The Physiologic Effects of Multiple Simultaneous Electronic Control Device Discharges

Law enforcement and military personnel use electronic control devices to control non-compliant and actively resistive subjects. The TASER® Shockwave is a new electronic control device designed specifically as an area denial device capable of delivering multiple simultaneous discharges. This is the first study to examine the effects of multiple simultaneous device discharges in humans.

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Critical Care

Early Glycemic Control in Critically Ill Emergency Department Patients: Pilot Trial

Glycemic control in the critically ill intensive care unit (ICU) patient has been shown to improve morbidity and mortality. We sought to investigate the effect of early glycemic control in critically ill emergency department (ED) patients in a small pilot trial.

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Critical Care

Eschmann Introducer Through Laryngeal Mask Airway: A Cadaveric Trial of An Alternate Means of Rescue Intubation

Laryngeal mask airways (LMAs) are often used as airway rescue devices where laryngoscopy is difficult. The LMA does not protect the airway and is preferably replaced with a cuffed endotracheal tube. There are reports of cases where an Eschmann tracheal tube introducer (ETTI) was successfully used to bridge between a standard LMA and an endotracheal tube. This project was designed to determine whether an Eschmann stylet can reliably be passed through an LMA into the trachea as a means of rescue intubation.

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Comparability of Results between Point-of-Care and Automated Instruments to Measure B-type Natriuretic Peptide

Heart failure is one of the leading causes of death in the U.S. The incorporation of B-type natriuretic peptide (BNP) measurements when triaging patients presenting with shortness of breath has improved the diagnostic and prognostic ability of physicians. Currently, there are no point-of-care systems for quantifying BNP that can be used without sacrificing accuracy. We compared the analytical performance of the Abbott i-STAT analyzer, a handheld point-of-care system for measuring BNP, with the lab-based system, the Abbott ARCHITECT.

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Dedicated Shift Wrap-up Time Does Not Improve Resident Sign-out Volume or Efficiency

Sign-out (SO) is a challenge to the emergency physician. Some training programs have instituted overlapping 9-hour shifts. The residents see patients for eight hours, and have one hour of wrap-up time. This hour helps them complete patient care, leaving fewer patients to sign-out. We examined whether this strategy impacts SO burden.

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Effect of a Medical Student Emergency Ultrasound Clerkship on Number of Emergency Department Ultrasounds

To determine whether a medical student emergency ultrasound clerkship has an effect on the number of patients undergoing ultrasonography and the number of total scans in the emergency department.

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Critical Care

The Utility of Bedside Ultrasound in the Detection of a Ruptured Globe in a Porcine Model

Recent case reports have shown that ultrasonography can be used to diagnose ocular pathology in an emergency setting. Ultrasound may be especially useful when periorbital edema and pain interfere with the examination of the post-traumatic eye.

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Critical Care

Terrain Park Injuries

This study examined demographics, injury pattern, and hospital outcome in patients injured in winter resort terrain parks.

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Factors Associated With False-Positive Emergency Medical Services Triage for Percutaneous Coronary Intervention

In 2005, Orange County California Emergency Medical Services (EMS) initiated a field 12-lead program to minimize time to emergency percutaneous coronary intervention (PCI) for field-identified acute myocardial infarction (MI). As the program matured, “false-positive” (defined as no PCI or coronary artery occlusion upon PCI) field MI activations have been identified as a problem for the program.

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Critical Care

Wound Botulism in Injection Drug Users: Time to Antitoxin Correlates with Intensive Care Unit Length of Stay

We sought to identify factors associated with need for mechanical ventilation (MV), length of intensive care unit (ICU) stay, length of hospital stay, and poor outcome in injection drug users (IDUs) with wound botulism (WB).

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Introducing a Clinical Practice Guideline Using Early CT in the Diagnosis of Scaphoid and Other Fractures

We developed and implemented clinical practice guideline (CPG) using computerized tomography (CT) as the initial imaging method in the emergency department management of scaphoid fractures. We hypothesized that this CPG would decrease unnecessary immobilization and lead to earlier return to work.

