Original Research Archives - Page 26 of 40 - The Western Journal of Emergency Medicine

The Social Media Index: Measuring the Impact of Emergency Medicine and Critical Care Websites

Volume 16, Issue 2, March 2015
Brent Thoma, MD, MA et al.

The number of educational resources created for emergency medicine and critical care (EMCC) that incorporate social media has increased dramatically. With no way to assess their impact or quality, it is challenging for educators to receive scholarly credit and for learners to identify respected resources. The Social Media index (SMi) was developed to help address this.

Westjem Read More

Ethical and Legal Issues

Do Emergency Physicians and Medical Students Find It Unethical to ‘Look up’ Their Patients on Facebook or Google?

Volume 16, Issue 2, March 2015
Maxim Ben-Yakov, MD et al.

The use of search engines and online social media (OSM) websites by healthcare providers is increasing and may even be used to search for patient information. This raises several ethical issues. The objective of this study is to evaluate the prevalence of OSM and web-searching for patient information and to explore attitudes towards the ethical appropriateness of these practices by physicians and trainees in the emergency department (ED).

Westjem Read More

Healthcare Utilization

Patients Who Use Multiple EDs: Quantifying the Degree of Overlap between ED Populations

Volume 16, Issue 2, March 2015
Baruch S. Fertel, MD, MPA et al.

The degree to which individual patients use multiple emergency departments (EDs) is not well-characterized. We determined the degree of overlap in ED population between three geographically proximate hospitals.

Westjem Read More

Kiosk versus In-person Screening for Alcohol and Drug Use in the Emergency Department: Patient Preferences and Disclosure

Volume 16, Issue 2, March 2015
Abigail Hankin, MD, MPH et al.

Annually eight million emergency department (ED) visits are attributable to alcohol use. Screening ED patients for at-risk alcohol and substance use is an integral component of screening, brief intervention, and referral to treatment programs, shown to be effective at reducing substance use. The objective is to evaluate ED patients’ acceptance of and willingness to disclose alcohol/substance use via a computer kiosk versus an in-person interview.

Westjem Read More

Injury Outcomes

Barriers and Disparities in Emergency Medical Services 911 Calls for Stroke Symptoms in the United States Adult Population: 2009 BRFSS Survey

Volume 15, Issue 2, March 2014
Munseok Seo, DrPH et al.

This study examines barriers and disparities in the intentions of American citizens, when dealing with stroke symptoms, to call 911. This study hypothesizes that low socioeconomic populations are less likely to call 911 in response to stroke recognition.

Westjem Read More

Ethical and Legal Issues

Effects of a Dedicated Regional Psychiatric Emergency Service on Boarding of Psychiatric Patients in Area Emergency Departments

Volume XV, Issue 1, February 2014
Scott Zeller, MD et al.

This study sought to assess the effects of a regional dedicated emergency psychiatric facility design known at the “Alameda Model” on boarding times and hospitalization rates for psychiatric patients in area EDs.

Westjem Read More

Discrepancy Between Clinician and Research Assistant in TIMI Score Calculation (TRIAGED CPU)

Volume 16 , Issue 1, January 2015
Brian T. Taylor, DO et al.

Several studies have attempted to demonstrate that the Thrombolysis in Myocardial Infarction (TIMI) risk score has the ability to risk stratify emergency department (ED) patients with potential acute coronary syndromes (ACS). Most of the studies we reviewed relied on trained research investigators to determine TIMI risk scores rather than ED providers functioning in their normal work capacity.

Westjem Read More

Routine Repeat Head CT may not be Indicated in Patients on Anticoagulant/Antiplatelet Therapy Following Mild Traumatic Brain Injury

Volume 16, Issue 1, January 2015
Kevin C. McCammack, MD

Evaluation recommendations for patients on anticoagulant and antiplatelet (ACAP) therapy that present after mild traumatic brain injury (TBI) are controversial. At our institution, an initial noncontrast head computed tomography (HCT) is performed, with a subsequent HCT performed six hours later to exclude delayed intracranial hemorrhage (ICH).

