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Western Journal of Emergency Medicine

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https://www.readbyqxmd.com/read/28611901/a-comparison-of-urolithiasis-in-the-presence-and-absence-of-microscopic-hematuria-in-the-emergency-department
#1
Jason M Mefford, Robert M Tungate, Leila Amini, Dongjin Suh, Craig L Anderson, Scott E Rudkin, Megan Boysen-Osborn
INTRODUCTION: Urolithiasis is a common medical condition that accounts for a large number of emergency department (ED) visits each year and contributes significantly to annual healthcare costs. Urinalysis is an important screening test for patients presenting with symptoms suspicious for urolithiasis. At present there is a paucity of medical literature examining the characteristics of ureteral stones in patients who have microscopic hematuria on urinalysis versus those who do not. The purpose of this study was to examine mean ureteral stone size and its relationship to the incidence of clinically significant hydronephrosis in patients with and without microscopic hematuria...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611900/replacement-of-dislodged-gastrostomy-tubes-after-stoma-dilation-in-the-pediatric-emergency-department
#2
Shiloni Bhambani, Tammy H Phan, Lance Brown, Andrea W Thorp
INTRODUCTION: A dislodged gastrostomy tube (GT) is a common complaint that requires evaluation in the pediatric emergency department (ED) and, on occasion, will require stoma dilation to successfully replace the GT. The objective of this study was to describe the frequency that stoma dilation is required, the success rate of replacement, complications encountered, and the techniques used to confirm placement of the GT after dilation. METHODS: We conducted a retrospective medical record review of children 0-18 years who presented to the pediatric ED from February 2013 through February 2015 with a dislodged GT that required stoma dilation by pediatric emergency physicians with serially increasing Foley catheter sizes prior to successful placement of the GT...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611899/perspectives-on-home-based-healthcare-as-an-alternative-to-hospital-admission-after-emergency-treatment
#3
Amy Stuck, Christopher Crowley, Tracy Martinez, Alan Wittgrove, Jesse J Brennan, Theodore C Chan, Edward M Castillo
INTRODUCTION: The study objective was to explore emergency physicians' (EP) awareness, willingness, and prior experience regarding transitioning patients to home-based healthcare following emergency department (ED) evaluation and treatment; and to explore patient selection criteria, processes, and services that would facilitate use of home-based healthcare as an alternative to hospitalization. METHODS: We provided a five-question survey to 52 EPs, gauging previous experience referring patients to home-based healthcare, patient selection, and motivators and challenges when considering home-based options as an alternative to admission...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611898/utility-of-the-history-and-physical-examination-in-the-detection-of-acute-coronary-syndromes-in-emergency-department-patients
#4
REVIEW
Zachary Dw Dezman, Amal Mattu, Richard Body
Chest pain accounts for approximately 6% of all emergency department (ED) visits and is the most common reason for emergency hospital admission. One of the most serious diagnoses emergency physicians must consider is acute coronary syndrome (ACS). This is both common and serious, as ischemic heart disease remains the single biggest cause of death in the western world. The history and physical examination are cornerstones of our diagnostic approach in this patient group. Their importance is emphasized in guidelines, but there is little evidence to support their supposed association...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611897/feasibility-of-an-ed-to-home-intervention-to-engage-patients-a-mixed-methods-investigation
#5
Jessica R Schumacher, Barbara J Lutz, Allyson G Hall, Jesse M Pines, Andrea L Jones, Phyllis Hendry, Colleen Kalynych, Donna L Carden
INTRODUCTION: Older, chronically ill patients with limited health literacy are often under-engaged in managing their health and turn to the emergency department (ED) for healthcare needs. We tested the impact of an ED-initiated coaching intervention on patient engagement and follow-up doctor visits in this high-risk population. We also explored patients' care-seeking decisions. METHODS: We conducted a mixed-methods study including a randomized controlled trial and in-depth interviews in two EDs in northern Florida...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611896/pain-perception-in-latino-vs-caucasian-and-male-vs-female-patients-is-there-really-a-difference
#6
Molly Aufiero, Holly Stankewicz, Shaila Quazi, Jeanne Jacoby, Jill Stoltzfus
INTRODUCTION: Pain is a common emergency department (ED) complaint. It is important to understand the differences in pain perception among different ethnic and demographic populations. METHODS: We applied a standardized painful stimulus to Caucasian and Latino adult patients to determine whether the level of pain reported differed depending on ethnicity (N=100; 50 Caucasian [C], 50 Latino [L] patients) and gender (N=100; 59 female, 41 male). Patients had an initial pain score of 0 or 1...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611895/academic-primer-series-key-papers-about-teaching-with-technology
#7
Megan Boysen-Osborn, Robert Cooney, Michael Gottlieb, Teresa M Chan, Aaron Brown, Andrew King, Adam Tobias, Brent Thoma
