Emergency Medicine Commons^™

A Curious Critic's Guide On Writing A Five-Star Student Evaluation: Five Lessons Learned From Food Blogging., Xiao Chi Zhang, Meryl Abrams, Dimitrios Papanagnou

Department of Emergency Medicine Faculty Papers

Timely feedback is critical in promoting learner self-reflection. When provided effectively, feedback can assist learners with the acquisition of new skills and knowledge in the ever-changing and complex landscape of healthcare. While the literature is replete on methods to provide feedback, faculty and supervisors receive little, if any, training on writing constructive feedback. Abbreviated comments (i.e., 'good job' or 'read more') provide little information on specific behaviors learners can change. As an avid food enthusiast and restaurant reviewer, I, too, am met with the challenge of writing a meaningful, constructive review (or evaluation) of a dining experience. To better assist …

Sex Specific Outcomes Of An Ed Stopping Elderly Accidents, Deaths, And Injuries (Ed-Steadi) Program, Marna R. Greenberg Do, Mph, Facep, Jeanne L. Jacoby Md, Robert D. Barraco Md, Mph, Victoria Goodheart Do, Alexander Youngdahl Do, Ryan Day Md, Danielle Collins Md, Lauren Crowley Ba, Bryan G. Kane Md

Department of Emergency Medicine

No abstract provided.

An Integrated Model Of Palliative Care In The Emergency Department To Improve Referrals, Jennifer L. Schlatter

Doctoral Projects

Introduction: The emergency department plays a critical role in the trajectory of in-hospital patient care. The Center to Advance Palliative Care (CAPC) along with the American College of Emergency Physicians (AECP) recommend early referral to palliative care for patients with life limiting illnesses that present to the emergency department. Research demonstrates that early palliative care consultations result in patient directed goals of care, improved symptom management, decreased length of stay, and reduced direct costs for inpatient hospitalizations.

Objectives: The goal of this project was to implement evidence-based recommendations for early palliative care referrals in an adult emergency department to improve …

Motorbike-Related Injuries & Safety Practices Among Motorbike Riders In Kisumu, Western Kenya In 2019, Rowan Poehler

Independent Study Project (ISP) Collection

Road traffic injuries are a growing public health problem throughout the world. Kenya has is known for having unsafe roads with an estimated 13,463 road traffic fatalities in 2016 and 24% of road traffic fatalities coming from 2-and 3-wheeled vehicles (WHO, 2018). This study sought to analyze road safety measures and road traffic injuries amongst motorbike taxi drivers in Kisumu, Kenya. A qualitative survey was administered to 152 motorbike taxi drivers in Kisumu over a two-week period in April 2019. The results were then analyzed. Results showed that 70% of drivers owned a helmet for themselves and 48.3% of drivers …

Emergency Departments And Care For Marginalized Populations, Irvin B. Harrell

Institute for the Humanities Theses

Healthcare providers in emergency departments (EDs) face a daunting daily task: providing health care in a triage setting to a diverse group of patients many with complex medical issues. Many patients rely on ED services out of financial necessity, when their healthcare issues could be better suited for care from a primary care physician. Many of these already vulnerable patients – minorities, those health illiterate, low-income, uninsured and those with language barriers – must also deal with ED overcrowding and staffing conditions. In some cases, patients leave without being seen while others face bed shortages. This study explores healthcare provider …

Emergency Department Skull Trephination For Management Of Acute Epidural Hematoma, Julie A. Fritzges Do

Department of Emergency Medicine

No abstract provided.

Using The Qsat To Generate Multi-Source Feedback On An In-Situ Pediatric Simulation Case, Michael C. Nguyen Md, Nicole Elliott Do, Michael R. Jong Md, Msc, Suzanne S. Puentes Bsn, Ccrn, Rn, Diane Begany Md, Matthew D. Cook Do, Louis Morolla Do, Zachary Matuzsan Do, Jennifer E. Macfarlan Mph, Bryan G. Kane Md

Department of Emergency Medicine

No abstract provided.

Opinions Of Academic Em Society Members On The New Acgme Common Program Requirements, Shawn M. Quinn Do, Bryan G. Kane Md, Marna R. Greenberg Do, Mph, Facep, Terrence E. Goyke, Steven Bird Md, Megan Schagrin Mba, Gavin C. Barr Jr. Md

Department of Emergency Medicine

No abstract provided.

