvarez, Resa E. Lewiss, Josie Acuna, Anthony Weekes, Kaylah Maloney, Uwe Stolz, Lori Stolz, Aalap Shah

Department of Emergency Medicine Faculty Papers

BACKGROUND: Recently, nontraditional educational resources like podcasts, blogs, and online media have gained prominence in medical education and are abundant within the field of point-of-care ultrasound (POCUS). However, the extent to which POCUS educators utilize online resources compared to traditional resources, like textbooks, journal articles, and in-person workshops, is unknown. We aim to define which types of educational resources are used and preferred by POCUS educators to teach trainees.

METHODS: An expert working group developed a survey aimed to characterize the types of materials used by POCUS educators and their perceived importance on a 6-point forced ranking scale. We administered …

Connecting Disciplines: Dermatologists Discuss Skin Cancer Screening In Physical Therapy, Michael T. Robinson, Lindsay Gietzen

Pacific Journal of Health

Background: This study aims to explore dermatologists’ perspectives on the integration of skin cancer screening within physical therapy practice. The hypothesis is that insights from dermatologists can enhance the efficacy and accuracy of skin cancer screening by physical therapists (PTs), thereby improving early detection rates and patient outcomes. Methods: A total of five dermatologists participated in this study, each with between 5 and 18 years of experience and a diverse range of expert opinions and insights. This qualitative study utilized semi-structured interviews with participating dermatologists. The interview questions focused on their knowledge of skin cancer screening, perceptions of its implementation …

Management Of Electrolyte Abnormalities In The Emergency Department, Todd W. Jones

Lynchburg Journal of Medical Science

The objective of this article review is to discuss standard treatment options and review emerging therapies for the more common electrolyte abnormalities. The number of emergency departments (ED) in the United States has declined over the past 15 years, which has created overcrowding. This makes it more difficult to prioritize patients based on severity. The importance of this topic is to assist providers in taking quick action on patients presenting with critical electrolyte levels in busy EDs. A literature search using PubMed from 2019 to 2024 identified numerous articles that supported the purpose. This review will discuss the various electrolyte …

Stop The Bleed! Acute Epistaxis Management, Christopher R. Cannell

Lynchburg Journal of Medical Science

Epistaxis, the most common Otolaryngology-related emergency, is responsible for one in 200 emergency department (ED) visits in the United States (US) and one-third of otolaryngology visits.^1,11 Up to 60% of the population will experience epistaxis during their lifetime, and 6% -10 % will require medical intervention.^2,3 Epistaxis occurs in children and adults and has a seasonal variation. Although 85% of nosebleeds are idiopathic, they are more frequent in those on supplemental oxygen, anticoagulation, antiplatelet therapy, and in those with other conditions that may predispose them to bleeding. Most clinicians will encounter patients with acute epistaxis; therefore, it is …

Be(D) Fast For Faster Screening, Allison Goshorn, Alaine Schauer

Articles, Abstracts, and Reports

No abstract provided.

Evaluating Medical Usage And Injury Prevalence At The 2024 College World Series, Roarick Schollmeyer, Jd Gregerson, Benjamin Stevens, Katie Weaver, Joseph Lippert

EMET Projects

Large-scale events such as the College World Series (CWS) pose unique challenges for medical services due to high crowd density, prolonged event durations, and variable environmental conditions. This study aimed to assess the medical usage rate (MUR) and injury prevalence at the 2024 CWS to inform future event planning and emergency medical preparedness. A retrospective analysis was conducted using patient encounter data collected between June 14 and June 24, 2024. Data sources included Union Medical event services, which documented on-site treatments and dispositions, and Omaha Fire Department EMS records detailing prehospital care. The MUR was calculated as the number of …

Subcutaneous Insulin Aspart Every 4 Hours In The Treatment Of Covid-19 Patients With Mild-To-Moderate Diabetic Ketoacidosis: A Case Series, Dararat Chiewchalermsri, Chayanin Wanittansirichok, Chutintorn Sriphrapradang

Journal of Community Hospital Internal Medicine Perspectives

This case series evaluates the efficacy and safety of subcutaneous (SC) insulin Aspart administered every four hours for managing mild-to-moderate diabetic ketoacidosis (DKA) in COVID-19 patients, addressing a current evidence gap. We conducted a retrospective review of confirmed COVID-19 patients over 15 years old who developed mild to moderate DKA between July 2020 and October 2021. Insulin Aspart was administered at 0.4 units/kg SC every 4 hours, reduced to 0.2 units/kg when blood glucose (BG) decreased to/dL, and SC basal insulin was initiated at 0.15-0.2 units/kg at DKA diagnosis. A total of seven patients, with a mean age of 67.4±13.2 …

