Original Research Archives - Page 12 of 40 - The Western Journal of Emergency Medicine

Critical Care

Clinical Features and Outcomes Associated with Angioedema in the Emergency Department

Sandefur, MD, et al.

Clinical features and outcome differences among nonhistaminergic vs histaminergic angioedema patients in the emergency department (ED) are poorly characterized. We aim to describe the clinical characteristics and outcomes among ED patients with angioedema by suspected etiology.

Westjem Read More

Critical Care

Three Airway Management Techniques for Airway Decontamination in Massive Emesis: A Manikin Study

Fiore, PharmD, et al.

This study compares the SALAD and IEI techniques with the traditional approach of ad hoc, rigid suction catheter airway decontamination and endotracheal intubation in the setting of massive simulated emesis.

Westjem Read More

Population Health Research Design

Techniques to Shorten a Screening Tool for Emergency Department Patients

Weiner, MD, et al.

Opioids are prescribed frequently in the emergency department (ED) setting, but screening tools are often of significant length and therefore limited in their utility. We describe and evaluate three approaches to shortening a screening tool: creation of a short form; curtailment; and stochastic curtailment.

Westjem Read More

Evaluation of a Standardized Cardiac Athletic Screening for National Collegiate Athletic Association (NCAA) Athletes

Fischetti, MD, et al.

Current screening techniques include history and physical exam (H and P), with or without an electrocardiogram (ECG). Adding point of care cardiac ultrasound has demonstrated benefits, but there is limited data about implementing this technology. We evaluated the feasibility of adding ultrasound to preparticipation screening for collegiate athletes.

Westjem Read More

Incidence and Causes of Iatrogenic Hypoglycemia in the Emergency Department

Chittineni, BS, et al.

The incidence and causes of iatrogenic hypoglycemia are not known. We aim to describe how often the cause of ED hypoglycemia is iatrogenic and to identify its specific causes.

Westjem Read More

Provider Workforce

Resource Utilization in Non-Academic Emergency Departments with Advanced Practice Providers

Aledhaim, NREMT-P, et al.

The objectives of this study were to compare resource utilization in EDs that use APPs in their staffing model with those that do not and to estimate costs associated with the utilized resources.

Westjem Read More

The Surgical Intervention for Traumatic Injury Scale: A Clinical Tool for Traumatic Brain Injury

Sribnick, MD, PhD, et al.

There is no widely used method for communicating the possible need for surgical intervention in patients with traumatic brain injury (TBI). This study describes a scoring system designed to communicate the potential need for surgical decompression in TBI patients.

Westjem Read More

Critical Care

Skill Proficiency is Predicted by Intubation Frequency of Emergency Medicine Attending Physicians

Gillett, MD, et al.

Endotracheal intubation (ETI) is a procedure that is specifically taught in residency, but little is known how best to maintain proficiency in this skill throughout the practitioner’s career. The goal of this study was to identify how the frequency of intubation correlated with measured performance.

Westjem Read More

Critical Care

Improvement in the Safety of Rapid Sequence Intubation in the Emergency Department with the Use of an Airway Continuous Quality Improvement Program

Sakles, MD, et al.

The purpose of this investigation is to describe an airway continuous quality improvement (CQI) program and its effect on the safety of rapid sequence intubation (RSI) in the emergency department (ED) over a 10-year period.

Westjem Read More

Thromboembolic Risk of 4-Factor Prothrombin Complex Concentrate versus Fresh Frozen Plasma for Urgent Warfarin Reversal in the Emergency Department

Maguire, PharmD, et al.

Our study found a significantly higher risk of thromboembolic events in patients receiving 4F-PCC compared to FFP for urgent warfarin reversal. This difference remained statistically significant when controlled for CNS bleeds and administration of vitamin K.

Westjem Read More

Radiograph Interpretation Discrepancies in a Community Hospital Emergency Department

Tranovich, DO, et al.

Studies have found conflicting results regarding the radiographic interpretation discrepancies between EPs and trained radiologists. The aim of this study was to identify the number of radiologic interpretation discrepancies between EPs and radiologists in a community ED setting.

Westjem Read More

Modification of the Emergency Severity Index Improves Mortality Prediction in Older Patients

Malinovska, MD, et al.

Older patients frequently present to the emergency department (ED) with nonspecific complaints (NSC), such as generalized weakness. They are at risk of adverse outcomes, and early risk stratification is crucial. The aim of this study was to assess the predictive power of additional clinical parameters in NSC patients.

Westjem Read More

Is National Resident Matching Program Rank Predictive of Resident Performance or Post-graduation Achievement? 10 Years at One Emergency Medicine Residency

Wall, MD, MPH, et al.

