Emergency Medicine Commons^™

Parenteral Ascorbic Acid For Treatment Of Sepsis, Lindsey Hiatt

Physician Assistant Scholarly Project Posters

Sepsis kills nearly 1 million people each year in the United States and sepsis-related hospitalizations cost approximately $24 billion annually (Paoli, Reynolds, Sinha, Gitlin, & Crouser, 2018). Current treatment guidelines are limited to targeted antibiotics and hemodynamic support. While antibiotics are the definitive treatment to eradicate the infectious pathogen, there are currently no standard-of-care treatments that consistently and successfully attenuate the damage sustained to the body by its own inflammatory response to infection. Many different treatments have been trialed and failed to show improved outcomes. Vitamin C, or ascorbic acid, has long been associated with supporting immune function, and has …

What Does Anxiety Look Like? Prevalence Among Ed Patients, Justin B. Anderson

Scholarship in Medicine - All Papers

The prevalence of mental illness in the US population is common, with an estimated value of 8%. The emergency department patient population is especially vulnerable to mental illness. Previous studies from 2012 and 2017 estimated the rate of undiagnosed mental illness in the Emergency Department (ED) at 41-42%.1,2 According to the studies, only a minority of these were identified by the physician.

DSM-5 defines the criteria for generalized anxiety disorder (GAD) as “excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school …

The Relationship Between Generalized Anxiety Disorder And Self-Reported Pain Scores Among Emergency Department Patients, Nicholas Seitz

Scholarship in Medicine - All Papers

Anxiety is common among Emergency Department (ED) patients. Self-reported pain scores have been associated with a variety of physical and psychological factors. However, the relationship between pain and anxiety in ED patients has not been previously reported. This study aims to identify a relationship between self-reported pain scores and the diagnosis of generalized anxiety disorder among ED patients.

This prospective patient survey study was conducted at Miami Valley Hospital, an urban ED in Dayton, Ohio. Eligible participants included ED patients age 18 or over, with a self-reported pain score ranging from 1-10 on the verbal numeric rating pain scale (VNRS). …

Cannabis Use And Association With Pain, Anxiety, And Depression Among Emergency Department Patients, John Detherage

Scholarship in Medicine - All Papers

Introduction:

Cannabis use is increasing nationwide. Many states have legalized medical and recreational use of cannabis. This study was undertaken to identify any association between cannabis use and chronic pain among ED patients.

Methods:

This was a prospective survey study of Emergency Department (ED) patients at Miami Valley Hospital, a level 1 trauma center in Dayton, Ohio conducted during June – August 2018. The survey included data regarding the frequency of cannabis use, chronic pain, and current mental illness.

Results:

Three hundred and sixty patients participated in this study. The majority of respondents were white (55%) or African American (42%). …

Becoming A Washington Firefighter, Connor Ridgeway

Undergraduate Honors Theses

For this project, under direction of Judy Beard and Matthew Martinson, I have created a manual to further assist individuals in the process of fulfilling dreams to become a firefighter. I have researched the vast number steps it takes to become a firefighter and provided helpful suggestions that will aid individuals throughout the process. Becoming a firefighter is a demanding process with physical abilities that need to be taken into consideration when going through the elaborate process. This project includes background information on structure firefighting, volunteer firefighting, wildland firefighting, emergency medical technicians, paramedics, and what the role of each of …

Utility Of Point-Of-Care Beta-Hydroxybutyrate Testing For Predicting Diabetic Ketoacidosis In The Pediatric Emergency Department, Michelle Knoll, Kelsee Halpin, Ryan Mcdonough

Posters

The objective of our investigation was to describe the diagnostic characteristics of point-of-care capillary beta-hydroxybutyrate (BOHB) testing to predict diabetic ketoacidosis among pediatric patients presenting with hyperglycemia in the pediatric emergency department.

Lamotrigine Odt-Induced Seizure In A 3-Year-Old Child After Accidental Ingestion, Ashley Griswold Do, Briana Tully, Kenneth D. Katz Md, Gillian A. Beauchamp Md, Matthew D. Cook Do, Robert D. Cannon Do

Department of Emergency Medicine

Lamotrigine is a new generation antiepileptic which blocks sodium channels and can cause significant toxicity in overdose. A case of a three-year-old child who suffered a seizure and required endotracheal intubation after accidental lamotrigine ingestion is presented. The lamotrigine concentration measured 23.2 mcg/mL which is the highest reported after accidental pediatric exposure. A review of the literature regarding pediatric lamotrigine poisoning is also included.

