Emergency Medicine Commons^™

Examining The Role Of Diagnosis In The Emergency Department Experience, Danielle Kovalsky, Bs, Angela Gerolamo, Phd, Aprn, Bcps, Amanda Doty, Ms, Alexzandra Gentsch, Lsw, Annemarie Jutel, Rn, Bphed (Hons), Phd, Kristin L. Rising, Md, Ms

CwiC Posters

Study Objective:

To explore the social, functional, and emotional needs that patients want addressed when seeking a diagnosis at their ED visit.

Emergency Surgery And Limitation Of Therapeutic Effort In Relation To Neurologic Deterioration In Elderly Patients – A Survey Of European Surgeons, Mihai Paduraru, Luca Ponchietti, Isidro M. Casas, Jorge Pereira, Aitor Landaluce-Olavarria, Diego Mariani

Journal of Mind and Medical Sciences

Background. In emergency surgery, a very heterogeneous approach is required in the decision making process, especially when considering the patient’s postoperative quality of life as well as medical, ethical, and legal factors. In some cases, the presence of an Advance Directive (AD) form may potentially help resolve the surgeon’s dilemma. Objectives. The primary objective of this survey was to investigate the opinions of surgeons across a representative cross-section of European countries regarding the decision making process using a specific case scenario so as to identify similarities and differences in practice. A secondary objective was to identify the possibility of establishing …

A Resident's Note, Syed Muhammad Mustahsan

Department of Emergency Medicine

No abstract provided.

Sex Differences In Pediatric Exploratory Exposures: A Retrospective Review Of National Poison Data System (Npds) Exposures 2007-2016, Gillian A. Beauchamp Md, B Zane Horowitz Md, Esther K. Choo Md, Mph, Marna R. Greenberg Do, Mph, Facep, Daniel A. Spyker Md, Phd

Department of Emergency Medicine

No abstract provided.

Impact Of Superstorm Sandy On Medicare Patients' Utilization Of Hospitals And Emergency Departments., Benoit Stryckman, Lauren Walsh, Brendan G. Carr, Nathaniel Hupert, Nicole Lurie

Department of Emergency Medicine Faculty Papers

INTRODUCTION: National health security requires that healthcare facilities be prepared to provide rapid, effective emergency and trauma care to all patients affected by a catastrophic event. We sought to quantify changes in healthcare utilization patterns for an at-risk Medicare population before, during, and after Superstorm Sandy's 2012 landfall in New Jersey (NJ).

METHODS: This study is a retrospective cohort study of Medicare beneficiaries impacted by Superstorm Sandy. We compared hospital emergency department (ED) and healthcare facility inpatient utilization in the weeks before and after Superstorm Sandy landfall using a 20% random sample of Medicare fee-for-service beneficiaries continuously enrolled in 2011 …

Sex Differences In Adverse Drug Reactions And Adverse Drug Events In Older Adults: A Retrospective Review Of National Poison Data System Cases 2007-2016., Gillian A. Beauchamp Md, B Zane Horowitz Md, Esther K. Choo Md, Mph, Marna R. Greenberg Do, Mph, Facep, Daniel A. Spyker Md, Phd

Department of Emergency Medicine

No abstract provided.

Sex Differences In Intentional Exposures Among Adolescents And Adults: A Retrospective Review Of National Poison Data System (Npds) Pharmaceutical Exposures 2007-2016, Gillian A. Beauchamp Md, B Zane Horowitz Md, Esther K. Choo Md, Mph, Marna R. Greenberg Do, Mph, Facep, Daniel A. Spyker Md, Phd

Department of Emergency Medicine

No abstract provided.

Not All Evidence Is Created Equal: Changes In Practice Require The Highest Possible Level Of Statistical Testing, Sandy Hunter

EKU Faculty and Staff Scholarship

The practice of medicine has come a long way over the past 150 years. For example, routine use of leeches to remove “bad blood” no longer occurs, and everyone involved in healthcare knows to wear personal protective equipment.