Each year residency programs expend considerable effort ranking applicants for the National Residency Matching Program (NRMP). We explored the relationship between residents’ NRMP rank list position as generated at our institution and their performance in residency and post-graduation to determine whether such efforts are justified.

Westjem Read More

Emergency Department Operations

SurgeCon: Priming a Community Emergency Department for Patient Flow Management

Patey, MD, et al.

We assessed the impact of SurgeCon, an ED patient-management protocol, on total patient visits, patients who left without being seen (LWBS), length of stay for departed patients (LOSDep), and physician initial assessment time (PIA) in a rural community hospital ED.

Westjem Read More

Emergency Department Operations

Decreasing the Lag Between Result Availability and Decision-Making in the Emergency Department Using Push Notifications

Koziatek, MD, et al.

We implemented a system that electronically alerts ED providers when test results are available for review via a smartphone- and smartwatch-push notification. We hypothesized this would reduce the time from result to clinical decision-making.

Westjem Read More

Emergency Department Operations

Transportation Preferences of Patients Discharged from the Emergency Department in the Era of Ridesharing Apps

Tomar, MD, et al.

Patients discharged from the emergency department (ED) may encounter difficulty finding transportation home, increasing length of stay and ED crowding. We sought to determine the preferences of patients discharged from the ED with regard to their transportation home, and their awareness and past use of ridesharing services such as Lyft and Uber.

Westjem Read More

Emergency Department Operations

Impact of Emergency Department Phlebotomists on Left-Before-Treatment-Completion Rates

Stowell, MD, et al.

The percentage of patients who leave before treatment completion (LBTC) is an important marker of department efficiency. Our study aimed to assess the impact of an ED phlebotomist, dedicated to obtaining blood specimen collection on waiting patients, on LBTC rates.

Westjem Read More

Variations in Opioid Prescribing Behavior by Physician Training

Leventhal, MD, et al.

Patients often present to the emergency department (ED) with painful conditions seeking analgesic relief. While there is known variability in the prescribing behaviors of emergency physicians, it is unknown if there are differences in these behaviors based on training level or by resident specialty.

Westjem Read More

Patient Communication

What Are We Measuring? Evaluating Physician-Specific Satisfaction Scores Between Emergency Departments

Sharp, MD, et al.

The goals of this study were to determine whether Press Ganey ED satisfaction scores for emergency physicians working at two different sites were consistent between sites, and to identify factors contributing to any variation.

Westjem Read More

Population Health Research Design

Access to Top-Cited Emergency Care Articles (Published Between 2012 and 2016) Without Subscription

Hamzy, MBBS, et al.

We describe access to the 500 most-cited emergency medicine (EM) articles (published between 2012 and 2016) in terms of publisher-based access (open access or subscription), alternate access routes (self-archived or author provided), and relative cost of access.

Westjem Read More

Are Rural and Urban Emergency Departments Equally Prepared to Reduce Avoidable Hospitalizations?

Greenwood-Ericksen, MD, et al.

A cross-sectional, web-based survey was emailed to medical directors and/or nurse managers of the 135 hospital-based EDs in Michigan. Questions included presence of clinical pathways, services to reduce admissions, and barriers to connecting patients to outpatient services.

Westjem Read More

Antivenom Treatment Is Associated with Fewer Patients using Opioids after Copperhead Envenomation

Freiermuth, MD, et al.

There is rising concern that an initial opioid prescription from the emergency department (ED) can lead to long-term addiction. This analysis sought to determine whether use of Fab antivenom (FabAV) for copperhead envenomation affected opioid use.

Westjem Read More

Availability of Bedside and Laboratory Testing for Carbon Monoxide Poisoning in the Upper Midwestern United States

Masters, MD, et al.

The objective of this study was to assess the ability to test patients for carbon monoxide (CO) exposure in all hospitals in three United States (U.S.) Midwestern states.

Westjem Read More

Feasibility of Telesimulation and Google Glass for Mass Casualty Triage Education and Training

McCoy, MD, et al.

Our goal was to evaluate the feasibility and effectiveness of using telesimulation to deliver an emergency medical services (EMS) course on mass casualty incident (MCI) training to healthcare providers overseas.

Westjem Read More

The Flipped Classroom: A Critical Appraisal

Kraut, MD, et al.

The objective of this study was to review and critically appraise the medical education literature pertaining to a flipped-classroom (FC) education model, and to highlight influential papers that inform our current understanding of the role of the FC in medical education.

Westjem Read More

Pertussis: The Identify, Isolate, Inform Tool Applied to a Re-emerging Respiratory Illness

Koenig, MD, et al.

Pertussis, commonly referred to as “whooping cough,” is a highly contagious acute respiratory infection that has exhibited cyclical outbreaks throughout the last century. Although vaccines have provided some immunity, many populations, including infants and pregnant women, remain at risk for serious illness.

Westjem Read More