Evaluate the impact of adding emergency medicine residents to a medium-size urban hospital by comparing emergency department (ED) admission rate, total census, length of stay (LOS), and proportion of patients who left without being seen (LWBS).
An electronic emergency department information system (EDIS) can monitor the progress of a patient visit, facilitate computerized physician order entry, display test results and generate an electronic medical record. Ideally, use of an EDIS will increase overall emergency department (ED) efficiency. However, in academic settings where new interns rotate through the ED monthly, the “learning curve” experienced by the new EDIS user may slow down patient care. In this study, we measured the impact of the “intern learning curve” on patient length of stay (LOS).
Two crowding metrics are often used to measure emergency department (ED) crowding: the occupancy rate and the emergency department work index (EDWIN) score. To evaluate these metrics for applicability in our community ED, we sought to measure their correlation with the number of patients who left without being seen (LWBS) and determine if either, or both, correlated with our daily LWBS rate. We hypothesized a statistically significant positive correlation between the number of patients who LWBS and both crowding metrics.
Bedside ultrasound interrogation of the thorax can aide the clinician in determining the cause of the respiratory dysfunction. Often plain radiographs are not sufficient to differentiate pathology. We present a case in which bedside ultrasound defined the pathology without the need for further imaging.
The U.S. Department of Health and Human Services Office of the Inspector General has issued a report concerning “high use” and “questionable use” ultrasound. Findings include those geographic areas where occurrences are most frequent, as well as the most common elements that characterize questionable use. While not its primary focus, emergency physician performed bedside ultrasound is within the scope of the report. Implications for emergency ultrasound are discussed and practice recommendations made for minimizing regulatory exposure for emergency physicians and departments.
Education in emergency ultrasound (EUS) has become an essential part of emergency medicine (EM) resident training. In 2009, comprehensive residency training guidelines were published to ensure proficiency in ultrasound education. The American College of Emergency Physicians (ACEP) recommends that 150 ultrasound exams be performed for physician competency. Our goal is to evaluate the current ultrasound practices among EM residency programs and assess the need for further formalization of EUS training.
Femur fractures typically affect elderly patients with multiple co-morbidities. Pain control can be difficult, requiring intensive nursing and physician care as elderly patients may manifest cardiovascular and respiratory complications from opiate administration. Ultrasound (US)-guided three-in-one (3-in-1) femoral nerve block (FNB) is an option for pain management in patients with femur fractures, as it provides regional anesthesia to the femoral, obturator and lateral cutaneous nerves. Our goal is to provide medical education regarding the use of US-guided 3-in-1FNB as a rapid and easy procedure that may provide optimal patient care in patients with femur fractures.
Simultaneous bilateral quadriceps tendon rupture is a rare injury. We report the case of bilateral quadriceps tendon rupture sustained with minimal force while refereeing a football game. The injury was suspected to be associated with statin use as the patient had no other identifiable risk factors. The diagnosis was confirmed using bedside ultrasound.
We assessed the acoustic transmission, image quality, and vessel integrity of the Blue Phantom™ 2 Vessel Original Ultrasound Training Model with repeated use.
Motor vehicle-pedestrian crash is a significant public health concern. The urban campus of Georgia State University poses unique challenges due to a large number of students and university employees. The objectives of this study are twofold: 1) to examine the correlation between specific features of the built environment on and around the University campus and pedestrian crashes; and 2) to identify crash clusters in the study area using network-based geospatial techniques.
Poisoning events, including exposures to hazardous materials, can involve multiple victims. Regional poison centers often are contacted in such events involving multiple victims.
Alcohol is more likely than any other drug to be involved in substance-related violence. In 2000 violence-related and self-directed injuries accounted for an estimated $37 billion and $33 billion in productivity losses and medical treatment, respectively. A review of emergency department data revealed violence and clinically identified trauma-related injuries have the strongest correlation among alcohol-dependent injuries.
To increase teen seat belt use among drivers at a rural high school by implementing the Drive Alive Pilot Program (DAPP), a theory-driven intervention built on highway safety best practices.
This research report examines the feasibility of identifying eligible trauma patients for a study providing an early therapeutic intervention for the prevention of posttraumatic stress disorder (PTSD), and identifies reasons around participation.
Internet usage has increased in recent years resulting in a growing number of documented reports of cyberbullying. Despite the rise in cyberbullying incidents, there is a dearth of research regarding high school students’ motivations for cyberbullying. The purpose of this study was to investigate high school students’ perceptions of the motivations for cyberbullying.
Dating violence is a significant health problem among youth that leads to adverse health outcomes, including injuries. Reciprocal violence (perpetrated by both partners) is associated with increased injury in adults, but very little is known about the prevalence and context for reciprocal violence, as well as injury rates, among youth. We sought to determine the prevalence and scope of reciprocal dating violence and injury occurrence among urban youth in a high-risk community.
The current study examines the associations between a range of risk factors and reports of suicide attempts and attempts requiring medical care in a nationally representative study of high school students. The goal is to examine sex differences in the risk factors associated with suicide attempts and attempt-related injuries requiring treatment by a health-care provider.
To assess rates of substance abuse (including tobacco, alcohol, and drug abuse) as well as rates of intimate partner violence (IPV) among African-American women seen in an urban emergency department (ED).
The purposes of this exploratory study were to a) describe physical health symptoms and diagnoses in abused immigrant Latinas, b) explore the relationships between the women’s physical health and their experiences of intimate partner violence (IPV), their history of childhood trauma and immigration status, and c) explore the correlations between their physical health, health-related quality of life (HRQOL), and mental health, specifically symptoms of posttraumatic stress disorder (PTSD) and major depressive disorder (MDD).
A growing body of literature suggests that intimate partner violence (IPV) occurs within same-sex relationships and that members of the Lesbian Gay Bisexual Transgender (LGBT) community face a number of unique challenges in accessing IPV-related services. This paper examines the use of an online survey, marketed through a popular social networking site, to collect data on the experience and perpetration of IPV among men who have sex with men (MSM) in the United States.
The objectives of this analysis were to: 1) assess the impact of socio-demographic factors on parents’ perception of the benefits of attending a parenting program designed to prevent child maltreatment vs. the costs in terms of time and difficulty to attend, 2) determine if perceived costs and benefits affected the association between socio-demographic factors and participation in a parenting program, and 3) assess whether race/ethnicity moderated the relationship between socio-demographic factors, perceived costs and benefits, and program participation.
Recently, after 17 eventful and rewarding years at Emory University, I decided it was time for a change. My son was about to graduate from college, and both the injury prevention center and academic department I had founded were flourishing under my successors. With a strong sense of anticipation, my wife and I set out to write a new chapter of our lives in Washington, DC, where I had agreed to join the RAND Corporation as the Paul O’Neill-Alcoa Chair of Policy Analysis.
Unintentional and violence-related injuries represent one of the leading causes of morbidity and mortality in the United States and have a profound impact on the physical, emotional, and economic lives of our society.
Author Affiliation Debra Houry, MD, MPH Emory University, Atlanta, GA Abigail Hankin, MD, MPH Emory University, Atlanta, GA Monica H. Swahn, PhD Georgia State University, Atlanta GA Injury is the leading cause of death in the United States for persons between the ages of 1 and 441. We see evidence of the scope and […]
A 15-year-old Hispanic primigravid female at 12 weeks gestation presented to the Emergency Department (ED) complaining of vaginal bleeding for two days. The patient denied any abdominal pain, nausea, vomiting, or fever.