Impact Of Diabetes On Fall Related Lower Limb Fractures, Bryce M. Bellon, Daniel Salinas, Patrick De La Torre Shutz, Hunter Butler, Sean Corcoran, Kelsey Baker

Research Symposium

Background: Diabetes is a disorder that affects many Americans, characterized primarily by hyperglycemia due to either insulin resistance or lack of insulin secretion. This condition not only impacts blood sugar levels but also has significant effects on bone health. In diabetes, bone density is often decreased due to reduced osteoblast activity, which is responsible for bone formation, and increased osteoclast activity, which leads to bone resorption. This imbalance accelerates the breakdown of bone. Additionally, diabetics frequently suffer from lower extremity arterial disease (LEAD), which results in poor vascularization of the lower limbs. These factors contribute to an increased risk of …

Blind Nasal Intubation As A Rescue Strategy In Difficult Airway Management, Riaz Chowdhury, Ashalatha K. Nair, Dheeraj Kamalam, Rohit Jaishankar

HCA Healthcare Journal of Medicine

Background

Airway management in emergency situations poses significant challenges, particularly in patients with difficult airway anatomy or comorbid conditions. Blind nasal intubation has been explored as a rescue technique when conventional methods fail. Masseter muscle rigidity (MMR), characterized by significant jaw muscle stiffness, is a recognized complication following succinylcholine administration that can complicate traditional approaches to securing an airway.

Case Presentation

A 75-year-old man with multiple comorbidities, including hypertension, prior stroke with paralysis, dementia, and a seizure disorder, presented with acute hypercapnic hypoxemic respiratory failure requiring emergent intubation. Orotracheal intubation failed due to trismus despite etomidate, succinylcholine, and rocuronium. Nasal …

Podcasting Towards Togetherness: Utilizing Podcasts To Improve Departmental Camaraderie And Well-Being, Michael Petrauskis, Colleen Gutman, Rosemarie Fernandez

Journal of Wellness

Introduction: Physician burnout is on the rise, and this is of particular concern in emergency medicine. Burnout is associated with medical errors, adverse events, poor professionalism, and litigation. A sense of community can build engagement and mitigate workplace stressors on well-being. Emergency physicians may have trouble connecting due to the nature of shift-work and various practice settings. Communication technology, and particularly podcasting, has the potential to help overcome these barriers and positively impact relatedness and well-being.

Approach: We developed an inward-facing podcast, “The ER Break Room” within the Department of Emergency Medicine at the University of Florida. Through the …

Characteristics And Outcomes Of Adults Hospitalized With Respiratory Syncytial Virus, Brian S. Shaw, Cara Slaton, Ian P. Murphy, Michael Mcalister, Daniel Egan, Kwabena Ayesu

The University of Louisville Journal of Respiratory Infections

Background: Respiratory syncytial virus (RSV) is a negative sense single-stranded RNA virus (ssRNA) that primarily causes respiratory infections in both children and older adults. We examined clinical characteristics and outcomes of hospitalized adult patients who tested positive for RSV.

Methods: This was a multicenter, retrospective, descriptive study that examined adult patients admitted with a positive RSV test over two years across eight hospitals in Orlando, Florida.

Results: A total of 120 patients were included, of which 88 (73%) were 60 years old and older. Overall, patients with RSV infection were caucasian (62%) with a median age of 70 years and …

Murder Mystery Solved! Unmasking Multi-Generational Familial Death As A Result Of Brugada Syndrome, Ryan Tam, Sandres Aodish, Jeremiah Tom, Mohammad Jawish

Advances in Clinical Medical Research and Healthcare Delivery

Brugada syndrome is an inherited condition that has an increased risk of developing ventricular arrhythmias and sudden cardiac death. This condition can be diagnosed by using the Shanghai Scoring System. Here, we present a patient with an incidental finding of Type 1 Brugada pattern on electrocardiogram amidst atypical neurological findings on presentation to the emergency department and a history of cardiac-related familial deaths of uncertain etiology.

