Clinical Decision Making: A Case Study Of The Effects Of Evidence Based Medicine And Past Empirical Experience In The Emergency Department,
2019
University of Nebraska at Omaha
Clinical Decision Making: A Case Study Of The Effects Of Evidence Based Medicine And Past Empirical Experience In The Emergency Department, Olivia Zeman-Renner
Theses/Capstones/Creative Projects
With a growing number of medical malpractice suits and the passage of policy that focuses on patient advocacy, an emphasis has been placed on research regarding the decision-making processes of physicians in everyday practices. Over the past decades, scholars have looked to specific clinical decision-making philosophies, how they can be implemented into practice, and the effects of such implementation, but little research has been done into the culmination of decision-making philosophies on a day-to-day basis. By focusing on single-case study of a Midwestern Emergency Department and asking Attending physicians to self-report their decision-making philosophies, this study serves as a transition …
Outpatient Treatment Of Pulmonary Embolism: A Single-Center Case Series,
2019
Maine Medical Center
Outpatient Treatment Of Pulmonary Embolism: A Single-Center Case Series, Annie Huyler, Casey Z. Macvane, Andrew Perron, Tania D Strout
MaineHealth Maine Medical Center
Background: Pulmonary embolus (PE) is associated with significant utilization of health care resources and financial burden Several additions that have allowed us to look at safely treating patients with PEs as outpatients:
• Simplified Pulmonary Embolism Severity Index (sPESI) -Risk stratifies patients based on their age, vital signs, and past medical history
• Novel oral anticoagulants
Primary Objective: To describe the population, treatment strategies, short-term complications and outcomes associated with outpatient management of PE following treatment in the ED.
Seerratus Anterior Plane Block (Sapb) Improves Paine Control In Rib Fractures,
2019
Maine Medical Center
Seerratus Anterior Plane Block (Sapb) Improves Paine Control In Rib Fractures, Randy Kring, Peter Croft, David Mackenzie, Christina Wilson, Joseph Rappold, Tania D. Strout
MaineHealth Maine Medical Center
Background:
•Trauma is a major cause of morbidity and mortality worldwide. Rib fractures are identified in at least 10% of all injured patients.
•Rib fractures can lead to significant respiratory complications, with pneumonia and respiratory failure occurring in up to 31% of patients with rib fractures. Early initiation of aggressive pain control and pulmonary hygiene with incentive spirometry are standard of care to prevent complications from developing.
•In the Emergency Department, patients with rib fractures typically receive systemic analgesia that is largely narcotic-based. This pain control strategy puts patients at risk for the side effects of narcotics such as constipation, …
Reducing Length Of Stay For Mental Health Patients,
2019
Maine Medical Center
Reducing Length Of Stay For Mental Health Patients, Faye Collins, Nancijean Goudey
MaineHealth Maine Medical Center
Background:
Our facility sees an average of over 200 mental health patients every month, with limited community resources. The length of stay (LOS) for these patients had slowly risen to unacceptable levels; the number of patients whose LOS was greater than 24 hours increased in fiscal year (FY) 2017, from 633 patients to 1145. Patients in crisis require expedited transfer to appropriate care locations. Our goal was to decrease the overall length of stay for mental health patients in the Emergency Department.
Utilization Of Acupuncture Services In The Emergency Department Setting: A Quality Improvement Study,
2019
Aurora Health Care
Utilization Of Acupuncture Services In The Emergency Department Setting: A Quality Improvement Study, John R. Burns, Jessica J. F. Kram, Vashir Xiong, Jeanne M. Stark Casadont, Tiffany A. Mullen, Nancy Conway, Dennis J. Baumgardner
Journal of Patient-Centered Research and Reviews
Purpose: Patients often present to the emergency department (ED) for pain. As opioid fatalities rise, alternative treatments are warranted for pain management. Acupuncture, a nonpharmacological treatment involving the insertion of needles into skin or tissue at specific points within the body, may help to decrease acute pain. Our study aimed to assess the utilization and impact of acupuncture in the ED for acute pain management.