Consent For Emergency Treatment: Emergency Department Patient Recall And Understanding, Ashley Lafountain

Scholarship in Medicine - All Papers

Informed consent is an important ethical and legal requirement that underlies the concept of patient autonomy. This prospective survey study was conducted to assess patient recall and understanding of consent for treatment in adult emergency department (ED) patients at an urban level 1 trauma center with annual volume of 95,000, Miami Valley Hospital. Out of a total 293 patients, most individuals reported only receiving a verbal explanation of the consent document (45%) or not reading the document at all (36%). About half of the patients recalled consenting to treatment (N=144, 49%) and over one third of patients could not recall …

Risk Factors For Pneumonia Following Rib Fractures, Brittany Bowers

Scholarship in Medicine - All Papers

Objective: Pneumonia is a known complication following rib fractures. The purpose of this study is to identify factors associated with the development of pneumonia following rib fractures. Methods: In this retrospective chart review, eligible participants included trauma patients with one or more rib fractures who were admitted to Miami Valley Hospital during 2012 through 2017. Variables studied included age, gender, injury severity score (ISS), mechanism of injury, smoking status, alcohol use, administration of influenza and pneumococcal vaccine, number and side of rib fracture(s), spirometer use, blood transfusion, and intravenous fluid administration.

Results: Among 78 cases and 74 controls, matched for …

Factors Contributing To The Negative And Unhealthy Psychological Conditions In The Ed Rn, Ariana M. Nieves

Honors Undergraduate Theses

The emergency department is a stressful environment. Emergency department registered nurses (ED RNs) are at an increased risk of development of negative and unhealthy psychological conditions due to their frequent exposure to stress and traumatic events. These conditions include post-traumatic stress disorder, compassion fatigue, and burnout syndrome, which are already known to be common in the emergency department registered nurse population. It is important to understand the factors that influence the development of these psychological conditions in order to provide better education to nurses regarding prevention of the development of these psychological conditions. This literature review aimed to identify articles …

Evaluating The Impact Of An Intervention To Promote Empathy For Patients With Substance Use Disorder In A Rural Emergency Department, Theresa Poling

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background

Negative attitudes of health professionals towards patients with SUD are common and contribute to suboptimal health care for this marginalized group of patients (Van-Boekel, Brouwers, Van-Weeghel & Garretson, 2013).

Objectives

Promoting empathy in the Emergency Department (ED) has the potential to increase nursing staff’s awareness of their attitudes and perceptions toward patients with SUD, thereby decreasing the stigma associated with addiction and improving patient care and patient outcomes. The rationale for implementing this project was to evaluate a tool to promote empathy. This tool was developed by the student researcher based on a literature search and analysis.

Design

This …

Integrate Behavioral Health In The Ed And Upstream, Katie Gilligan, Heidi Beazizo

Books, Presentations, Posters, Etc.

This interactive session will describe the changes being tested by 10 hospitals in the Integrating Behavioral Health in the ED and Upstream Learning Community, convened by IHI and Well Being Trust, to achieve meaningful improvements for patients with mental health and substance abuse conditions, their families, and ED staff. Participants will learn from experts and participating team members, share learning with other participants, and develop action plans for bringing this critical work to their organizations.

After this presentation you will be able to:

1. Describe a theory of change and set of core measures to improve patient outcomes, experience, and staff …

Assessment Of Patient-Centered Approaches To Collect Sexual Orientation And Gender Identity Information In The Emergency Department: The Equality Study, Adil H. Haider, Rachel R. Adler, Eric Schneider, Tarsicio Uribe Leitz, Anju Ranjit, Christina Ta, Adele Levine, Omar Harfouch, Danielle Pelaez, Lisa Kodadek

Section of General Surgery

Importance: Health care and government organizations call for routine collection of sexual orientation and gender identity (SOGI) information in the clinical setting, yet patient preferences for collection methods remain unknown.
Objective: To assess of the optimal patient-centered approach for SOGI collection in the emergency department (ED) setting.
Design, setting, and participants: This matched cohort study (Emergency Department Query for Patient-Centered Approaches to Sexual Orientation and Gender Identity [EQUALITY] Study) of 4 EDs on the east coast of the United States sequentially tested 2 different SOGI collection approaches between February 2016 and March 2017. Multivariable ordered logistic regression was used to …

A Scoping Review Of The Associations Between Mental Health And Factors Related To Hiv Acquisition And Disease Progression In Conflict-Affected Populations, Erica Koegler, Erica Koegler, Caitlin Kennedy

Social Work Faculty Works

The association between poor mental health and factors related to HIV acquisition and disease progression (also referred to as HIV-related factors) may be stronger among conflict-affected populations given elevated rates of mental health disorders. We conducted a scoping review of the literature to identify evidence-based associations between mental health (depression, anxiety, and post-traumatic stress disorder [PTSD]) and factors related to HIV acquisition and progression in conflict-affected populations. Five electronic databases were searched on October 10, 2014 and updated on March 7, 2017 to identify peer-reviewed publications presenting primary data from January 1, 1994 to March 7, 2017. Articles were included …

Rethinking Emergency Response To Mass Casualty Incidents: Disaster Medicine Education And The Role Of Medical Students, Claire Zurlo, Edward Jasper, Md, Mph

Phase 1

Introduction: The threat of a mass casualty incident (MCI) is one that must be taken seriously and for which hospitals must be prepared. In the wake of a disaster, emergency departments are often taxed beyond their ability to handle the demands of incoming traumas. In response to this, Dr. Edward Jasper, an emergency physician at Thomas Jefferson Hospital, designed the Hospital Emergency Response Team (HERT) to alleviate the pressure on the ED during a MCI. The HERT is a team of nursing and medical students who are FEMA trained to respond in the event of a MCI.