The Use Of An ‘Acclimatisation’ Heatwave Measure To Compare Temperature-Related Demand For Emergency Services In Australia, Botswana, Netherlands, Pakistan, And Usa, Naomi Van Der Linden, Thomas Longden, John R. Richards, Munawar Khursheed, Wilhelmina M. T. Goddijn, Michiel J. Van Veelen, Uzma R. Khan, M. Christien Van Der Linden

Department of Emergency Medicine

Background: Heatwaves have been linked to increased risk of mortality and morbidity and are projected to increase in frequency and intensity due to climate change. The current study uses emergency department (ED) data from Australia, Botswana, Netherlands, Pakistan, and the United States of America to evaluate the impact of heatwaves on ED attendances, admissions and mortality.
Methods: Routinely collected time series data were obtained from 18 hospitals. Two separate thresholds (≥4 and ≥7) of the acclimatisation excess heat index (EHIaccl) were used to define "hot days". Analyses included descriptive statistics, independent samples T-tests to determine differences in case mix between …

Acquiring Blood Pressures On High Risk Sepsis Patients In The Ed, Mckenna Scharlau, Jacob Schneider

Nurse Presentations

Describes a project to improve use of the Sepsis Tool in the Emergency Department and to improve documentation of blood pressure measurements in high risk sepsis patients under three years of age.

Safety Oriented, Low-Cost Peritonsillar Abscess Needle Aspiration Model For Emergency Medicine Simulation, Anne Mai Bs, Julie A. Fritzges Do, Gavin C. Barr Jr. Md, Marna R. Greenberg Do, Mph, Facep, Smeet Bhimani Do

Department of Emergency Medicine

No abstract provided.

Prehospital Troponin Testing Protocol For Accelerated Diagnosis And Early Intervention In Chest Pain Patients, Ronald D. Meador

DNP Final Reports

Non-ST elevation acute coronary syndromes (NSTE-ACS) have significant morbidity and mortality rates despite the progress made in diagnosis and management and represent a significant public health burden in the United States. Lengthy diagnostic algorithms contribute to emergency department over-crowding, increased health care costs, and adverse patient outcomes. A troponin assay instituted earlier in the diagnostic pathway of patients with chest pain suspected of NSTE-ACS will reduce time to definitive diagnosis and medical intervention. This will improve patient outcomes, decrease emergency department crowding through improved ED workflow, and reduce the economic burden. The Star Model of Knowledge Transformation was used to …

An Exploration Of Why Healthcare Professionals Under-Report Observed Patient Aggression, Sydney Bonta

UNO Student Research and Creative Activity Fair

An Exploration of Why Healthcare Professionals Under-Report Observed Patient Aggression

Authors: Sydney Bonta & Lisa L. Scherer, Ph.D.

Advisor: Lisa L. Scherer, Ph.D.

According to the 2011 US Bureau of Justice Statistics report, medical professionals experienced the third highest proportion of workplace violence (WPV), with violence primarily emanating from patient. In a national survey of nurses employed in hospitals, 76% stated that they had encountered some sort of violence in their workplace (Speroni, Fitch, Dawson, Dugan, Atherton, & Leesburg, 2014). Similarly, patient aggression against physicians has long been a problem (Morrison, Lantos, Levinson, 1998). Despite this widespread exposure to WPV …

The Opioid Crisis: Exploring The Effects On First Responders And Healthcare Professionals, Rachel Lubischer, Dawne Frain

UNO Student Research and Creative Activity Fair

In 2017, the National Department of Health and Human Services declared the opioid crisis a public health emergency (The White House, 2018). Although Nebraska ranks among the states with the lowest number of drug overdose deaths, rising opioid use creates safety concerns for first responders and healthcare professionals, and leads to strained resources in many jurisdictions. We hope to increase our audience’s knowledge on the opioid crisis, how it effects first responders and healthcare professionals, and pertinent policies and initiatives in Nebraska. Our audience will leave this presentation better equipped to initiate discussions with friends, family, and community members about …

Geographical Variation And Predictors Of Physical Activity Level In Adults With Congenital Heart Disease., Lena Larsson, Bengt Johansson, Camilla Sandberg, Silke Apers, Adrienne Kovacs, Koen Luyckx, Corina Thomet, Werner Budts, Junko Enomoto, Maayke Sluman, Jou-Kou Wang, Jamie Jackson, Paul Khairy, Stephen Cook, Luis Alday, Katrine Eriksen, Mikael Dellborg, Malin Berghammer, Gwen Rempel, Samuel Menahem, Maryanne Caruana, Martha Tomlin, Alexandra Soufi, Susan Fernandes, Kamila White, Edward Callus, Shelby Kutty, Philip Moons

Psychology Faculty Works

Background: Physical activity is important to maintain and promote health. This is of particular interest in patients with congenital heart disease (CHD) where acquired heart disease should be prevented. The World Health Organization (WHO) recommends a minimum of 2.5 h/week of physical activity exceeding 3 metabolic equivalents (METS) to achieve positive health effects. It is unknown whether physical activity levels (PAL) in adult CHD patients differ by country of origin. Methods: 3896 adults with CHD recruited from 15 countries over 5 continents completed self-reported instruments, including the Health Behaviour Scale (HBS-CHD), within the APPROACH-IS project. For each patient, we calculated …

Prognostic Value Of A Modified Surprise Question Designed For Use In The Emergency Department Setting., Samir A Haydar, Tania D Strout, Alicia G Bond, Paul Kj Han

Articles, Abstracts, and Reports

OBJECTIVE: Few reliable and valid prognostic tools are available to help emergency physicians identify patients who might benefit from early palliative approaches. We sought to determine if responses to a modified version of the surprise question, "Would you be surprised if this patient died in the next 30 days" could predict in-hospital mortality and resource utilization for hospitalized emergency department patients.

METHODS: For this observational study, emergency physicians responded to the modified surprise question with each admission over a five-month study period. Logistic regression analyses were completed and standard test characteristics evaluated.

RESULTS: 6,122 visits were evaluated. Emergency physicians responded …

A Case Report Of Massive Acetaminophen Poisoning Treated With A Novel “Triple Therapy”: N-Acetylcysteine, 4-Methylpyrazole, And Hemodialysis, Emily A. Kiernan Do, Julie A. Fritzges Do, Kathryn Henry Do, Kenneth D. Katz Md

Department of Emergency Medicine

Massive acetaminophen (N-acetyl-p-aminophenol; APAP) ingestion is characterized by a rapid onset of mitochondrial dysfunction, including metabolic acidosis, lactemia, and altered mental status without hepatotoxicity which may not respond to the standard doses of N-acetylcysteine (NAC). A 64-year-old woman without medical history presented comatose after an ingestion of 208 tablets of Tylenol PM™ (APAP 500 mg and diphenhydramine 25 mg). The initial APAP concentration measured 1,017 µg/mL (therapeutic range 10-30 µg/mL), and elevated anion gap metabolic acidosis, lactemia, and 5-oxoprolinemia were detected. High-dose intravenous (IV) NAC, 4-methylpyrazole (4-MP), and hemodialysis (HD) were initiated. She was transferred to a liver …

Pediatric Ingestion Of Multiple Button Batteries, Johnny Fong Md, Tony Zitek

School of Medicine Faculty Research

A two-year-old male presented to the pediatric emergency department for possible foreign body ingestion. Two hours prior to arrival, the child was found with the packaging for 10 button batteries, but his mother was only able to find one battery. The patient had no symptoms. Physical exam was within normal limits. Radiographs (Image 1) showed six foreign bodies within the stomach and one distally

Icatibant Is Not Helpful For The Treatment Of Ace Inhibitor-Induced Angioedema, Samantha R. Schwartz

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Sinert R, Levy P, Bernstein JA, et al. Randomized trial of icatibant for angiotensin-converting enzyme inhibitor-induced upper airway angioedema. J Allergy Clin Immunol Pract. 2017; 5(5): 1402-1409. doi: 10.1016/j.jaip.2017.03.003.

Early Dexamethasone Administration In Adults With Suspected Meningitis Lowers Morbidity And Mortality, Dana Siegel

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of de Gans J, van de Beek D, Investigators EDiABMS. Dexamethasone in adults with bacterial meningitis. New Eng J Med. 2002;347(20):1549-1556. doi: 10.1056/NEJMoa021334.