Changes to practice have (at times) been slow in coming. However, we simply can no longer routinely rely on providing care without evidence that it works. Investigators conduct rigorous studies to determine the efficacy of treatments. This philosophy of testing clinical practices using research methods to validate their efficacy and safety is known as evidence-based medicine.1

Sex Differences In Rt-Pa Utilization At Hospitals Treating Stroke: The National Inpatient Sample., Amelia K. Boehme, Brendan G. Carr, Scott Eric Kasner, Karen C Albright, Michael J. Kallan, Mitchell S V S.V. Elkind, Charles C. Branas, Michael T. Mullen

Department of Emergency Medicine Faculty Papers

BACKGROUND AND PURPOSE: Sex and race disparities in recombinant tissue plasminogen activator (rt-PA) use have been reported. We sought to explore sex and race differences in the utilization of rt-PA at primary stroke centers (PSCs) compared to non-PSCs across the US.

METHODS: Data from the National (Nationwide) Inpatient Sample (NIS) 2004-2010 was utilized to assess sex differences in treatment for ischemic stroke in PSCs compared to non-PSCs.

RESULTS: There were 304,152 hospitalizations with a primary diagnosis of ischemic stroke between 2004 and 2010 in the analysis: 75,160 (24.7%) patients were evaluated at a PSC. A little over half of the …

Accuracy Of Emergency Medical Services Dispatcher And Crew Diagnosis Of Stroke In Clinical Practice., Judy Jia, Roger Band, Michael E. Abboud, William Pajerowski, Michelle Guo, Guy David, C. Crawford Mechem, Steven R Messé, Brendan G. Carr, Michael T Mullen

Department of Emergency Medicine Faculty Papers

BACKGROUND: Accurate recognition of stroke symptoms by Emergency Medical Services (EMS) is necessary for timely care of acute stroke patients. We assessed the accuracy of stroke diagnosis by EMS in clinical practice in a major US city.

METHODS AND RESULTS: Philadelphia Fire Department data were merged with data from a single comprehensive stroke center to identify patients diagnosed with stroke or TIA from 9/2009 to 10/2012. Sensitivity and positive predictive value (PPV) were calculated. Multivariable logistic regression identified variables associated with correct EMS diagnosis. There were 709 total cases, with 400 having a discharge diagnosis of stroke or TIA. EMS …

Abruptio Placentae With Type Ii Respiratory Failure Secondary To Acute Interstitial Pneumonia Responsive To Steroids., Muhammad Umer Salim, Syed Muhammad Mustahsan, Anum Fatima

Department of Emergency Medicine

Acute Interstitial Pneumonia (AIP) is categorized as Idiopathic Interstitial Pneumonia (IIP), in which the cause is unknown. Ayoung female of 22 years presented in 34 weeks gestation with abruptio placentae (AP) and underwent Lower Segment Caesarian Section (LSCS) for AP. It progressed to type II respiratory failure secondary to AIPon 4th day post-surgery. It remained unresponsive when treated with noninvasive ventilation (NIV-BiPAP) along with antibiotics. Later, a trial treatment of pulse therapy of Methylprednisolone was executed on 7th day post-surgery which resulted in dramatic improvement in symptoms. It is uncommon to have type II respiratory failure secondary to AIP, and …

Sex Specific Analysis Of The Vulnerable Elders Survey As A Predictor Of Falls., Rebecca Brown Md, Marna R. Greenberg Do, Mph, Facep, Bryan G. Kane Md, Robert D. Barraco Md, Mph, Jeanne L. Jacoby Md

Department of Emergency Medicine

No abstract provided.

No Sex-Specific Differences In Preference Of Management Options To Prevent Elderly Falls, Marna R. Greenberg Do, Mph, Facep, Jeanne L. Jacoby Md, Robert D. Barraco Md, Mph, Bernadette Glenn-Porter Bs, Kyle Durics Bs, Ryan Day Md, Victoria Goodheart Do, Danielle Mills Md, Alexander Youngdahl Do, Bryan G. Kane Md

Department of Emergency Medicine

No abstract provided.

Incorporating Sex And Gender Into Culturally Competent Simulation In Medical Education (Poster)., Gillian A. Beauchamp Md, Alyson J. Mcgregor Md, Ma, Esther K. Choo Md, Mph, Basmah Safdar Md, Alexander M. Rosenau Do, Marna R. Greenberg Do, Mph, Facep

Department of Emergency Medicine

No abstract provided.

