Original Research Archives - Page 27 of 40 - The Western Journal of Emergency Medicine

Emergency Department Operations

Using Lean-Based Systems Engineering to Increase Capacity in the Emergency Department

Volume 15, Issue 7, November 2014
Benjamin A. White, MD et al.

While emergency department (ED) crowding has myriad causes and negative downstream effects, applying systems engineering science and targeting throughput remains a potential solution to increase functional capacity. However, the most effective techniques for broad application in the ED remain unclear.

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Emergency Department Operations

What Do Patients Want? Survey of Patient Desires for Education in an Urban University Hospital

Volume 15, Issue 7, November 2014
Thomas Seibert, MD, MS et al.

This study examines the emergency department (ED) waiting room (WR) population’s knowledge about the ED process and hospital function and explores the types of educational materials that might appeal to patients and their companions in an ED waiting room.

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Healthcare Utilization

Impact of a Health Information Exchange on Resource Use and Medicare-Allowable Reimbursements at 11 Emergency Departments in a Midsized City

Volume 15, Issue 7, November 2014
Steven H. Saef, MD, MSCR et al.

Use clinician perceptions to estimate the impact of a health information exchange (HIE) on emergency department (ED) care at four major hospital systems (HS) within a region.

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Critical Care

Noninvasive Hemodynamic Monitoring in Emergency Patients with Suspected Heart Failure, Sepsis and Stroke: The Premium Registry

Volume 15, Issue 7, November 2014
Richard M. Nowak, MD et al.

Noninvasive hemodynamic (HD) assessments in the emergency department (ED) might assist in the diagnosis, therapeutic plan development and risk stratification of acutely ill patients.

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Critical Care

Shock Index and Prediction of Traumatic Hemorrhagic Shock 28-Day Mortality: Data from the DCLHb Resuscitation Clinical Trials

Volume 15, Issue 7, November 2015
Edward P. Sloan, MD, MPH et al.

To assess the ability of the shock index (SI) to predict 28-day mortality in traumatic hemorrhagic shock patients treated in the diaspirin cross-linked hemoglobin (DCLHb) resuscitation clinical trials.

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Bedside Ultrasonography as an Adjunct to Routine Evaluation of Acute Appendicitis in the Emergency Department

Volume 15, Issue 7, November 2014
Samuel H.F. Lam, MD et al.

Appendicitis is a common condition presenting to the emergency department (ED). Increasingly emergency physicians (EP) are using bedside ultrasound (BUS) as an adjunct diagnostic tool.

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Ultrasound-Guided Small Vessel Cannulation: Long-Axis Approach Is Equivalent to Short-Axis in Novice Sonographers Experienced with Landmark-Based Cannulation

Volume 15, Issue 7, November 2014
Catherine S. Erickson, MD et al.

Our primary objective was to describe the time to vessel penetration and difficulty of long-axis and short-axis approaches for ultrasound-guided small vessel penetration in novice sonographers experienced with landmark-based small vessel penetration.

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Accuracy of a Novel Ultrasound Technique for Confirmation of Endotracheal Intubation by Expert and Novice Emergency Physicians

Volume 15, Issue 7, November 2014
Michael Gottlieb, et al.

Recent research has investigated the use of ultrasound (US) for confirming endotracheal tube (ETT) placement with varying techniques, accuracies, and challenges. Our objective was to evaluate the accuracy of a novel, simplified, four-step (4S) technique.

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Impact of a Physician-in-Triage Process on Resident Education

Volume 15, Issue 7, November 2014
Bret A. Nicks, MD, MHA et al.

Emergency department (ED) crowding negatively impacts patient care quality and efficiency. To reduce crowding many EDs use a physician-in-triage (PIT) process.

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Randomized Trial of a Novel ACLS Teaching Tool: Does it Improve Student Performance?

Volume 15, Issue 7, November 2014
Nicholas Nacca, MD et al.

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Learning Curves for Direct Laryngoscopy and GlideScope® Video Laryngoscopy in an Emergency Medicine Residency

Volume 15, Issue 7, November 2014
John C. Sakles, MD et al.