Development And Validation Of Risk Stratification For Heart Failure After Acute Coronary Syndrome Based On Dynamic S100a8/A9 Levels, Jie Ma, Ke Ma, Jing Chen, Xinying Yang, Fei Gao, Hai Gao, Hui Zhang, Xin-Liang Ma, Jie Du, Ping Li, Yulin Li

Department of Emergency Medicine Faculty Papers

BACKGROUND: The early assessment of heart failure (HF) risk in patients with acute coronary syndrome (ACS) can help reduce mortality. S100A8/A9 is not only rapidly released after myocardial ischemia, but is also involved in reperfusion injury, which is an important predictor of HF after ACS. We attempted to construct a reliable HF risk stratification tool for evaluating patients with ACS after reperfusion therapy based on S100A8/A9 dynamic changes.

METHODS AND RESULTS: This prospective study included 3 independent cohorts of patients with ACS who received reperfusion therapy. The discovery cohort was divided into 2 subgroups: the longitudinal subgroup (n=264) with serum …

Hospice Patients In The Emergency Department: Challenging High-Risk Encounters With Unanswered Questions And Unquestioned Answers, Jason K Bowman, Joan M Teno, Kei Ouchi

Faculty, Staff and Students Publications

No abstract provided.

Acute Carpal Tunnel Syndrome Secondary To Handcuffs Necessitating Emergency Orthopedic Consultation And Operative Intervention, Fabian Jano, Kelly Mackenzie, Vivek Biololikar, David Goldberger, Andrei Tuluca

Department of Emergency Medicine Faculty Papers

We present a case of acute carpal tunnel syndrome secondary to tight handcuffs in a detained patient. The severity of the motor and sensory deficits prompted consultation with orthopedic specialists and admission for an observation period with ultimate emergency operative intervention. Handcuff neuropathies are well documented in the literature, mainly involving the superficial branch of the radial nerve, which has strict sensory input into the dorsum of the hand. Less common median nerve neuropathies have also been documented following handcuff injury; however, none have required emergency intervention. We aim to highlight this unusual presentation and the emergency nature of the …

Neurovascular Complications Of Acute Aortic Syndrome, Dean Zeldich, Matthew Bierowski, Leah Shabo, Sridhara Yaddanapudi, Gregary Marhefka

Jefferson Hospital Staff Papers and Presentations

Acute aortic syndromes (AAS) such as aortic dissection, intramural hematoma, and penetrating aortic ulcer pose significant neurovascular risks, affecting patient outcomes. This review examines the incidence, clinical presentation, and outcomes of neurovascular complications in AAS patients. Common complications include stroke, spinal cord ischemia, and transient ischemic attacks, with stroke being the most prevalent. Managing aortic dissection necessitates careful blood pressure control to prevent dissection progression while avoiding compromised cerebral and spinal perfusion. Carotid involvement, particularly dissection, increases stroke and transient ischemic attack risks. Emergency surgical interventions, though essential to prevent rupture or repair dissection, carry risks of perioperative neurovascular complications. …

Viscoelastic Hemostatic Assays Are Associated With Mortality And Blood Transfusion In A Multicenter Cohort, Shyam Murali, Eric Winter, Nicolas M. Chanes, Allyson M. Hynes, Madhu Subramanian, Alison A. Smith, Mark J. Seamon, Jeremy W. Cannon

School of Medicine Faculty Publications

Objectives: Trauma-induced coagulopathy (TIC) carries significant risks, including increased mortality. Traditional TIC definitions rely on laboratories that result slowly and do not highlight therapeutic targets. We hypothesized that a TIC score, based on thromboelastography (TEG) and rotational thromboelastometry (ROTEM), collectively termed viscoelastic hemostatic assays, is associated with in-hospital mortality and packed red blood cell (pRBC) transfusion. Methods: This retrospective cohort study used a database of adult patients undergoing institutional massive transfusion at seven level 1 trauma centers (2013-2018). A “TIC score” was developed, with 1 point assigned for abnormal TEG R-time ( ≥ 9 min) or ROTEM clot time ( …

Hook, Line And Lid: Managing A Fishhook Injury To The Eye, Daniel Tate, Lisa Persaud, Jonathan Leggett

South Atlantic Division GME Research Day 2025

No abstract provided.

Extrinsic Motivation Enhances Clinical Ultrasound Utilization Amongst Residents, Bailey Spencer, Steven Rickett, Jacob Pope, Sanna Ho-Gotshall, Casey Wilson

South Atlantic Division GME Research Day 2025

No abstract provided.