Original Research Archives - Page 28 of 40 - The Western Journal of Emergency Medicine

Effects of a Web-based Educational Module on Pediatric Emergency Medicine Physicians’ Knowledge, Attitudes, and Behaviors Regarding Youth Violence

Volume 15, Issue 5, August 2014
Tracy E. Madsen, MD et al.

Youth seen in the emergency department (ED) with injuries from youth violence (YV) have increased risk for future violent injury and death. Pediatric emergency medicine (PEM) physicians rarely receive training in, or perform, YV screening and intervention. Our objective was to examine effects of a web-based educational module on PEM physicians’ knowledge, attitudes, and behaviors regarding YV screening and interventions in the ED.

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Screening for Violence Risk Factors Identifies Young Adults at Risk for Return Emergency Department Visit for Injury

Volume 15, Issue 5, August 2014
Abigail Hankin, MD, MPH et al.

Homicide is the second leading cause of death among youth aged 15–24. Prior cross-sectional studies, in non-healthcare settings, have reported exposure to community violence, peer behavior, and delinquency as risk factors for violent injury

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Texting While Driving: Does the New Law Work Among Healthcare Providers?

Volume 15, Issue 5, August 2014
Anitha E. Mathew, MD, MPH et al.

This study assessed whether Georgia Senate Bill 360, a statewide law passed in August 2010, that prohibits text messaging while driving, resulted in a decrease in this behavior among emergency medicine (EM) and general surgery (GS) healthcare providers.

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Impact of Gender on Patient Preferences for Technology-Based Behavioral Interventions

Volume 15, Issue 5, August 2014
David J. Kim, MD et al.

Technology-based interventions offer an opportunity to address high-risk behaviors in the emergency department (ED). Prior studies suggest behavioral health strategies are more effective when gender differences are considered. However, the role of gender in ED patient preferences for technology-based interventions has not been examined. The objective was to assess whether patient preferences for technology-based interventions varies by gender.

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“The Internet is a Mask”: High School Students’ Suggestions for Preventing Cyberbullying

Volume 15, Issue 5, August 2014
Leandra N. Parris, PhD et al.

Interactions through technology have an important impact on today’s youth. While some of these interactions are positive, there are concerns regarding students engaging in negative interactions like cyberbullying behaviors and the negative impact these behaviors have on others. The purpose of the current study was to explore participant suggestions for both students and adults for preventing cyberbullying incidents.

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Can Social Networking Be Used to Promote Engagement in Child Maltreatment Prevention Programs? Two Pilot Studies

Volume 15, Issue 5, August 2014
Anna Edwards-Gaura, PhD et al.

Child maltreatment is one of the United States’ most significant public health problems. In efforts to prevent maltreatment experts recommend use of Behavioral Parent Training Programs (BPTs), which focus on teaching skills that will replace and prevent maltreating behavior.

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Use of Social Media During Public Emergencies by People with Disabilities

Volume 15, Issue 5, August 2014
John T. Morris, PhD et al.

People with disabilities are generally more vulnerable during disasters and public emergencies than the general population. Physical, sensory and cognitive impairments may result in greater difficulty in receiving and understanding emergency alert information, and greater difficulty in taking appropriate action. The use of social media in the United States has grown considerably in recent years. This has generated increasing interest on the part of national, state and local jurisdictions in leveraging these channels to communicate public health and safety information. How and to what extent people with disabilities use social and other communications media during public emergencies can help public safety organizations understand the communication needs of the citizens in their jurisdictions, and plan their social media and other communications strategies accordingly.

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Treatment Protocol Assessment

Epidemiology of Nursemaid’s Elbow

Volume 15, Issue 4, July 2014
Sarah Vitello, DO et al.

To provide an epidemiological description of radial head subluxation, also known as nursemaid’s elbow, from a database of emergency department visits.

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Evaluation of Karl Storz CMAC Tip™ Device Versus Traditional Airway Suction in a Cadaver Model

Volume 15, Issue 4, July 2014
Demis N. Lipe, MD et al.

We compared the efficacy of Karl Storz CMAC Tip™ with inline suction to CMAC with traditional suction device in cadaveric models simulating difficult airways, using media mimicking pulmonary edema and vomit.