Sex And Gender In Emergency Medicine: An Innovative Elective And Toolkit For Incorporation Into Trainee Education., Lauren Walter Md, Gillian A. Beauchamp Md, Rebecca Barron Md, Mph, Tracy E. Madsen Md, Scm, Marna R. Greenberg Do, Mph, Facep, Alyson J. Mcgregor Md, Ma

Department of Emergency Medicine

No abstract provided.

Gender Differences In Effectiveness Of The "Timed Up And Go" (Tug) Test As A Screening Tool For Geriatric Fall Risk Assessment., Richard Chow Do, Marna R. Greenberg Do, Mph, Facep, Jeanne L. Jacoby Md, Robert D. Barraco Md, Mph, Bryan G. Kane Md

Department of Emergency Medicine

No abstract provided.

Gender Differences In Emergency Medicine Resident Self-Assessment Of Clinical Teaching, Alan R. Cherney Md, Amy B. Smith Phd, Charles C. Worrilow Md, Kevin Weaver D.O.,Facoep, Dawn M. Yenser, Jennifer E. Macfarlan Mph, Marna R. Greenberg Do, Mph, Facep, Bryan G. Kane Md

Department of Emergency Medicine

No abstract provided.

Post-Traumatic Stress Disorder And Its Predictors In Emergency Medical Service Personnel: A Cross-Sectional Study From Karachi, Pakistan, Salima Kerai, Uzma R. Khan, Muhammad Islam, Nargis Asad, Junaid Razzak, Omrana Pasha

Department of Paediatrics and Child Health

Background: Emergency medical service (EMS) personnel who work to provide emergency medical care at the scene and during transportation are exposed to various kinds of stressors and are particularly susceptible to developing stress-reactions. This study assesses symptoms of post-traumatic stress disorder and its predictors among the personnel of a selected EMS in Karachi, Pakistan.
Methods: Data were gathered from 518 personnel working in an EMS setting from February to May 2014. Participants were screened for post-traumatic stress symptoms using the Impact of Event Scale-Revised (IES-R). Demographic and work-related characteristics, coping styles and the social support systems of the participants were …

Accurate Cytogenetic Biodosimetry Through Automated Dicentric Chromosome Curation And Metaphase Cell Selection, Jin Liu, Yanxin Li, Ruth Wilkins, Canadian Nuclear Laboratories, Joan H. Knoll, Peter Rogan

Biochemistry Publications

Accurate digital image analysis of abnormal microscopic structures relies on high quality images and on minimizing the rates of false positive (FP) and negative objects in images. Cytogenetic biodosimetry detects dicentric chromosomes (DCs) that arise from exposure to ionizing radiation, and determines radiation dose received based on DC frequency. Improvements in automated DC recognition increase the accuracy of dose estimates by reclassifying FP DCs as monocentric chromosomes or chromosome fragments. We also present image segmentation methods to rank high quality digital metaphase images and eliminate suboptimal metaphase cells. A set of chromosome morphology segmentation methods selectively filtered out FP DCs …

A Retrospective Review Of Paediatric Head Injuries In Asia - A Pan Asian Trauma Outcomes Study (Patos) Collaboration, Shu-Ling Chong, Uzma R. Khan, Indumathy Santhanam, Jun Seok Seo, Quan Wang, Sabariah Faizah Jamaluddin,, Quoc Ai Hoang Quoc, Su Yah Chew, Marcus Eng Hock Ong

Department of Emergency Medicine

Objective: We aim to examine the mechanisms of head-injured children presenting to participating centres in the Pan Asian Trauma Outcomes Study (PATOS) and to evaluate the association between mechanism of injury and severe outcomes.
Design and Setting: We performed a retrospective review of medical records among emergency departments (EDs) of eight PATOS centres, from September 2014 - August 2015.
Participants: We included children <16 years old who presented within 24 hours of head injury and were admitted for observation or required a computed tomography (CT) of the brain from the ED. We excluded children with known coagulopathies, neurological co-morbidities or prior neurosurgery. We reviewed the mechanism, intent, location and object involved in each injury, and the patients' physical findings on presentation.
Outcomes: Primary outcomes were death, endotracheal intubation or neurosurgical intervention. Secondary outcomes included hospital and ED length of stay.
Results: 1438 children were analysed. 953 children (66.3%) were male and the median age was 5.0 years (IQR …