Emergency Medicine Commons^™

Use Of Serial Smartphone-Based Assessments To Characterize Diverse Neuropsychiatric Symptom Trajectories In A Large Trauma Survivor Cohort, Francesca L Beaudoin, Xinming An, Archana Basu, Yinyao Ji, Mochuan Liu, Ronald C Kessler, Robert F Doughtery, Donglin Zeng, Kenneth A Bollen, Stacey L House, Jennifer S Stevens, Thomas C Neylan, Gari D Clifford, Tanja Jovanovic, Sarah D Linnstaedt, Laura T Germine, Scott L Rauch, John P Haran, Alan B Storrow, Christopher Lewandowski, Paul I Musey, Phyllis L Hendry, Sophia Sheikh, Christopher W Jones, Brittany E Punches, Michael C Kurz, Robert A Swor, Vishnu P Murty, Meghan E Mcgrath, Lauren A Hudak, Jose L Pascual, Elizabeth M Datner, Anna Marie Chang, Claire Pearson, David A Peak, Roland C Merchant, Robert M Domeier, Niels K Rathlev, Brian J O' Neil, Paulina Sergot, Leon D Sanchez, Steven E Bruce, Justin T Baker, Jutta Joormann, Mark W Miller, Robert H Pietrzak, Deanna M Barch, Diego A Pizzagalli, John F Sheridan, Jordan W Smoller, Steven E Harte, James M Elliott, Karestan C Koenen, Kerry J Ressler, Samuel A Mclean

Department of Emergency Medicine Faculty Papers

The authors sought to characterize adverse posttraumatic neuropsychiatric sequelae (APNS) symptom trajectories across ten symptom domains (pain, depression, sleep, nightmares, avoidance, re-experiencing, anxiety, hyperarousal, somatic, and mental/fatigue symptoms) in a large, diverse, understudied sample of motor vehicle collision (MVC) survivors. More than two thousand MVC survivors were enrolled in the emergency department (ED) and completed a rotating battery of brief smartphone-based surveys over a 2-month period. Measurement models developed from survey item responses were used in latent growth curve/mixture modeling to characterize homogeneous symptom trajectories. Associations between individual trajectories and pre-trauma and peritraumatic characteristics and traditional outcomes were compared, along …

Second Victim Syndrome: Nurturing Well-Being And Resilience In The Medical Community, Daniel Basselgia

East Florida Division GME Research Day 2023

Please see supplemental content for full abstract with references.

Second Victim Syndrome (SVS), a phenomenon observed in healthcare, refers to the emotional, psychological, and physical distress experienced by healthcare providers involved in adverse patient events. This paper explores the multifaceted impact of SVS on healthcare professionals, the underlying contributing factors, and proposes comprehensive strategies to foster well-being and resilience within the medical community. By recognizing and addressing SVS, healthcare organizations can create a supportive environment that enhances the overall quality of patient care and ensures the long-term vitality of their workforce.

Delay In Transfers From The Emergency Department To Inpatient Floors, Kaelan Chan, Frank Salamone, Jennifer Tram, Jasmine Zhao

Far West Division GME Research Day 2023

No abstract provided.

Residency Burnout And Wellness, Harmanjit Khokhar, Dennis Cardriche

East Florida Division GME Research Day 2023

Intro: Wellness and burnout are two components of residency. Burnout is defined as a condition defined by emotional exhaustion, depersonalization, and decreased feelings of accomplishments. Wellness is the accumulation of positive habits affecting mental, physical and emotional health. Burnout has been associated with “negative effects on quality of care, patient satisfaction and patient safety (1).”

The Objective: Objective of this review is to explore the connection between wellness and burnout, as well as future considerations, including research. While further research on burnout is an important avenue to pursue, tangible interventions may shed light on protective factors against the negative effects …

Improving Intravenous Catheter Insertion Success In Difficult Access Patients, Heidi Berry

Doctor of Nursing Practice Projects

Around one in every nine Emergency Department (ED) patients have Difficult Intravenous Access (DIVA) and 25% of ED patients will require more than one attempt (Fields et al., 2014a). Failed insertion attempts contribute to decreased patient satisfaction, care delays, and financial losses. The freestanding ED affiliated with a multi-state, not-for-profit healthcare system in an urban community had difficulty with first-attempt Peripheral IV (PIV) insertion success in identified patients. The target population was the clinical staff of the freestanding ED which included Registered Nurses and Paramedics. The objective outcome was to enhance personal knowledge of PIV catheter insertion in difficult-access patients …

Ambulance Response In Eight Minutes Or Less: Are Comorbidities A Factor, Blaine Rourke, Heather Rhodes, Antonio Pepe

South Atlantic Division GME Research Day 2023

No abstract provided.

Quality Improvement: Implementation Of Rapid Mri Protocol At Gsmc For Further Evaluation Of Suspected Pediatric Appendicitis, Colin W. Woolard, Christian Salinas, Allison Hudak, Jeffery Durbin

South Atlantic Division GME Research Day 2023

No abstract provided.

A Case Of Transient Left Bundle Branch Block, Taylor Craig, Vincent Grekoski, Kashan Mahmood, Laura Tortora

East Florida Division GME Research Day 2023

Please see supplemental content for full abstract with references.

Episodic bundle branch blocks are a phenomenon associated with many clinical conditions seen in the emergency department. Intermittent BBBs by definition show both normal conduction and BBB within a single electrocardiographic tracing, where a transient BBB is described as a conduction defect that which then returns to normal. The most common cause of both transient and episodic BBB is rate related however there are many causes.1 Acute LBBB should lead to suspicion of acute coronary syndrome until proven otherwise, however other many other precipitating causes can factor into the overall clinical …

Invasive Testing For Pre-Operative Localization Of Parathyroid Tumors, Akua Graf, Craig Cochran, Samira Sadowski, Naris Nilubol, William F. Simonds, Lee S. Weinstein, Richard Chang, Smita Jha

East Florida Division GME Research Day 2023

Context: The identification of parathyroid tumor(s) in patients with persistent/recurrent primary hyperparathyroidism (PHPT) is critical for a successful re-operative surgery. If non-invasive studies (ultrasound, CT, MRI, sestamibi) fail to conclusively localize the tumor, invasive procedures (arteriography and selective venous sampling) are performed.

Objective: To describe our experience with invasive studies for parathyroid tumor localization and provide follow-up data on selective arterial hypocalcemic stimulation with central venous sampling, a technique developed at our center.

Methods: We identified patients who underwent preoperative invasive testing for localization of parathyroid tumor from 1991-2020. The result of each invasive localization study (arteriogram, hypocalcemic stimulation and …

Dead End: Challenges In Healthcare Delivery To Older Adults With History Of Dementia And Incarceration- A Case Report, Shruti Anand, Saket Saxena

Journal of Geriatric Emergency Medicine

No abstract provided.

Emergency Department Thoracotomy As An Intervention For Penetrating Trauma To The Thoracic Cavity: A Systematic Review, Samuel Scherf

Theses and Graduate Projects

Emergent thoracic surgery involving the heart has been taking place for 126 years. Thoracic penetrating trauma is occurring more and more frequently in the US, and while 90% of patients with penetrating thoracic trauma die en route to hospital, the ones who arrive in extremis have better chances of survival now than ever due to an improving 60+ year practice of emergency department thoracotomy (EDT). This review has a primary objective of comparing the literature and history of EDT as a lifesaving intervention for patients with penetrating thoracic trauma and resulting mortality. It also aims to give context on EDT …

Pulsing Staples: A Case Report Of Superficial Temporal Artery Pseudoaneurysm And Literature Review Of The Same, Austin Mccrea, Jonathan Hardin, Patrick Melmer, Saptarshi Biswas

South Atlantic Division GME Research Day 2023

No abstract provided.