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Typed Versus Voice Recognition for Data Entry in Electronic Health Records: Emergency Physician Time Use and Interruptions

Volume 15, Issue 4, July 2014
Jonathan E. dela Cruz, MD et al.

Use of electronic health record (EHR) systems can place a considerable data entry burden upon the emergency department (ED) physician. Voice recognition data entry has been proposed as one mechanism to mitigate some of this burden; however, no reports are available specifically comparing emergency physician (EP) time use or number of interruptions between typed and voice recognition data entry-based EHRs. We designed this study to compare physician time use and interruptions between an EHR system using typed data entry versus an EHR with voice recognition.

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Availability of Insurance Linkage Programs in U.S. Emergency Departments

Volume 15, Issue 4, July 2014
Mia Kanak, MPH et al.

As millions of uninsured citizens who use emergency department (ED) services are now eligible for health insurance under the Affordable Care Act, the ED is ideally situated to facilitate linkage to insurance. Forty percent of U.S. EDs report having an insurance linkage program. This is the first national study to examine the characteristics of EDs that offer or do not offer these programs.

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Impact of the Balance Billing Ban on California Emergency Providers

Volume 15, Issue 4, July 2014
Bing Pao, MD et al.

The objective of this study was to examine reimbursement trends for emergency provider professional services following the balance billing ban in California.

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Provider Workforce

Multidimensional Attitudes of Emergency Medicine Residents Toward Older Adults

Volume 15, Issue 4, July 2014
Teresita M. Hogan, MD et al.

The demands of our rapidly expanding older population strain many emergency departments (EDs), and older patients experience disproportionately high adverse health outcomes. Trainee attitude is key in improving care for older adults. There is negligible knowledge of baseline emergency medicine (EM) resident attitudes regarding elder patients

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Prehospital Care

Emergency Physician Awareness of Prehospital Procedures and Medications

Volume 15, Issue 4, July 2014
Rachel Waldron, MD et al.

Maintaining patient safety during transition from prehospital to emergency department (ED) care depends on effective handoff communication between providers. We sought to determine emergency physicians’ (EP) knowledge of the care provided by paramedics in terms of both procedures and medications, and whether the use of a verbal report improved physician accuracy.

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Prehospital Care

Expansion of U.S. Emergency Medical Service Routing for Stroke Care: 2000–2010

Volume 15, Issue 4, July 2014
Natalie Hanks, MS et al.

Organized stroke systems of care include preferential emergency medical services (EMS) routing to deliver suspected stroke patients to designated hospitals. To characterize the growth and implementation of EMS routing of stroke nationwide, we describe the proportion of stroke hospitalizations in the United States (U.S.) occurring within regions having adopted these protocols.

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Practice Variability

Clinical Management of Skin and Soft Tissue Infections in the U.S. Emergency Departments

Volume 15, Issue 4, July 2014
Rakesh D. Mistry, MD, MS et al.

Community-associated methicillin resistant Staphylococcus aureus (CA-MRSA) has emerged as the most common cause of skin and soft-tissue infections (SSTI) in the United States. A nearly three-fold increase in SSTI visit rates had been documented in the nation’s emergency departments (ED). The objective of this study was to determine characteristics associated with ED performance of incision and drainage (I+D) and use of adjuvant antibiotics in the management of skin and soft tissue infections (SSTI).

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Analysis of Medication Errors in Simulated Pediatric Resuscitation by Residents

Volume 15, Issue 4, July 2014
Evelyn Porter, MD et al.

The objective of our study was to estimate the incidence of prescribing medication errors specifically made by a trainee and identify factors associated with these errors during the simulated resuscitation of a critically ill child.

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Injury Prevention

Successful Conviction of Intoxicated Drivers at a Level I Trauma Center

Volume 15, Issue 4, July 2014
James F. Holmes, MD, MPH et al.

Conviction rates for drivers driving under the influence (DUI) and in motor vehicle collisions (MVC) presenting to trauma centers are based primarily on data from the 1990s.

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Injury Outcomes

Comparison of Three Prehospital Cervical Spine Protocols for Missed Injuries

Volume 15, Issue 4, July 2014
Rick Hong, MD et al.

