Emergency Medicine Commons^™

I Don't Have A Diagnosis For You: Preparing Medical Students To Communicate Diagnostic Uncertainty In The Emergency Department, Maria Poluch, Jordan Feingold-Link, Nethra S. Ankam, Jared Kilpatrick, Kenzie Cameron, Shruti Chandra, Amanda Doty, Matthew Klein, Danielle Mccarthy, Kristin L. Rising, David Salzman, Deborah Ziring, Dimitrios Papanagnou

Department of Emergency Medicine Faculty Papers

Introduction: Diagnostic uncertainty abounds in medicine, and communication of that uncertainty is critical to the delivery of high-quality patient care. While there has been training in communicating diagnostic uncertainty directed towards residents, a gap remains in preparing medical students to understand and communicate diagnostic uncertainty. We developed a session to introduce medical students to diagnostic uncertainty and to practice communicating uncertainty using a checklist during role-play patient conversations.

Methods: This virtual session was conducted for third-year medical students at the conclusion of their core clerkships. It consisted of prework, didactic lecture, peer role-play, and debriefing. The prework included reflection prompts …

Attitudes Among Healthcare Professionals Towards Cardiopulmonary Resuscitation During Covid-19., Safinaz Al-Shiakh, Quincy K Tran, Amy Caggiula, Ivan Berezowski, Basma Barnawi, Ali Pourmand

Emergency Medicine Faculty Publications

No abstract provided.

What You Need To Know About Em Administration Fellowships, Michael Muradian

Articles

No abstract provided.

Impact Of Urgent Care Centers And Telehealth In The Ed, Javed Osmani, Michael Muradian, Christina Brown, Nicholas Stark

Articles

No abstract provided.

Multidisciplinary Care For Refractory Pediatric Functional Abdominal Pain Decreases Emergency And Inpatient Utilization, Andrew S Chu, Laura Torres, Grace Kao, Caroyl Gilbert, Evelyn Caro Monico, Bruno P Chumpitazi

Faculty, Staff and Students Publications

Children with refractory functional abdominal pain (FAP) experience functional disability and may utilize emergency department (ED) and/or inpatient services. Whether multidisciplinary programs which help care for children with refractory FAP affect acute healthcare utilization is unknown. A retrospective chart review of children initially evaluated by the outpatient Multidisciplinary Abdominal Pain Program (MAPP) from October 2016 to May 2019 was completed. Patient characteristics and number of ED visits and hospitalizations for abdominal pain in the year prior to versus year after MAPP evaluation were captured. Thirty-eight children (ages 9-17 years [median 13 years]) were included. The median number of ED visits/patient/year …

Covid-19 Hospital And Emergency Department Visitor Policies In The United States: Impact On Persons With Cognitive Or Physical Impairment Or Receiving End-Of-Life Care, Alexander X Lo, Logan K Wedel, Shan W Liu, Thiti Wongtangman, Phraewa Thatphet, Ilianna Santangelo, Anita N Chary, Paul D Biddinger, Corita R Grudzen, Maura Kennedy

Faculty, Staff and Students Publications

OBJECTIVE: To characterize the national distribution of COVID-19 hospital and emergency department visitor restriction policies across the United States, focusing on patients with cognitive or physical impairment or receiving end-of-life care.

METHODS: Cross-sectional study of visitor policies and exceptions, using a nationally representative random sample of EDs and hospitals during the first wave of the COVID-19 pandemic, by trained study investigators using standardized instrument.