A Case Of Traumatic Hyphema In A Healthy Young Male, Casey Wilson, Thelmari Raubenheimer

South Atlantic Division GME Research Day 2023

No abstract provided.

Mvc Rollover With Visual Left Wrist Deformity, Nicholas Hale, Jonathan Leggett

South Atlantic Division GME Research Day 2023

No abstract provided.

A Rare Constellation Of Devastating Injuries - Open Pelvic Fracture With Testicular Disruption: A Case Report, Margaret Rose, Jamie Pham, Kelly Champlin, Saptarshi Biswas

South Atlantic Division GME Research Day 2023

No abstract provided.

The Impact Of Demographic Factors And Language On Stroke Metrics Within The Hca Healthcare System, Henry Yelkin, Glenn Goodwin, Jonghoon Chang, Mchenry Mauger, Erin Marra

East Florida Division GME Research Day 2023

Background: Effective evaluation of stroke symptoms necessitates a comprehensive clinical assessment, influencing the timely administration of tissue plasminogen activator (tPA). This study examines the relationship between patients’ preferred language as well demographic factors and stroke care metrics within the framework of the HCA Healthcare System.

Methods: A retrospective study design was used to examine the national HCA database for all patients admitted to an HCA hospital with a diagnosis of stroke and with a recorded NIH stroke scale (NIHSS) between the years of 2017 and 2022. 37,956 patient visits from 170 HCA hospitals were analyzed to compare stroke metrics including …

From Pest Control To Poison Control: A Novel Case Report Of Delayed Carbamate Poisoning., Kashan Mahmood, Erin Marra, Taylor Craig, Gaurav Patel

East Florida Division GME Research Day 2023

Introduction: Carbamates are a class of insecticides structurally and mechanistically similar to organophosphate (OP) insecticides. Carbamates are N-methyl carbamates derived from a carbamic acid and cause carbamylation of acetylcholinesterase at neuronal synapses and neuromuscular junctions. While they possess a similar mechanism of action to the irreversible phosphorylation of acetylcholinesterase by organophosphates, carbamates bind to acetylcholinesterase reversibly. Subsequently, carbamates typically have a similar toxicological presentation to OP poisonings with a duration of toxicity that is typically less than 24 hours.

Case Presentation: We present a case of a 51-year-old male who was complaining of diarrhea, lacrimation, salivation, headache, photophobia, diaphoresis, and …

A Case Of Hyperkalemia Secondary To Table Salt Alternative In A Patient With Normal Renal Function, Souhil M. Jaafil, Laura Tortora, Erin Marra, Steven Shapiro

East Florida Division GME Research Day 2023

Introduction: Hyperkalemia is a commonly presenting electrolyte derangement, usually secondary to chronic kidney disease or medication use. In one retrospective study by Singer et al of 100,260 Emergency Department (ED) patient visits it was found that 1 in 11 ED patients presented with a potassium derangement (1). Patients can present in various ways, from asymptomatic to life threatening arrhythmias. A less commonly recognized cause of hyperkalemia is dietary substitutions for everyday table salt. Ayach et al reported a patient with potassium of 9.8 mmol/L secondar to dietary substitutions but with acute kidney injury and ACE inhibitor use (2). Through a …

Insight Into Drug Use Trends Based On Emergency Department Urine Drug Screen Results From An Acute Care Hospital In Tennessee, Carmen Wolfe, Michael A. Hayoun, Sue Lynn Myhre

TriStar Division Research Day 2023

No abstract provided.

Incidence Of Adult (>40y) Traumatic Brain Injury And Likelihood Of Routine Discharge: Do Co-Morbidities Matter?, Yelena Pecheny, Heather Rhodes, Stephanie Anderson, Antonio Pepe, Donald Courtney

South Atlantic Division GME Research Day 2023

No abstract provided.