We wanted to compare 3 existing emergency medical services (EMS) immobilization protocols: the Prehospital Trauma Life Support (PHTLS, mechanism-based); the Domeier protocol (parallels the National Emergency X-Radiography Utilization Study [NEXUS] criteria); and the Hankins’ criteria (immobilization for patients <12 or >65 years, those with altered consciousness, focal neurologic deficit, distracting injury, or midline or paraspinal tenderness).To determine the proportion of patients who would require cervical immobilization per protocol and the number of missed cervical spine injuries, had each protocol been followed with 100% compliance.

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Injury Outcomes

Yield and Clinical Predictors of Thoracic Spine Injury from Chest Computed Tomography for Blunt Trauma

Volume 15, Issue 4, July 2014
Mark I. Langdorf, MD, MHPE et al.

Cost and radiation risk have prompted intense examination of trauma patient imaging. A proposed decision instrument (DI) for the use of chest computed tomography (CT), (CCT) in blunt trauma patients includes thoracic spine (TS) tenderness, altered mental status (AMS) and distracting painful injury (DPI) as potential predictor variables. TS CT is a separate, costly study whose value is currently ill-defined. The objective of this study is to determine test characteristics of these predictor variables alone, and in combination, to derive a TS injury DI.

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Emergency Department Operations

Adherence to Head Computed Tomography Guidelines for Mild Traumatic Brain Injury

Volume 15, Issue 4, July 2014
Landon A. Jones, MD et al.

Traumatic brain injury (TBI) is a significant health concern. While 70–90% of TBI cases are considered mild, decision-making regarding imaging can be difficult. This survey aimed to assess whether clinicians’ decision-making was consistent with the most recent American College of Emergency Physicians (ACEP) clinical recommendations regarding indications for a non-contrast head computed tomography (CT) in patients with mild TBI.

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Emergency Department Operations

Application of a Proactive Risk Analysis to Emergency Department Sickle Cell Care

Volume 15, Issue 4, July 2014
Victoria L. Thornton, MD, MBA et al.

Patients with sickle cell disease (SCD) often seek care in emergency departments (EDs) for severe pain. However, there is evidence that they experience inaccurate assessment, suboptimal care, and inadequate follow-up referrals. The aim of this project was to 1) explore the feasibility of applying a failure modes, effects and criticality analysis (FMECA) in two EDs examining four processes of care (triage, analgesic management, high risk/high users, and referrals made) for patients with SCD, and 2) report the failures of these care processes in each ED.

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Emergency Department Operations

Characteristics of United States Emergency Departments that Routinely Perform Alcohol Risk Screening and Counseling for Patients Presenting with Drinking–related Complaints

Volume 15, Issue 4, July 2014
Michael A. Yokell, ScB et al.

Emergency department (ED) screening and counseling for alcohol misuse have been shown to reduce at-risk drinking. However, barriers to more widespread adoption of this service remain unclear.

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Deliberate Apprenticeship in the Pediatric Emergency Department Improves Experience for Third-year Students

Volume 15, Issue 4, July 2014
Maya Subbarao Iyer, MD et al.

The Pediatric Emergency Department (PED) provides medical students with learning in a high-volume, fast-paced environment; characteristics that can be stressful for new students. Shadowing can improve transitioning, yet this alone does not facilitate students’ development of independent medical care competencies. This study evaluates if third-year medical students’ deliberate apprenticeship with senior residents increases students’ comfort and patient exposure in the PED.

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Analysis of the Evaluative Components on the Standard Letter of Recommendation (SLOR) in Emergency Medicine

Volume 15, Issue 4, July 2014
Kristi H. Grall, MD, MHPE et al.

The standard letter of recommendation in emergency medicine (SLOR) was developed to standardize the evaluation of applicants, improve inter-rater reliability, and discourage grade inflation. The primary objective of this study was to describe the distribution of categorical variables on the SLOR in order to characterize scoring tendencies of writers.

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Assessing Knowledge Base on Geriatric Competencies for Emergency Medicine Residents

Volume 15, Issue 4, July 2014
Teresita M. Hogan, MD et al.

Emergency care of older adults requires specialized knowledge of their unique physiology, atypical presentations, and care transitions. Older adults often require distinctive assessment, treatment and disposition. Emergency medicine (EM) residents should develop expertise and efficiency in geriatric care. Older adults represent over 25% of most emergency department (ED) volumes.

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