Endotracheal intubation (ETI) is currently considered superior to supraglottic airway devices (SGA) for survival and other outcomes among adults with non-traumatic out-of-hospital cardiac arrest (OHCA). We aimed to determine if the research supports this conclusion by conducting a systematic review.

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Management of In-Flight Medical Emergencies: Are Senior Medical Students Prepared to Respond to this Community Need?

Volume 15, Issue 7, November 2014
Robert J. Katzer, MD, MBA et al.

In-flight medical emergencies on commercial aircraft are common in both domestic and international flights. We hypothesized that fourth-year medical students feel inadequately prepared to lend assistance during in-flight medical emergencies. This multicenter study of two U.S. medical schools obtains a baseline assessment of knowledge and confidence in managing in-flight medical emergencies.

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The Flipped Classroom: A Modality for Mixed Asynchronous and Synchronous Learning in a Residency Program

Volume 15, Issue 7, November 2014
Timothy P. Young, MD et al.

A “flipped classroom” educational model exchanges the traditional format of a classroom lecture and homework problem set.

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Critical Care

Epidemiología del Síndrome de Respuesta Inflamatoria Sistémica en el Departamento de Emergencia

Volume 15, Issue 3, May 2014
Horeczko T, MD, MSCR, et al.

Guías de consenso recomiendan cernimiento de sepsis para adultos con síndrome de respuesta inflamatoria sistémica (SIRS), pero la epidemiología de SIRS en pacientes adultos de sala de emergencia (ED) es poco entendida. Énfasis reciente en cuidado de salud costo efectivo y basado en resultados, motiva la evaluación del desempeño de esfuerzos de gran escala tales como cernimiento de sepsis. Estudiamos una muestra representativa nacional para clarificar la epidemiología de SIRS en la sala de emergencia y su categoría subsecuente de enfermedad.

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Injury Prevention

Disposición para Cambiar y Razones para Reducir Intencionalmente el Consumo de Alcohol en el Departamento de Medicina de Emergencia versus la Población de Trauma

Volume 15, Issue 3, May 2014
Harrison C, MD, MPH et al.

El objetivo primario era identificar las razones más comunes para la intención de disminuir el uso de alcohol en la sala de emergencia (ED) y en la población de pacientes de trauma. El objetivo secundario era determinar la asociación entre la razón de disminuir el consumo de alcohol y el nivel de educación.

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Estudio del Temor a la Impericia Médica de los Estudiantes de Medicina y la Medicina Defensiva: ¿Un “Currículo Oculto”?

Volume 15, Issue 3, May 2014
Johnston W, MD et al.

La medicina defensiva es una práctica médica en la cual la intención primordial de los proveedores de la salud es evitar críticas y demandas en lugar de proveer las necesidades médicas de sus pacientes. El propósito de este estudio es caracterizar la exposición de los estudiantes de medicina a la medicina defensiva durante sus rotaciones de escuela de medicina.

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USEFUL: Examen Sonográfico para Lesiones Subyacentes Incorporado al Examen Físico

Volume 15, Issue 3, May 2014
Steller J, MD et al.

El Examen de Cernimiento con Sonograma para la evaluación de Lesiones Subyacentes (USEFUL) fue desarrollado en un intento por establecer un rol para sonografía “bedside” en el marco de cuidado preventivo y primario. El propósito de nuestro estudio piloto era determinar si los estudiantes eran capaces de llevar a cabo todos los “scans” requeridos para USEFUL de manera que este examen físico asistido por sonografía complemente el examen físico estándar en la misma estructura de pies a cabeza. Nosotros también nos propusimos evaluar el tiempo necesario para un examen adecuado y analizar si los tiempos mejoraban con repetición y entrenamiento previo en sonografía.

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Compassion Fatigue is Similar in Emergency Medicine Residents Compared to other Medical and Surgical Specialties

Volume 15, Issue 6, September 2014
M. Fernanda Bellolio, MD, MS et al.

Compassion fatigue (CF) is the emotional and physical burden felt by those helping others in distress, leading to a reduced capacity and interest in being empathetic towards future suffering. Emergency care providers are at an increased risk of CF secondary to their first responder roles and exposure to traumatic events. We aimed to investigate the current state of compassion fatigue among emergency medicine (EM) resident physicians, including an assessment of contributing factors.