INTRODUCTION: Modern learners have immediate, unlimited access to a wide variety of online resources. To appeal to this current generation of learners, educators must embrace the use of technology. However, educators must balance newer, novel technologies with traditional methods to achieve the best learning outcomes. Therefore, we aimed to review several papers useful for faculty members wishing to incorporate technology into instructional design. METHODS: We identified a broad list of papers relevant to teaching and learning with technology within the online discussions of the Academic Life in Emergency Medicine (ALiEM) Faculty Incubator...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611894/academic-primer-series-key-papers-about-peer-review
#8
Lalena M Yarris, Michael Gottlieb, Kevin Scott, Christopher Sampson, Emily Rose, Teresa M Chan, Jonathan Ilgen
INTRODUCTION: Peer review, a cornerstone of academia, promotes rigor and relevance in scientific publishing. As educators are encouraged to adopt a more scholarly approach to medical education, peer review is becoming increasingly important. Junior educators both receive the reviews of their peers, and are also asked to participate as reviewers themselves. As such, it is imperative for junior clinician educators to be well-versed in the art of peer reviewing their colleagues' work. In this article, our goal was to identify and summarize key papers that may be helpful for faculty members interested in learning more about the peer-review process and how to improve their reviewing skills...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611893/academic-primer-series-key-papers-about-competency-based-medical-education
#9
Robert Cooney, Teresa M Chan, Michael Gottlieb, Michael Abraham, Sylvia Alden, Jillian Mongelluzzo, Michael Pasirstein, Jonathan Sherbino
INTRODUCTION: Competency-based medical education (CBME) presents a paradigm shift in medical training. This outcome-based education movement has triggered substantive changes across the globe. Since this transition is only beginning, many faculty members may not have experience with CBME nor a solid foundation in the grounding literature. We identify and summarize key papers to help faculty members learn more about CBME. METHODS: Based on the online discussions of the 2016-2017 ALiEM Faculty Incubator program, a series of papers on the topic of CBME was developed...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611892/academic-primer-series-five-key-papers-about-study-designs-in-medical-education
#10
Michael Gottlieb, Teresa M Chan, Jenna Fredette, Anne Messman, Daniel W Robinson, Robert Cooney, Megan Boysen-Osborn, Jonathan Sherbino
INTRODUCTION: A proper understanding of study design is essential to creating successful studies. This is also important when reading or peer reviewing publications. In this article, we aimed to identify and summarize key papers that would be helpful for faculty members interested in learning more about study design in medical education research. METHODS: The online discussions of the 2016-2017 Academic Life in Emergency Medicine Faculty Incubator program included a robust and vigorous discussion about education study design, which highlighted a number of papers on that topic...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611891/a-user-s-guide-to-the-aliem-emergency-medicine-match-advice-web-series
#11
Michael A Gisondi, Abra Fant, Nahzinine Shakeri, Benjamin H Schnapp, Michelle Lin
ALiEM EM Match Advice is a web series hosted on the Academic Life in Emergency Medicine website. The intended audience includes senior medical students seeking a residency in emergency medicine (EM) and the faculty members who advise them. Each episode features a panel of three EM program directors who discuss a critical step in the residency application process. This article serves as a user's guide to the series, including a timeline for viewing each episode, brief summaries of the panel discussions, and reflection questions for discussion between students and their faculty advisors...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611890/index-to-predict-in-hospital-mortality-in-older-adults-after-non-traumatic-emergency-department-intubations
#12
Kei Ouchi, Samuel Hohmann, Tadahiro Goto, Peter Ueda, Emily L Aaronson, Daniel J Pallin, Marcia A Testa, James A Tulsky, Jeremiah D Schuur, Mara A Schonberg
INTRODUCTION: Our goal was to develop and validate an index to predict in-hospital mortality in older adults after non-traumatic emergency department (ED) intubations. METHODS: We used Vizient administrative data from hospitalizations of 22,374 adults ≥75 years who underwent non-traumatic ED intubation from 2008-2015 at nearly 300 U.S. hospitals to develop and validate an index to predict in-hospital mortality. We randomly selected one half of participants for the development cohort and one half for the validation cohort...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611889/evaluating-the-laboratory-risk-indicator-to-differentiate-cellulitis-from-necrotizing-fasciitis-in-the-emergency-department
#13
Michael M Neeki, Fanglong Dong, Christine Au, Jake Toy, Nima Khoshab, Carol Lee, Eugene Kwong, Ho Wang Yuen, Jonathan Lee, Arbi Ayvazian, Pamela Lux, Rodney Borger
INTRODUCTION: Necrotizing fasciitis (NF) is an uncommon but rapidly progressive infection that results in gross morbidity and mortality if not treated in its early stages. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score is used to distinguish NF from other soft tissue infections such as cellulitis or abscess. This study analyzed the ability of the LRINEC score to accurately rule out NF in patients who were confirmed to have cellulitis, as well as the capability to differentiate cellulitis from NF...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611888/efficacy-and-safety-of-tranexamic-acid-in-prehospital-traumatic-hemorrhagic-shock-outcomes-of-the-cal-pat-study
#14
Michael M Neeki, Fanglong Dong, Jake Toy, Reza Vaezazizi, Joe Powell, Nina Jabourian, Alex Jabourian, David Wong, