Original Research Archives - Page 10 of 40 - The Western Journal of Emergency Medicine

Provider Workforce

#MeToo in EM: A Multicenter Survey of Academic Emergency Medicine Faculty on Their Experiences with Gender Discrimination and Sexual Harassment

Lu, MD, et al.

Gender-based discrimination and sexual harassment of female physicians are well documented. The #MeToo movement has brought renewed attention to these problems. This study examined academic emergency physicians’ experiences with workplace gender discrimination and sexual harassment.

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Emergency Department Clinicians’ Attitudes Toward Opioid Use Disorder and Emergency Department-initiated Buprenorphine Treatment: A Mixed-Methods Study

Im, MD, et al.

Emergency department (ED) visits related to opioid use disorder (OUD) have increased nearly twofold over the last decade. Treatment with buprenorphine has been demonstrated to decrease opioid-related overdose deaths. In this study, we aimed to better understand ED clinicians’ attitudes toward the initiation of buprenorphine treatment in the ED.

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Ketamine Safety and Use in the Emergency Department for Pain and Agitation/Delirium: A Health System Experience

Mo, PharmD, et al.

Two protocols were developed to guide the use of subdissociative dose ketamine (SDDK) for analgesia and dissociative sedation ketamine for severe agitation/excited delirium in the emergency department (ED). We sought to evaluate the safety of these protocols implemented in 18 EDs within a large health system.

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Co-Occurrence of Multiple Risk Factors and Intimate Partner Violence in an Urban Emergency Department

Caetano, MD, PhD, et al.

Urban emergency departments (ED) provide care to populations with multiple health-related and overlapping risk factors, many of which are associated with intimate partner violence (IPV). We examine the 12-month rate of physical IPV and its association with multiple joint risk factors in an urban ED.

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Population Health Research Design

Quality and Publication of Emergency Medicine Trials Registered in ClinicalTrials.gov

Calvocoressi, PhD, et al.

Promoting emergency medicine (EM) clinical trials research remains a priority. To characterize the status of clinical EM research, this study assessed trial quality, funding source, and publication of EM clinical trials and compared EM and non-EM trials on these key metrics. We also examined the volume of EM trials and their subspecialty areas.

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Population Health Research Design

Federal Funding in Emergency Medicine: Demographics and Perspectives of Awardees

Chai, MD, et al.

Emergency physicians face multiple challenges to obtaining federal funding. The objective of this investigation was to describe the demographics of federally-funded emergency physicians and identify key challenges in obtaining funding.

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Emergency Department Operations

“Breaking” the Emergency Department: Does the Culture of Emergency Medicine Present a Barrier to Self-Care?

O’Shea, MBBS, MA, et al.

Our goal was to critically examine emergency physician’s (EP) beliefs about taking breaks for self-care on shift. Our operational definition of a break for self-care included time not engaging in direct patient care, eating, drinking, using the bathroom, or leaving a clinical area for a mental break

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Emergency Department Operations

A Playroom Internal Waiting Area Improves Productivity in the Pediatric Emergency Department

Walsh, MB, et al.

Pediatric emergency department (PED) volume is often constrained by the number of available treatment rooms. In many PEDs patients occupy treatment rooms while awaiting test results or imaging, thereby delaying care for patients who arrive after them.

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Abscess Size and Depth on Ultrasound and Association with Treatment Failure without Drainage

Russell, MD, et al.

Smaller and more superficial abscesses may not require a drainage procedure for cure. The goal of this study was to evaluate the optimal abscess size and depth cut-off for determining when a drainage procedure is necessary.

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Tricuspid Annular Plane of Systolic Excursion (TAPSE) for the Evaluation of Patients with Severe Sepsis and Septic Shock

Lahham, MD, et al.

Sepsis is a systemic infection that can rapidly progress into multi organ failure and shock if left untreated. Previous studies have demonstrated the utility of point of care ultrasound (POCUS) in the evaluation of patients with sepsis. However, limited data exists on the evaluation of the tricuspid annular plane of systolic excursion (TAPSE) in patients with sepsis.

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Comparison of Ultrasound-Guided Vs Traditional Arterial Cannulation by Emergency Medicine Residents

Wilson, MD, et al.

We sought to determine whether ultrasound-guided arterial cannulation (USGAC) is more successful than traditional radial artery cannulation (AC) as performed by emergency medicine (EM) residents with standard ultrasound training.

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Does Orally-Administered Radiocontrast Impair Ultrasound Image Quality in Pediatric Patients?

Patel, MD, et al.

The objective of this study was to evaluate whether early administration of ORC in children with abdominal pain receiving abdominal CT for possible appendicitis obscures subsequent abdominal US image quality.

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How to Stop the Bleed: First Care Provider Model for Developing Public Trauma Response Beyond Basic Hemorrhage Control

Bobko, MD, et al.

Recent programs, such as the federal “Stop The Bleed” campaign, have placed the emphasis of public training on hemorrhage control. However, recent attacks demonstrate that access to wounded, recognition of injury, and rapid evacuation are equally as important as hemorrhage control in minimizing mortality.