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Emergency Department Patients with Psychiatric Complaints Return at Higher Rates than Controls

  Author Affiliation Troy E. Madsen, MD University of Utah, Division of Emergency Medicine, Salt Lake City, UT Anne Bennett, MD University of Utah, Division of Emergency Medicine, Salt Lake City, UT Steven Groke, BSN University of Utah, Division of Emergency Medicine, Salt Lake City, UT Anne Zink, MD University of Utah, Division of Emergency […]

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Critical Care

Unsuspected Pulmonary Embolism in Observation Unit Patients

Many emergency department (ED) patients with cardiopulmonary symptoms such as chest pain or dyspnea are placed in observation units but do not undergo specific diagnostic testing for pulmonary embolism (PE). The role of observation units in the diagnosis of PE has not been studied. We hypothesized that there was a small but significant rate of unsuspected PE in our observation unit population.

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Reimbursement for Emergency Department Electrocardiography and Radiograph Interpretations: What Is It Worth for the Emergency Physician

To determine the impact of this billing practice on actual EP reimbursement we undertook an analysis that allows calculation of physician reimbursement from billing data.

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Factors Applicants Value when Selecting an Emergency Medicine Residency

Little is known about the factors important to applicants when selecting an emergency medicine residency. We sought to identify which residency-specific criteria applicants value in selecting a training program.

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Procedural Skills Training During Emergency Medicine Residency: Are We Teaching the Right Things?

The Residency Review Committee training requirements for emergency medicine residents (EM) are defined by consensus panels, with specific topics abstracted from lists of patient complaints and diagnostic codes. The relevance of specific curricular topics to actual practice has not been studied. We compared residency graduates’ self-assessed preparation during training to importance in practice for a variety of EM procedural skills.

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Critical Care

Surgeons’ and Emergency Physicians’ Perceptions of Trauma Management and Training

The study objective was to determine whether surgeons and emergency medicine physicians (EMPs) have differing opinions on trauma residency training and trauma management in clinical practice.

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Critical Care

Left Ventricular Hypertrophy May Be Transient in the Emergency Department

To assess the reproducibility of serial ECGs done in the emergency department (ED) with regard to the presence or absence of LVH.

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Critical Care

Linear Correlation of Endotracheal Tube Cuff Pressure and Volume

Endotracheal tube cuff (ETTc) inflation by standard methods may result in excessive ETTc pressure. Previous studies have indicated that methods of cuff inflation most frequently used to inflate ETTcs include palpation of the tension in the pilot balloon or injection of a predetermined volume of air to inflate the pilot balloon. If a logarithmic relationship exists between ETTc volume and ETTc pressure, small volumes of additional air will result in dramatic pressure increases after a volume threshold is reached. Our goal was to determine whether the relationship between ETTc volume and ETTc pressure is linear or non-linear.

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Injury Prevention

Crash Injury Prediction and Vehicle Damage Reporting by Paramedics

The accuracy of pre-hospital crash scene details and crash victim assessment has important implications for initial trauma care assessment and management. Similarly, it is known to influence physician perception of crash victim injury severity. The goal of this feasibility study was to examine paramedic accuracy in predicting crash victim injury profile, disability outcome at hospital discharge, and reporting vehicle damage with other crash variables.

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Ed Administration

Male Patient Visits to the Emergency Department Decline During the Play of Major Sporting Events

To study whether emergency department (ED) visits by male patients wane simultaneously with the play of scheduled professional and college sports events.

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Ed Administration

Routine Laboratory Testing to Evaluate for Medical Illness in Psychiatric Patients in the Emergency Department Is Largely Unrevealing

This is a prospective study of psychiatric patients presenting to the emergency department (ED) to determine the value of routine laboratory studies used to attempt to exclude concomitant medical illness.

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Ed Administration

Higher Inpatient Medical Surgical Bed Occupancy Extends Admitted Patients’ Stay

Determine the effect that increased medical surgical (med/surg) bed occupancy has on the time interval from admission order to arrival in the bed for the patients admitted from the emergency department (ED).

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Injury Prevention

Analysis of Urobilinogen and Urine Bilirubin for Intra-Abdominal Injury in Blunt Trauma Patients

To determine the point prevalence of urine bilirubin, urine hemoglobin and urobilinogen in blunt trauma patients, and to evaluate its utility as a screening tool for intra-abdominal injury.

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Injury Prevention

Factors Associated with Complications in Older Adults with Isolated Blunt Chest Trauma

To determine the prevalence of adverse events in elderly trauma patients with isolated blunt thoracic trauma, and to identify variables associated with these adverse events.

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Injury Prevention

Cervical Spine Motion During Extrication: A Pilot Study

Spinal immobilization is one of the most commonly performed pre-hospital procedures. Little research has been done on the movement of the neck during immobilization and extrication.

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