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BE-SAFE: Bedside Sonography for Assessment of the Fetus in Emergencies: Educational Intervention for Late-pregnancy Obstetric Ultrasound

Volume 15, Issue 6, September 2014
Sachita Shah, MD et al.

Late obstetric emergencies are time critical presentations in the emergency department. Evaluation to ensure the safety of mother and child includes rapid assessment of fetal viability, fetal heart rate (FHR), fetal lie, and estimated gestational age (EGA). Point-of-care (POC) obstetric ultrasound (OBUS) offers the advantage of being able to provide all these measurements. We studied the impact of POC OBUS training on emergency physician (EP) confidence, knowledge, and OBUS skill performance on a live model.

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Performance Accuracy of Hand-on-needle versus Hand-on-syringe Technique for Ultrasound-guided Regional Anesthesia Simulation for Emergency Medicine Residents

Volume 15, Issue 6, September 2014
Brian Johnson, MD, MPH et al.

Ultrasound-guided nerve blocks (UGNB) are increasingly used in emergency care. The hand-on-syringe (HS) needle technique is ideally suited to the emergency department setting because it allows a single operator to perform the block without assistance.

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Consensus Development of a Pediatric Emergency Medicine Clerkship Curriculum

Volume 15, Issue 6, September 2014
Kim L. Askew, MD et al.

As emergency medicine (EM) has become a more prominent feature in the clinical years of medical school training, national EM clerkship curricula have been published to address the need to standardize students’ experiences in the field. However, current national student curricula in EM do not include core pediatric emergency medicine (PEM) concepts.

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Emergency Department Access

Exploring Real-time Patient Decision-making for Acute Care: A Pilot Study

Volume 15, Issue 6, September 2014
Adam L. Sharp, MD, MS et al.

Research has described emergency department (ED) use patterns in detail. However, evidence is lacking on how, at the time a decision is made, patients decide if healthcare is required or where to seek care.

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Emergency Department Operations

Implementation of a Team-based Physician Staffing Model at an Academic Emergency Department

Volume 15, Issue 6, September 2014
Jose V. Nable, MD et al.

There is scant literature regarding the optimal resident physician staffing model of academic emergency departments (ED) that maximizes learning opportunities. A department of emergency medicine at a large inner-city academic hospital initiated a team-based staffing model.

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Emergency Department Operations

Reducing Patient Placement Errors in Emergency Department Admissions: Right Patient, Right Bed

Volume 15, Issue 6, September 2014
Niels K. Rathlev, MD et al.

Because lack of inpatient capacity is associated with emergency department (ED) crowding, more efficient bed management could potentially alleviate this problem. Our goal was to assess the impact of involving a patient placement manager (PPM) early in the decision to hospitalize ED patients. The PPMs are clinically experienced registered nurses trained in the institution-specific criteria for correct unit and bed placement.

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Injury Outcomes

Motor Vehicle Crash-Associated Eye Injuries Presenting to U.S. Emergency Departments

Volume 15, Issue 6, September 2014
Grayson W. Armstrong, BA et al.

Motor vehicle crashes (MVCs) are a leading cause of injury in the United States (U.S.). Detailed knowledge of MVC eye injuries presenting to U.S. emergency departments (ED) will aid clinicians in diagnosis and management. The objective of the study was to describe the incidence, risk factors, and characteristics of non-fatal motor vehicle crash-associated eye injuries presenting to U.S. EDs from 2001 to 2008.

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Impact of Post-Intubation Interventions on Mortality in Patients Boarding in the Emergency Department

Volume 15, Issue 6, September 2014
Rahul Bhat, MD et al.

Emergency physicians frequently perform endotracheal intubation and mechanical ventilation. The impact of instituting early post-intubation interventions on patients boarding in the emergency department (ED) is not well studied. We sought to determine the impact of post-intubation interventions (arterial blood gas sampling, obtaining a chest x-ray (CXR), gastric decompression, early sedation, appropriate initial tidal volume, and quantitative capnography) on outcomes of mortality, ventilator-associated pneumonia (VAP), ventilator days, and intensive care unit (ICU) length-of-stay (LOS).

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