Methods: We conducted a retrospective analysis of purposefully collected quality improvement data. Patients who were ≥18 years old and who presented to the ED at an urban medical center in Wisconsin during 2017 were offered …
Improving Bronchiolitis Care Across Multiple Care Settings Using A Deimplementation Bundle,
2019
Children's Mercy Hospital
Improving Bronchiolitis Care Across Multiple Care Settings Using A Deimplementation Bundle, Amanda Nedved, Kathleen Berg, Troy Richardson, Amanda Montalbano, Matthew B. Johnson
Posters
Despite the availability of a bronchiolitis CPG; variation in care practices still existed at our institution. The aim of our quality improvement (QI) project was to increase overall adherence with our institutional CPG in patients 60 days to 24 months of age diagnosed with bronchiolitis in the urgent care centers (UCC), emergency departments (ED), and general inpatient units from a baseline of 40.9% to 60% by the end of two bronchiolitis seasons.
Patients With Refractory Out-Of-Cardiac Arrest And Sustained Ventricular Fibrillation As Candidates For Extracorporeal Cardiopulmonary Resuscitation - Prospective Multi-Center Observational Study.,
2019
National Cerebral and Cardiovascular Centre; Kumamoto University
Patients With Refractory Out-Of-Cardiac Arrest And Sustained Ventricular Fibrillation As Candidates For Extracorporeal Cardiopulmonary Resuscitation - Prospective Multi-Center Observational Study., Takahiro Nakashima, Teruo Noguchi, Yoshio Tahara, Kunihiro Nishimura, Soshiro Ogata, Satoshi Yasuda, Daisuke Onozuka, Naoto Morimura, Ken Nagao, David F. Gaieski, Yasufumi Asai, Hiroyuki Yokota, Satoshi Nara, Mamoru Hase, Takahiro Atsumi, Tetsuya Sakamoto
Department of Emergency Medicine Faculty Papers
BACKGROUND: We investigated whether patients with out-of-hospital cardiac arrest (OHCA) and sustained ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) or conversion to pulseless electrical activity/asystole (PEA/asystole) benefit more from extracorporeal cardiopulmonary resuscitation (ECPR). Methods and Results: We analyzed data from the Study of Advanced Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan, which was a prospective, multicenter, observational study with 22 institutions in the ECPR group and 17 institutions in the conventional CPR (CCPR) group. Patients were divided into 4 groups by cardiac rhythm and CPR group. The primary endpoint was favorable neurological outcome, defined as Cerebral Performance Category 1 …
Information And Readiness Build Resilience: The Role Of The Disaster Information Management Research Center,
2019
National Library of Medicine
Information And Readiness Build Resilience: The Role Of The Disaster Information Management Research Center, Stacey J. Arnesen, Florence Chang
Collaborative Librarianship
The National Library of Medicine (NLM) established the Disaster Information Management Research Center (DIMRC) in 2008 based on its history of providing health information for disaster preparedness, response, and recovery. The NLM long range plan (Charting a Course for the 21st Century: NLM's Long Range Plan 2006-2016) called for creation of a center to show "a strong commitment to disaster remediation and to provide a platform for demonstrating how libraries and librarians can be part of the solution to this national problem". NLM was urged to "ensure continuous access to health information and effective use of libraries and …
An Evaluation Of Risk Attitudes And Risk Tolerance In Emergency Medicine Residents.,
2019
Thomas Jefferson University
An Evaluation Of Risk Attitudes And Risk Tolerance In Emergency Medicine Residents., Carlos Rodriguez, Nishad A Rahman, Kory London, Robin Naples, Simran Buttar, Xiao Chi Zhang, Hyunjoo Lee, Joshua Rudner, Dimitrios Papanagnou
Department of Emergency Medicine Faculty Papers
Introduction Previous studies have shown that risk attitudes and tolerance for uncertainty are significant factors in clinical decision-making, particularly in the practice of defensive medicine. These attributes have also been linked with rates of physician burnout. To date, the risk profile of emergency medicine (EM) physicians has not yet been described. Our goal was to examine the risk profile of EM residents using a widely available risk tolerance and attitude assessment tool. Methods First-, second-, and third-year residents of Thomas Jefferson University Hospital's EM residency program completed the commercially available, unmodified Risk Type Compass, a validated instrument offered by Multi-Health …
Acute Fondaparinux (Arixtra) Intentional Overdose Via Self-Injection: A Case Report,
2019
Lehigh Valley Health Network
Acute Fondaparinux (Arixtra) Intentional Overdose Via Self-Injection: A Case Report, Andrew L. Koons Do, Kenneth D. Katz Md, Matthew D. Cook Do, Robert D. Cannon Do, Gillian A. Beauchamp Md, Ryan M. Surmaitis Do
Department of Emergency Medicine
No abstract provided.
