Emergency Medicine Commons^™

Multidisciplinary Lethal Means Safety Counseling Design And Implementation: Training And Identifying Barriers In A Children's Hospital, Cassandra L. Stegall, Brendon Carnell, Jaime M. Golden, Rupa Kapoor, John H. Fanton, Paul C. Mullan, Alexandra P. Leader

Department of Pediatrics Faculty Publications

Background

Access to lethal means contributes significantly to suicide completion. Lethal means safety counseling (LMSC) is an injury prevention strategy to limit access to firearms, medications, and other means of injury. Not previously evaluated in the trauma setting, this study aims to design and implement a standardized LMSC protocol for pediatric patient discharge education in emergency (ED), trauma, and inpatient psychiatry settings.

Methods

A single-center quality improvement study at an academic pediatric urban tertiary Level-one trauma center was performed from July 2023 to February 2024. Protocol was implemented for pediatric patients discharged from three departments: ED, surgery trauma service, and …

How Do Patient-Provider Relationships Affect Patient Satisfaction?, Rose D. Lightspeed

Anthós

This article reviews studies on patient satisfaction within the U.S. healthcare system to investigate how physicians’ behavior influences patients’ reported quality of care. Medical negligence, neglect, and cognitive biases are identified from the reviewed literature as physician behaviors that affect the patient-provider relationship and patient satisfaction. Emphasizing patient satisfaction and involvement in their care as important considerations when evaluating patient-provider relationships, Lightspeed underscores how the complex dynamic between patient and provider–including physicians’ reported feeling of inadequate interpersonal skills and patients’ sensitivity to dismissive communication–contributes to reduced satisfaction rates. Lightspeed argues that increasing physician awareness of these factors that influence patient …

Emergency Action Plan Adoption Across Athletic Training Practice Settings, Samantha E. Scarneo-Miller, Rebecca L. Stearns, Christianne M. Eason, Alicia M. Pike Lacy, Rebecca M. Lopez, Zachary K. Winkelmann, Rebecca M. Hirschhorn, Susan W. Yeargin

Rehabilitation Sciences Faculty Publications

Context:

The 2024 NATA Position Statement provides updated recommendations for EAP adoption. Past research on the 2002 statement showed limited adoption by ATs. Assessing current adoption across practice settings offers a clearer picture of the EAP implementation landscape.

Objectives:

To examine ATs' adoption of new EAP best-practice recommendations across practice settings.

Design:

Cross-Sectional study.

Setting:

Online questionnaire.

Patients or Other Participants:

Clinically active ATs (n=614) working in any practice setting (Youth, Secondary School, Division 1 Power 4, Collegiate athletics – Not Power 4, Non-Major Professional Sports, Professional Sports, Non-Sideline).

Main Outcome Measures:

Prevalence of an EAP, adoption of recommendations, and …

Blurry With A Chance Of Ultrasound: A Case Of Sudden Vision Loss, Anjeza Cipi, Emily Sealy

Department of Emergency Medicine Faculty Publications

[Case presentation] A 30-year-old man with Crohn’s disease presented to the emergency department (ED) with sudden, painless vision loss in his left eye. He described a central dark spot that rapidly progressed over 5 minutes to near-complete central vision loss, sparing peripheral vision. He denied trauma, exertion, Valsalva, or anticoagulant use. Point-of-care ultrasound (POCUS) was performed on supine patient using a high-frequency linear probe (10-15 MHz) with copious gel over the closed eyelid, avoiding direct pressure. While instructing the patient to look in different directions, the eye was scanned in its entirety in transverse and sagittal planes. Gain and depth …

Hooked On Sight: Teen With Eye Trauma, Anjeza Cipi, Emily Sealy

Department of Emergency Medicine Faculty Publications

[Case presentation] A 14-year-old male with no prior ocular history presented to the emergency department after accidentally striking his left eye on a metal garden hook while on vacation. He experienced a brief flash of light but denied floaters, vision changes, pain, or diplopia. Visual acuity was 20/20 bilaterally with correction. Pupils were equal and reactive, intraocular pressures were normal, and extraocular movements were intact. The injury noted is seen in Figures 1 and 2. There was no evidence of scleral penetration or foreign body on slit lamp examination. Intraocular pressure measurements were deferred until globe rupture was ruled out …

Letter Of Concern From The Association Of Academic Chairs Of Emergency Medicine Regarding Acgme Proposed Changes, Richard J. Hamilton, Lance B. Becker, Richard E. Wolfe, D. Adam Algren, Arnold Thomas, Michael Baumann, Ross P. Berkeley, Terrell S. Caffery, Chad Cannon, Theodore J. Corbin, Michael E. Chansky, Harinder S. Dhindsa, Charles L. Emerman, David A. Farcy, Chris Fox, Michael A. Gibbs, Christopher S. Goode, Steven "Andy" Godwin, Dietrich Jehle, David Johnson, Samuel M. Keim, Babak Khazaeni, Barry J. Knapp, Clint Hawthorne, John D. Hoyle Jr., Michael Christopher Kurz, Evan Leibner, Robert Mcnamara, Robert F. Mccormack, Edward A. Michelson, Chadwick Miller, Ashley Norse, Andrew Nugent, Brian J. O'Neil, David T. Overton, Edward A. Panacek, William F. Paolo, Denis R. Pauzé, Amanda L. Perez, Ralph J. Riviello, Scott W. Rodi, Peter S. Pang, Juan A. Gonzalez Sanchez, David P. Sklar, Ben C. Smith, Jeffrey R. Stowell, Marc D. Squillante, J. Jeremy Thomas, Terry Vanden Hoek, Gregory A. Volturo, E. Lea Walters, Thomas E. Wyatt, Donald M. Yealy

Department of Emergency Medicine Faculty Publications

This letter, signed by over 50 academic chairs of emergency medicine, urges the ACGME to reconsider a proposed mandate requiring all emergency medicine residency programs to adopt a four-year training model. The authors argue that current three-year programs are supported by data demonstrating equivalent educational and clinical outcomes compared to four-year formats. They criticize the flawed survey methodology underpinning the proposal, note the loss of milestone-based training flexibility, and highlight the lack of added scholarly or clinical value in the fourth year. The letter also outlines negative consequences for fellowship participation, workforce development, trainee debt, and diversity. The signatories advocate …

Risk And Protective Factors For Sudden Infant Death Syndrome (Sids) In Low-Resource Communities In Kolkata India: A Mixed Methods Exploratory Study Of Semi-Structured Interviews And Survey Data, Susan Samreth, Alexandra Leader, Jillian Kiely, Turja Chakrabarti, Rupa Kapoor

Department of Pediatrics Faculty Publications

Sudden Unexpected Infant Death (SUID), Sudden Infant Death Syndrome (SIDS) and infant sleep practices are widely documented and studied in high-resource countries. Knowledge of SUID/SIDS occurrence, risk factors and protective factors in low or middle-resource countries such as India is lacking. This was an exploratory study using a mixed methods (qualitative and quantitative) approach to better understand infant sleep practices and the various factors that may influence them amongst caregivers in 5 low-income communities in Kolkata, India. Twenty-eight and 22 caregivers of infants < 12 months old were recruited using a convenience sampling approach to participate in semi-structured interviews (phase 1) and a survey (phase 2), respectively. This research was conducted in partnership with Pratit International, a locally based NGO dedicated to providing comprehensive health care to disenfranchised communities in Kolkata. Analysis of qualitative and quantitative data found that infant caregivers frequently described risk factors (e.g., bedsharing, soft sleep surface, infant sleep position, objects in sleep area, environmental smoke exposure, low rates of pacifier use) and protective factors (e.g., breastfeeding, routine immunization/prenatal care, low rates of caregiver substance use) that have been associated with SIDS in high resource communities. Qualitative data revealed that certain caregivers' reasons for infant sleep position were rooted in cultural beliefs. Prenatal and postnatal sleep education given by a healthcare professional were limited and awareness of safer sleep advice in the community was low. These study findings suggest the need to provide safer sleep education resources in a culturally appropriate manner and can help guide future research on potential interventions such as the baby box.

Virtual Learning In Emergency Medicine Residency Programs, Ashley Rider, Laura Oh, Rahul Bhat, Michael Gottlieb, Bruce Lo, Ulemu Luhanga, Shayne Gue, Jason Laenngfeld, Sarah Greenberger, Jeffery Hill, Jonathan Heidt

Department of Emergency Medicine Faculty Publications

During the COVID-19 pandemic, educational systems worldwide faced significant disruptions as in-person learning became unfeasible. In response, many institutions, including graduate medical education programs, swiftly transitioned to virtual learning platforms to adapt to these challenges. The rapid and unplanned pivot in learning format resulted in temporary negative impacts on residency training. Conversely, the experience of the rapid shift may have resulted in some long-term benefits while also preparing programs for future disruptions. This review aimed to discuss the advantages and disadvantages of virtual learning, potential mitigation strategies for the realized disadvantages, and potential areas of future research.