RESULTS: Of the 352 hospitals studied, 326 (93%) had a COVID-19 hospital-wide visitor restriction policy and 164 (47%) also had an ED-specific policy. Hospital-wide policies were more prevalent at academic than non-academic (96% vs 90%;

CONCLUSION: …

Rates Of Publication Of Fcps Dissertations In International And National Peer-Review Journals Among Residents At Akuh; A Cross Sectional Review Of 15 Years, Ainulakbar Mughal, Syed Akbar Abbas, Abdul Basit Shah Vardag, Muhammad Wasif, Soubia Akhtar, Ayesha Abbasi

Section of Otolaryngology, Head & Neck Surgery

Objective: To see the rate of publication of postgraduate residents' dissertation.
Methods: The single-centre retrospective cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, and comprised research publications from the residents of the departments of Surgery and Medicine who graduated between 2005 and 2020. The surgical subspecialties included Otolaryngology, Ophthalmology, Dentistry, General Surgery, Orthopaedics, Paediatric Surgery, Urology, Plastic Surgery and Cardiovascular Surgery. Data comprised demographics, current institution, current designation, information on dissertation/paper publication, topic of study, year of completion of dissertation, input from the research department, delay in exam due to incomplete dissertation and whether the paper got …

Effect Of Coronary Artery Disease On Covid-19-Prognosis And Risk Assessment: A Systematic Review And Meta-Analysis, Lukasz Szarpak, Malgorzata Mierzejewska, Jonasz Jurek, Anna Kochanowska, Aleksandra Gasecka, Zenon Truszewski, Michal Pruc, Natasza Blek, Zubaid Rafique, Krzysztof J Filipiak, Andrea Denegri, Milosz J Jaguszewski

Faculty, Staff and Students Publications

Simple Summary

As of October 2021, over 245 million people have been infected and nearly 5 million have died due to COVID-19. Atherosclerosis is a lipid-driven chronic inflammation of the arterial wall with coronary artery disease (CAD) that may lead to acute coronary syndrome (ACS), which remains the main cause of death in developed countries. We believe that due to CAD development factors affecting the vessel wall, the SARS-CoV-2 infection may precipitate further advancement of future thromboembolic events by a plaque erosion or rupture. Therefore, this metanalysis aims to unambiguously establish the role of the history of CAD in mortality …

What's In Your Box? Dental Trauma Management, Amy Smark

Website/Multimedia Contributions

No abstract provided.

Simulation-Based System Analysis: Testing Preparedness For Extracorporeal Membrane Oxygenation Cannulation In Pediatric Covid-19 Patients., Alyssa Stoner, Robert Schremmer, Mikaela A. Miller, Kari L. Davidson, Rachael L. Pedigo, Jamie S. Parson, Christopher S. Kennedy, Eugenia K. Pallotto, Jenna Miller

Manuscripts, Articles, Book Chapters and Other Papers

Introduction: Coronavirus Disease-2019 presents risk to both patients and medical teams. Staff-intensive, complex procedures such as extracorporeal membrane oxygenation (ECMO) or extracorporeal cardiopulmonary resuscitation (eCPR) may increase chances of exposure and spread. This investigation aimed to rapidly deploy an in situ Simulation-based Clinical Systems Testing (SbCST) framework to identify Latent Safety Threats (LSTs) related to ECMO/eCPR initiation during a pandemic.

Methods: The adapted SbCST framework tested systems related to ECMO/eCPR initiation in the Neonatal and Pediatric Intensive Care Units. Systems were evaluated in six domains (Resources, Processes/Systems, Facilities, Clinical Performance, Infection Control, and Communication). We conducted three high-fidelity simulations with …

Principles Of Hypotensive Shock: A Video Introduction To Pathophysiology And Treatment Strategies, Brittany Macdonald, Nicholas Macdonald, Jacob Garcia, Xiao Chi Zhang, Dimitrios Papanagnou

Department of Emergency Medicine Faculty Papers

Audience: Emergency medicine interns, medical students, and mid-level providers (physician assistants, nurse practitioners).