Westjem Read More

Timing of Discharge Follow-up for Acute Pulmonary Embolism: Retrospective Cohort Study

Volume 16, Issue 1, January 2015
David R. Vinson, MD et al.

Historically, emergency department (ED) patients with pulmonary embolism (PE) have been admitted for several days of inpatient care. Growing evidence suggests that selected ED patients with PE can be safely discharged home after a short length of stay.

Westjem Read More

Injury Prevention

Descriptive Study of Prescriptions for Opioids from a Suburban Academic Emergency Department Before New York’s I-STOP Act

Volume 16, Issue 1, January 2015
Lyncean Ung, DO et al.

Controlled prescription opioid use is perceived as a national problem attributed to all specialties.

Westjem Read More

Predictors of Psychiatric Boarding in the Emergency Department

Volume 16, Issue 1, January 2015
Ryan K. Misek, DO et al.

The emergency psychiatric care is system is overburdened in the United States. Patients experiencing psychiatric emergencies often require resources not available at the initial treating facility and frequently require transfer to an appropriate psychiatric facility.

Westjem Read More

Healthcare Utilization

Factors Associated with Decision to Hospitalize Emergency Department Patients with Skin and Soft Tissue Infection

Volume 16, Issue 1, January 2015
David A. Talan, MD et al.

Emergency department (ED) hospitalizations for skin and soft tissue infection (SSTI) have increased, while concern for costs has grown and outpatient parenteral antibiotic options have expanded. To identify opportunities to reduce admissions, we explored factors that influence the decision to hospitalize an ED patient with a SSTI.

Westjem Read More

Healthcare Utilization

Trauma Center Staffing, Infrastructure, and Patient Characteristics that Influence Trauma Center Need

Volume 16, Issue 1, January 2015
Mark Faul, PhD, MA et al.

The most effective use of trauma center resources helps reduce morbidity and mortality, while saving costs. Identifying critical infrastructure characteristics, patient characteristics and staffing components of a trauma center associated with the proportion of patients needing major trauma care will help planners create better systems for patient care.

Westjem Read More

Healthcare Utilization

Evaluation of Healthcare Use Trends of High-Risk Female Intimate Partner Violence Victims

Volume 16, Issue 1, January 2015
Robyn M. Hoelle, MD et al.

Practitioners need more information about intimate partner violence (IPV) victims’ healthcare use trends. We used a novel data-linkage method and complaint categorization allowing us to evaluate IPV victims healthcare use trends compared to the date of their victimization.

Westjem Read More

Objective Structured Clinical Examinations Provide Valid Clinical Skills Assessment in Emergency Medicine Education

Volume 16, Issue 1, January 2015
Joshua Wallenstein, MD et al.

Evaluation of emergency medicine (EM) learners based on observed performance in the emergency department (ED) is limited by factors such as reproducibility and patient safety. EM educators depend on standardized and reproducible assessments such as the objective structured clinical examination (OSCE).

Westjem Read More

Change to an Informal Interview Dress Code Improves Residency Applicant Perceptions

Volume 16, Issue 1, January 2015
H. Gene Hern, Jr., MD, MS et al.

Residency interview apparel has traditionally been the dark business suit. We changed the interview dress code from a traditionally established unwritten ‘formal’ attire to an explicitly described ‘informal’ attire

Westjem Read More

Educational Technology Improves ECG Interpretation of Acute Myocardial Infarction among Medical Students and Emergency Medicine Residents

Volume 16, Issue 1, January 2015
Ali Pourmand, MD et al.

Asynchronous online training has become an increasingly popular educational format in the new era of technology-based professional development. We sought to evaluate the impact of an online asynchronous training module on the ability of medical students and emergency medicine (EM) residents to detect electrocardiogram (ECG) abnormalities of an acute myocardial infarction (AMI).