Beware Of Barbiturates: Coma And Hypothermia In A 94-Year-Old Woman Due To Combined Secobarbital And Pentobarbital Toxicity,
2019
Lehigh Valley Health Network
Beware Of Barbiturates: Coma And Hypothermia In A 94-Year-Old Woman Due To Combined Secobarbital And Pentobarbital Toxicity, Andrew L. Koons Do, Amy Wier Do, Kenneth D. Katz Md, Matthew D. Cook Do, Robert D. Cannon Do, Gillian A. Beauchamp Md, Ryan M. Surmaitis Do
Department of Emergency Medicine
No abstract provided.
Coronary Angiography After Cardiac Arrest - The Right Timing Or The Right Patients?,
2019
University of Pennsylvania
Coronary Angiography After Cardiac Arrest - The Right Timing Or The Right Patients?, Benjamin S. Abella, David F. Gaieski
Department of Emergency Medicine Faculty Papers
No abstract provided.
Defining And Measuring Quality In Acute Paediatric Trauma Stabilisation: A Phenomenographic Study.,
2019
Children's Mercy Hospital
Defining And Measuring Quality In Acute Paediatric Trauma Stabilisation: A Phenomenographic Study., Ralph James Mackinnon, Karin Pukk-Härenstam, Ulrica Von Thiele Schwarz, Christopher S. Kennedy, Terese Stenfors
Manuscripts, Articles, Book Chapters and Other Papers
Objectives: Trauma is the leading cause of death in children. The lack of an accepted definition of what constitutes a high-quality stabilisation of a traumatically injured child has limited the evaluation of direct interventions in simulation-based education and service-delivery models to improve trauma care. The aim of this study was to create a framework that delineates quality by exploring the perceptions of the multi-disciplinary team providing and improving this initial care.
Methods: Interviews were conducted with 36 experienced UK trauma team members and governance administrators (clinical directors to executive board level), from three standard UK trauma units. This study used …
Feasibility Of Incorporating Components Of A ‘Sex And Gender’ In Em Toolkit Into Residency Education,
2019
Lehigh Valley Health Network
Feasibility Of Incorporating Components Of A ‘Sex And Gender’ In Em Toolkit Into Residency Education, Alyson J. Mcgregor Md, Ma, Marna R. Greenberg Do, Mph, Facep, Rebecca Barron Md, Mph, Lauren A. Walter Md, Jeannette Wolfe Md, Ashley L. Deutsch Md, Steven A. Johnson Md, Derek A. Robinett Md, Gillian A. Beauchamp Md
Department of Emergency Medicine
No abstract provided.
Hallway Bed Status Is Associated With Lower Patient Satisfaction,
2019
Lehigh Valley Health Network
Hallway Bed Status Is Associated With Lower Patient Satisfaction, Max Needham Ba, Kathryn B. Bartlett Do, Akshay Gupta Do, John J. Scholz Do, Jennifer Sadowski Do, Bryan G. Kane Md, Jeanne L. Jacoby Md, Marna R. Greenberg Do, Mph, Facep, David M. Richardson Md
Department of Emergency Medicine
No abstract provided.
