Emergency Medicine Commons^™

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 …

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 …

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.

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.

Burnout In The Emergency Room: Corrective Measures Vs. The Absence Of Solutions, Zane Walters, Zachary Woodall

Theses, Dissertations and Capstones

Introduction: Physician burnout has become an increasingly prevalent and critical issue in healthcare systems worldwide, particularly among emergency room physicians who face high-stress, high-demand working conditions. Burnout manifests as emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment, leading to negative outcomes for physicians’ mental health, job satisfaction, and overall career longevity. This phenomenon not only threatens the well-being of physicians but also compromises patient care quality and contributes to costly turnover within healthcare organizations.

Purpose of the Study: The aim of this study was to systematically investigate the impact of burnout interventions on emergency room physicians. …

The Benefit Of Protected Time Before Emergency Medicine Didactic, Stevley M. Koshy, Garrett Reber, David Lindow

Gulf Coast Division GME Research Day 2025

No abstract provided.

Interprofessional Neonatal Resuscitation Simulations: An In-Situ Assessment Of Pediatric Readiness At A Multi-Site Academic Center, Jessyca C. Gibson, Petru C. Nemes

South Atlantic Division GME Research Day 2025

No abstract provided.

Barbiturates Versus Benzodiazepines For Adults With Severe Alcohol Withdrawal, Frank Schaefer, Alexandra Doan, Jarratt Lark, Scott Gutovitz

South Atlantic Division GME Research Day 2025

No abstract provided.

Utilization Of Er Paramedics At The Ems Entrance, Mark Barkat

Gulf Coast Division GME Research Day 2025

No abstract provided.

Improving Internal Medicine And Emergency Department Communication - The Ed Map Project, Syed Raza, Srinidhi Shyamkumar, Eric Riha, Zuhair Ali

Gulf Coast Division GME Research Day 2025

No abstract provided.

Managing Thyroid Storm In A 40 Year Old Male Patient: A Case Report, Mark Barkat

Gulf Coast Division GME Research Day 2025

No abstract provided.

A Case Of Meningitis With Pyogenic Ventriculitis, Shterna Frand, Matthew Gutzmer, Melissa Jaworski, Calan Teel, Premal Patel

North Texas Research Forum 2025

Bacterial meningitis and subsequent pyogenic ventriculitis in patients with complex medical histories and prior cranial surgeries presents significant diagnostic and management challenges. While typical signs of infection such as fever and leukocytosis may be present, secondary complications including seizure, respiratory failure, and pyogenic ventriculitis can complicate the clinical course. This case illustrates the need for comprehensive evaluation and tailored intervention in immunocompromised patients presenting with atypical infection. The case involved a 63-year-old female with a prior craniotomy and multiple comorbidities, presenting to the Emergency Department with acute encephalopathy and suspected bacterial meningitis. Upon transfer to the ICU following acute onset …

Beta-Lactam Allergy De-Labeling Quality Improvement, Eric Riha, Alexandria Kim, David Kim, Brandon Robinson, Kevin Garnepudi

Gulf Coast Division GME Research Day 2025

No abstract provided.

The Utilization Of Podcasts And Test Enhanced Learning In Paramedic And Resident Education, Vincente Loera

Gulf Coast Division GME Research Day 2025

No abstract provided.

Isolated Unilateral Medial Rectus Palsy Due To Acute Pontine Infarction, Miranda Bingham, Shterna Frand, Charley Meadows, Sanjay Sharma

North Texas Research Forum 2025

Isolated unilateral medial rectus palsy is a rare but significant clinical manifestation of acute pontine infarction, often presenting without the typical neurological deficits seen in brainstem strokes. This case report highlights a 61-year-old male with a history of hypertension and diabetes who presented with four days of double vision, with no other significant neurological symptoms such as headache, speech disturbances, or focal weakness. On examination, the patient exhibited an isolated inability to adduct his left eye, without any visual deficits or abnormalities in other cranial nerve functions. Neuroimaging, specifically MRI, confirmed the diagnosis of an acute left pontine infarction. The …