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UNIFIED: Understanding New Information from Emergency Departments Involved in the San Bernardino Terrorist Attack

Smith, MD, et al.

The primary objective of this study was to gather and detail the common experiences from those hospital-based health professionals directly involved in the response to the San Bernardino terrorism attack on December 2, 2015. Secondary objectives included gathering information on experiences participants found were best practices.

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Predictors of Patient Satisfaction and the Perceived Quality of Healthcare in an Emergency Department in Portugal

Abidova, M. Phil, et al.

The goal of this study was to identify the key predictors of patient satisfaction and perceived quality of healthcare in the framework of an emergency department (ED).

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Role of Point-of-Care Testing in Reducing Time to Treatment Decision-Making in Urgency Patients: A Randomized Controlled Trial

Chaisirin, MD, et al.

Shortening emergency department (ED) visit time can reduce ED crowding, morbidity and mortality, and improve patient satisfaction. Point-of-care testing (POCT) has the potential to decrease laboratory turnaround time, possibly leading to shorter time to decision-making and ED length of stay (LOS). We aimed to determine whether the implementation of POCT could reduce time to decision-making and ED LOS.

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Innovative Approaches to Emergency Medical Services Fellowship Challenges

Weston, MD, MPH, et al.

Since the development of an Accreditation Council of Graduate Medical Education (ACGME)-accredited emergency medical services (EMS) fellowship, there has been little published literature on effective methods of content delivery or training modalities. Here we explore a variety of innovative approaches to the development and revision of the EMS fellowship curriculum.

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Does the Removal of Textbook Reading from Emergency Medicine Resident Education Negatively Affect In-Service Scores?

Ju, MD, et al.

At our institution, due to resident feedback a change in curriculum was initiated. Our objective was to determine whether assigned Evidence-Based Medicine (EBM) articles and Rosh Review questions were non-inferior to Tintinalli textbook readings. We further hypothesized that the non-textbook assigned curriculum would lead to higher resident satisfaction, greater utilization, and a preference over the old curriculum.

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Challenges Related to the Implementation of an EMS-Administered, Large Vessel Occlusion Stroke Score

Lawner, DO, MS, EMT-P, et al.

Timely access to interventional therapy has been linked to improved stroke outcomes. Accurate triage depends upon the use of a validated screening tool in addition to several emergency medical system (EMS)-specific factors. This study examines the integration of a modified Rapid Arterial oCcclusion Evaluation (mRACE) score into an existing stroke treatment protocol.

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Mistriaged Advanced Life Support Patients in a Two-Tiered, Suburban Emergency Medical Services System

Bucher, MD, et al.

Our study examines patients who were triaged and admitted to a critical care location, including an intensive care unit (ICU), cardiac catheterization laboratory, or operating room (OR).

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Prehospital Trauma Scene and Transport Times for Pediatric and Adult Patients

Ashburn, MD, et al.

Increased out-of-hospital time is associated with worse outcomes in trauma. Sparse literature exists comparing prehospital scene and transport time management intervals between adult and pediatric trauma patients. National Emergency Medical Services guidelines recommend that trauma scene time be less than 10 minutes. The objective of this study was to examine prehospital time intervals in adult and pediatric trauma patients.

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Qualitative Research of Violent Incidents Toward Young Paramedics in the Czech Republic

Knor, MD, PhD, et al.

We conducted this study to explore the process of violence against EMS providers, using the Strauss/Corbin systematic approach of grounded theory to create a paradigm model. The participants in this research included personnel who had at least two years experience in the EMS systems of the city of Prague and the Central Bohemian Region, and who had been victims of violence.

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A Roadmap for the Student Pursuing a Career in Pediatric Emergency Medicine

Leetch, MD, et al.

Questions regarding differences between the training pathways are common among medical students. We present a comparative analysis of training pathways highlighting major curricular differences to aid in students’ understanding of these training options.

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Does the Medium Matter? Evaluating the Depth of Reflective Writing by Medical Students on Social Media Compared to the Traditional Private Essay Using the REFLECT Rubric

Brown, MD, et al.

Using sociomateriality as a conceptual framework, we aimed to compare the depth of reflection in RW samples submitted by medical students in a traditional private essay format to those posted on a secure social media platform.

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What’s All the Chatter? A Mixed-Methods Analysis of Emergency Physicians’ Tweets

Riddell, MD, et al.

While there has been debate about the value of Twitter as an effective educational delivery tool, little attention has been paid to the nature of the conversation occurring on Twitter. We aim to describe how influential EPs use Twitter by characterizing the language, purpose, frequencies, content, and degree of engagement of their tweets.

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Usability of Learning Moment: Features of an E-learning Tool That Maximize Adoption by Students

Chu, MD, MPH, et al.

We created Learning Moment (LM), a web-based application that integrates principles of asynchronous learning and learning portfolios into a platform on which students can document and share learning experiences that occur during clinical work. We sought to evaluate the usability of LM and identify features that optimize adoption by users.

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