Current Trends In School Nursing For Diabetes & Dermatology, Ali Al-Nahi, Jeffrey Dickerson, Enith Espinosa Palmett, Shterna Frand, Garrett Furth, Matthew Gutzmer, Marshall Hall, Sana Khan, Shana-Kay Lambert-Johnson, Henry Lim, Kelly Mofor, Lakshmi Morla, Ali Nazim, Rui Zhang, Christian Scheufele, Zara Soomro, Michele Mccarroll, Taylor Pickering, Jasmine Silva, Brina Gonzalez, Devika Adusumilli, Sherri Morgan, Nischal Pokhrel

North Texas Research Forum 2025

Background: School nurses are on the front lines of assessing, identifying and treating school-age children with a number of health complications. Implementing nursing services in schools has previously demonstrated improved medical care costs for students, less productivity loss for parents, and less productivity loss for teachers. As a result, nursing services in schools provide a cost-beneficial investment of public money, and warrant both financial support from policy makers as well as educational support from local healthcare services. Aim Statement: This quality improvement project addressed the targeted continuing education gap topics of Dermatology and Diabetes management in school age children. Methods: …

Assessing The Role Of Negative Troponin Tests In Discharge Decisions And Long-Term Outcomes For Ed Chest Pain Patients, Rajiv Shah, Nicholas Pennington, Julia Iman, Dominic Juarez, Akriti Arora, Dennis Besong

South Atlantic Division GME Research Day 2025

No abstract provided.

Pre-Hospital Naloxone Use Patterns And Patient Cutcomes: A National Observational Study, Martin Wegman, Jessica Adams, Jonathan Fisher, Remle Crowe, Zachary Dezman, Jennifer Naples, Mallika Mundkur, J Brent Myers, Scott G. Weiner

South Atlantic Division GME Research Day 2025

No abstract provided.

Pericapsular Nerve Group (Peng) Block Vs. The Fascia Iliaca Compartment (Fic) Block For Patients With Isolated Hip Fractures In The Emergency Department, Daniel Dagenhart, Taryn Hoffman, Matthew Carr, Martin Wegman

South Atlantic Division GME Research Day 2025

No abstract provided.

Seizure In The Setting Of Metoprolol Overdose, Shilpa Amin, Justin H. Le, Hannah Sodergren

South Atlantic Division GME Research Day 2025

No abstract provided.

A Strange Case Of Sudden-Onset Dysphagia: Esophageal Dysmotility And Dilation In A Lupus Patient, Arjavon Talebzadeh, Trevor Williams

South Atlantic Division GME Research Day 2025

No abstract provided.

High Rates Of Avoidable Computed Tomography Angiography For Pulmonary Embolism Exclusion, Kalyan Mantha, Angelo Kantrales, Kerolos Abadeer, Pranav Bommineni, Nicholas Prewitt, Martin Wegman

South Atlantic Division GME Research Day 2025

No abstract provided.

Inpatient Vs. Outpatient Management Outcomes Of Ectopic Pregnancy With Methotrexate, Courtney Smith, Taryn Hoffman, Kavya Davuluri, Ashley Brodrick, Taylor Penny, Robyn Meadows, Martin Wegman

South Atlantic Division GME Research Day 2025

No abstract provided.

Staphylococcal Scalded Skin Syndrome In Melanatedskin: A Pediatric Case Report, Aleah Lafrancis-Ream, Hannah Chotiner, Scott Gutovitz

South Atlantic Division GME Research Day 2025

No abstract provided.

Case Report Of Tricyclic Antidepressant Toxicity With Prolonged Qt/Qtc And Widened Qrs On Ekg, Alexandra Doan, Joshua Wilkes, Jonathan Leggett, Jarratt Lark

South Atlantic Division GME Research Day 2025

No abstract provided.

Retrospective Comparison Of Emergency Department (Ed) Length Of Stay (Los) Between Marijuana And Alcohol Users, Paul Bomar, Jonathan Leggett, Lisa Persaud, Franklin Schaefer, Vanessa Knapp, Lauren Eisenberg, Austin Johnson

South Atlantic Division GME Research Day 2025

No abstract provided.

Real-World Interventional Outcomes For Cardiogenic Shock Complicating Acute Myocardial Infarction, John E. Brush Jr., Ann M. Harper, Luke C. Kohan, Zachary Bouker, Kaivalya Dandamudi, Deepak R. Talreja

Department of Medicine Faculty Publications

Acute myocardial infarction with cardiogenic shock (AMICS) carries high mortality and remains a major concern. This concern drives use of interventions with marginal benefit and some evidence of harm. The configuration of hospital care and allocation of interventions for AMICS in our health system created a natural experiment to analyze interventional outcomes for patients with AMICS.

Objective

To compare clinical outcomes among AMICS patients treated with mechanical circulatory support (MCS) using a micro-axial left ventricular assist device and intra-aortic balloon counter-pulsation (IABP).

Design, setting, participants, outcome measures

In this observational study in a large health system, we used clinical registry …