Westjem Read More

Correlation of the NBME Advanced Clinical Examination in EM and the National EM M4 exams

Volume 16, Issue 1, January 2015
Katherine Hiller, MD, MPH et al.

Since 2011 two online, validated exams for fourth-year emergency medicine (EM) students have been available (National EM M4 Exams). In 2013 the National Board of Medical Examiners offered the Advanced Clinical Examination in Emergency Medicine (EM-ACE).

Westjem Read More

Ultrafest: A Novel Approach to Ultrasound in Medical Education Leads to Improvement in Written and Clinical Examinations

Volume 16, Issue 1, January 2015
Kiah Connolly, MD et al.

Our objective was to evaluate the effectiveness of hands-on training at a bedside ultrasound (US) symposium (“Ultrafest”) to improve both clinical knowledge and image acquisition skills of medical students. Primary outcome measure was improvement in multiple choice questions on pulmonary or Focused Assessment with Sonography in Trauma (FAST) US knowledge. Secondary outcome was improvement in image acquisition for either pulmonary or FAST.

Westjem Read More

Validation of a Decision Rule for Selective TSH Screening in Atrial Fibrillation

Volume 16, Issue 1, January 2015
Shawna D. Bellew, MD et al.

Atrial fibrillation (AF) is the most common cardiac dysrhythmia. Current guidelines recommend obtaining thyroid-stimulating hormone (TSH) levels in all patients presenting with AF.

Westjem Read More

Improving Door-to-balloon Time by Decreasing Door-to-ECG time for Walk-in STEMI Patients

Volume 16, Issue 1, January 2015
Christopher J. Coyne, MD et al.

The American Heart Association/American College of Cardiology guidelines recommend rapid door-to-electrocardiography (ECG) times for patients with ST-segment elevation myocardial infarction (STEMI). Previous quality improvement research at our institution revealed that we were not meeting this benchmark for walk-in STEMI patients.

Westjem Read More

Factors Influencing Rate of Testicular Salvage in Acute Testicular Torsion at a Tertiary Pediatric Center

Volume 16, Issue 1, January 2015
Puneeta Ramachandra, MD et al.

Studies have demonstrated that variables other than duration of symptoms can affect outcomes in children with acute testicular torsion. We examined demographic and logistical factors, including inter-hospital transfer, which may affect outcomes at a tertiary pediatric referral center.

Westjem Read More

Emergency Department Access

Lack of Gender Disparities in Emergency Department Triage of Acute Stroke Patients

Volume 16, Issue 1, January 2015
Tracy E. Madsen, MD, ScM et al.

Previous literature has shown gender disparities in the care of acute ischemic stroke. Compared to men, women wait longer for brain imaging and are less likely to receive intravenous (IV) tissue plasminogen activator (tPA).

Westjem Read More

Utility of Vital Signs in Mass Casualty-Disaster Triage

Volume 15, Issue 7, November 2014
David E. Hogan, DO, MPH et al.

The triage of patients during a mass casualty – disaster (MCD) event presents the emergency healthcare provider with a complex and difficult issue. The task of evaluating casualties rapidly, using primarily the skills of physical examination, while still accurately identifying casualties likely to have critical injury or illness, may be impossible to achieve in practice.

Westjem Read More

Prehospital Care

Prehospital Use of IM Ketamine for Sedation of Violent and Agitated Patients

Volume 15, Issue 7, November 2014
Kenneth A. Scheppke, MD et al.

Violent and agitated patients pose a serious challenge for emergency medical services (EMS) personnel. Rapid control of these patients is paramount to successful prehospital evaluation and also for the safety of both the patient and crew.

Westjem Read More

Prehospital Care

National Trends in the Utilization of Emergency Medical Services for Acute Myocardial Infarction and Stroke

Volume 15, Issue 7, November 2014
Katie Tataris, MD, MPH et al.

The emergency medical services (EMS) system plays a crucial role in the chain of survival for acute myocardial infarction (AMI) and stroke.

Westjem Read More