Status Of Sex And Gender In Emergency Medicine A Five Year Follow Up Report,
2019
Lehigh Valley Health Network
Status Of Sex And Gender In Emergency Medicine A Five Year Follow Up Report, Basmah Safdar Md, Msc, Kimberly E. Ona Ayala Ba, Syed Shayan Ali Md, Benjamin J. Seifer Bsme, Michelle Hong Bs, Ms, Marna R. Greenberg Do, Mph, Facep, Esther K. Choo Md, Mph, Alyson J. Mcgregor Md, Ma
Department of Emergency Medicine
No abstract provided.
The Anticipated Negative Impact On Emergency Medicine Faculty Of The New Acgme Common Program Requirements (Poster).,
2019
Lehigh Valley Health Network
The Anticipated Negative Impact On Emergency Medicine Faculty Of The New Acgme Common Program Requirements (Poster)., Shawn M. Quinn Do, Bryan G. Kane Md, Terrence E. Goyke, Dawn M. Yenser C-Tagme, Marna R. Greenberg Do, Mph, Facep, Gavin C. Barr Jr. Md
Department of Emergency Medicine
No abstract provided.
A Case Of Creutzfeldt-Jakob Disease Presenting With Depression And Anxiety,
2019
Lehigh Valley Health Network
A Case Of Creutzfeldt-Jakob Disease Presenting With Depression And Anxiety, Kathryn B. Bartlett Do, Kathleen E. Kane Md, Bryan G. Kane Md, Kevin Weaver D.O.,Facoep, Gavin C. Barr Jr. Md
Department of Emergency Medicine
No abstract provided.
Search And Rescue: The Importance Of Using Tracking Systems In Rural 135 Operations,
2019
Embry-Riddle Aeronautical University
Search And Rescue: The Importance Of Using Tracking Systems In Rural 135 Operations, April Larsen, Brent D. Bowen
Student Works
In January 2020, under the NextGen initiative put in place by the Federal Aviation Administration (FAA), all aircraft flying in controlled airspace, both general aviation and commercial operations, will be required to have an Automatic Dependent Surveillance – Broadcast (ADS–B) system installed and operational. However, this is not required for Title 14 Code of Federal Regulations (CFR) Part 135 operations taking place outside of controlled airspace. Part 135 of the Federal Aviation Regulations (FAR) refers to aircraft operating as on-demand or air taxi services. A substantial amount of these operator’s bases, as well as flights, are conducted outside of controlled …
The Vitamin C, Thiamine And Steroids In Sepsis (Victas) Protocol: A Prospective, Multi-Center, Double-Blind, Adaptive Sample Size, Randomized, Placebo-Controlled, Clinical Trial.,
2019
Johns Hopkins University
The Vitamin C, Thiamine And Steroids In Sepsis (Victas) Protocol: A Prospective, Multi-Center, Double-Blind, Adaptive Sample Size, Randomized, Placebo-Controlled, Clinical Trial., David N. Hager, Michael H. Hooper, Gordon R. Bernard, Laurence W. Busse, E. Wesley Ely, Alpha A. Fowler, David F. Gaieski, Alex Hall, Jeremiah S. Hinson, James C. Jackson, Gabor D. Kelen, Mark Levine, Christopher J. Lindsell, Richard E. Malone, Anna Mcglothlin, Richard E. Rothman, Kert Viele, David W. Wright, Jonathan E. Sevransky, Greg S. Martin
Department of Emergency Medicine Faculty Papers
BACKGROUND: Sepsis accounts for 30% to 50% of all in-hospital deaths in the United States. Other than antibiotics and source control, management strategies are largely supportive with fluid resuscitation and respiratory, renal, and circulatory support. Intravenous vitamin C in conjunction with thiamine and hydrocortisone has recently been suggested to improve outcomes in patients with sepsis in a single-center before-and-after study. However, before this therapeutic strategy is adopted, a rigorous assessment of its efficacy is needed.
METHODS: The Vitamin C, Thiamine and Steroids in Sepsis (VICTAS) trial is a prospective, multi-center, double-blind, adaptive sample size, randomized, placebo-controlled trial. It will enroll …