Introduction: Shock is defined as a state of global tissue hypoxia and is typically the result of hypotension and circulatory system failure. A variety of disease states may ultimately culminate in hypotensive shock through one or more generally recognized mechanisms – hypovolemic, cardiogenic, obstructive, and/or distributive shock. These mechanisms differ significantly in terms of their pathophysiology and requisite treatment. While the effects of hypotensive shock are initially reversible, untreated hypotensive shock may rapidly progress to multiorgan failure and death. Hence, the ability to promptly recognize a state …

Trends In Premature Mortality From Acute Myocardial Infarction In The United States, 1999 To 2019, Sourbha S. Dani, Ahmad N. Lone, Zulqarnain Javed, Muhammad S. Khan, Muhammad Zia Khan, Edo Kaluski, Salim S. Virani, Michael D. Shapiro, Miguel Cainzos‐Achirica, Khurram Nasir

Office of the Provost

Pagination are not provided by the author/publisher. This work was published before the author joined Aga Khan University.

Bedside Diagnosis Of Hemoperitoneum By Characteristics Of Fluid Visualized On Focused Assessment With Sonography In Trauma Exam In A Patient In Non-Traumatic Shock, Margarita S. Popova, Khai-El Johnson, Daniel R. King, Megan T. Quintana, Kendarius Talton, Keith S. Boniface

Emergency Medicine Faculty Publications

No abstract provided.

The Effects Of 465nm Blue Light On Sleepiness & Fatigue, Mark E. Childress

DNP Research Projects

Abstract

Background: Exhaustion is now accepted in nursing culture. Staff suffering from sleepiness and fatigue are more likely to commit medical errors and sentinel events. Emergency department nurses have the greatest risk of committing these errors. Currently, there is no relief provided to shift workers beyond a single 30-minute meal break within a 12-hour period. Other researched mitigation strategies have either failed or are unrealistic in this environment.

Local Problem: Emergency Department nurses at Parkridge Medical Center in Chattanooga, TN suffer from chronic sleepiness and fatigue that is exacerbated by shift duration, excessive workload, a stressful environment, and lack of …

Massive Blood Transfusion Practises: A Survey Of Level 1 Trauma Centers, Rebecca C. Parker

DNP Research Projects

Abstract

Background: Traumatic injury is the leading cause of death for individuals under the age of 45 years old, regardless of race, origin, or sex (CDC, 2019). Among patients who sustain traumatic injury, hemorrhage remains the leading cause of death (American College of Surgeons [ACS], 2014). Hemodynamic stability may be achieved through administration of blood products such as packed red blood cells (PRBC), plasma, and platelets (PTL). Patients with severe exsanguination may require administration of blood products in large quantities, also known as a massive blood transfusion (MBT).

Local Problem: Nationally, traumatic injury accounts for over 150,000 deaths annually (American …

Impact Of Care Handoff Methods On Emergency Department Throughput Times, Shelby Graves

DNP Research Projects

Abstract

Background: Emergency department (ED) overcrowding leads to detrimental results including increased morbidity and mortality, delay in evaluation of treatment, increased cost of care, increased length of stay, diminished staff satisfaction, increased ambulance diversion, and reputation damage for the entire institution (American College of Emergency Physicians, 2019). A study performed at three high volume community hospitals revealed inefficiency of nursing handover as one of the many contributors to prolonged ED length of stay (Salehi, 2019).

Local Problem: According to the 2018 Emergency Department Benchmarking Alliance (EDBA) data survey the average length of time from patient arrival to admission disposition was …

Care Alert Program In Chronic Recurrent Ed Utilizing Patients, Kaitlyn Phelps, Erica Gibbons, Jonathan Leggett, Jonathan Bryan

South Atlantic Division GME Research Day 2022

No abstract provided.

Envenomation By A Gaboon Viper, Mary Claire Lark, Jarratt Lark

South Atlantic Division GME Research Day 2022

No abstract provided.

Triceps Tendon Avulsion In Elderly Male, Mary Claire Lark, Garrett Root, Bryan T. Luu

South Atlantic Division GME Research Day 2022

No abstract provided.

Corneal Ulcer On The Verge Of Rupture: An Ocular Emergency In A Free-Standing Emergency Room, Kevin Thomas, Garrett Root

South Atlantic Division GME Research Day 2022

No abstract provided.