Objective: The primary …

The Effects Of Reentry Programs On Healthcare Accessibility And Resulting Emergency Department Strain By Ex-Inmates: An Integrative Literature Review, Kaitlyn Muratori

Grace Peterson Nursing Research Colloquium

THE EFFECTS OF REENTRY PROGRAMS ON HEALTHCARE ACCESSIBILITY AND RESULTING EMERGENCY DEPARTMENT STRAIN BY EX-INMATES

Kaitlyn Muratori

Faculty Sponsor: Dr. Christina Lattner

Background: Ex-inmates are significantly more likely to use emergency rooms to seek treatment for substance abuse, mental health disorders, or poor management of chronic conditions which, if not treated on a community level, ultimately contributes to overboarding in the emergency department.

Objectives: The purpose of this literature review is to use current research to examine the relationship between reentry programs across the US and healthcare accessibility, as well as the resulting strain of emergency room misuse by ex-inmates. …

Challenging Hazards Amidst Observational Simulation In The Emergency Department: Advancing Gamification In Simulation Education Through A Novel Resident-Led Skills Competition., Nicholas Salerno, Dimitrios Papanagnou, Md, Priyha Mahesh, Kaitlin M Bowers, Scott H Pasichow, Sara Paradise, Xiao Chi Zhang

Department of Emergency Medicine Faculty Papers

Medical simulation competitions have become an increasingly popular method to provide a hands-on "gamified" approach to education and training in the health professions. The most well-known competition, SimWars, consists of well-coordinated teams that are tasked with completing a series of mind-bending clinical scenarios in front of a live audience through 'bracket-style' elimination rounds. Similarly, challenging hazards amidst observational simulation (CHAOS) in the emergency department (ED) is another novel approach to gamification in both its structure and feel. Conducted at the Council of Emergency Medicine Resident Directors (CORD) 2018 National Assembly in San Antonio, Texas, instead of assigning premeditated teams, it …

A Three-Dimensional Printed Low-Cost Anterior Shoulder Dislocation Model For Ultrasound-Guided Injection Training., Zachary Risler, Mark A. Magee, Jacob M. Mazza, Kelly Goodsell, Arthur K. Au, Resa E. Lewiss, Robert S. Pugliese, Bon Ku

Department of Emergency Medicine Faculty Papers

Anterior shoulder dislocations are the most common, large joint dislocations that present to the emergency department (ED). Numerous studies support the use of intraarticular local anesthetic injections for the safe, effective, and time-saving reduction of these dislocations. Simulation training is an alternative and effective method for training compared to bedside learning. There are no commercially available ultrasound-compatible shoulder dislocation models. We utilized a three-dimensional (3D) printer to print a model that allows the visualization of the ultrasound anatomy (sonoanatomy) of an anterior shoulder dislocation. We utilized an open-source file of a shoulder, available from embodi3D® (Bellevue, WA, US). After …

Impact Of Legalizing Recreational Cannabis Sales On Cannabis Exposure Calls To Poison Centers 2008-2017, Gillian A. Beauchamp Md, Robert G. Hendrickson Md, B. Zane Horowitz Md, Daniel A. Spyker Md, Phd

Department of Emergency Medicine

No abstract provided.

"It's A Precious Gift, Not To Waste": Is Routine Cross Matching Necessary In Orthopedics Surgery?: Retrospective Study Of 699 Patients In 9 Different Procedures, Obada Hasan, Eraj Khurshid Khan, Moiz Ali, Sadaf Sheikh, Anum Fatima, Haroon Ur Rashid

Section of Orthopaedic Surgery

Background: Orthopedic surgeries are usually associated with excessive blood loss which leads surgeons to overestimate need for blood transfusions and over ordering of blood. The cross matched blood, when not used, leads to the wastage of blood bank resources in terms of time, money and manpower. The objective of this study was to investigate the compliance to previously proposed MSBOS and to provide updated recommendations for all orthopedic procedures.
Methods: A retrospective analysis was conducted between 1st June 2015 and 31st May 2016. Patients admitted to the orthopedic surgery service for whom blood products were requested were included. Cross Match/Transfusion …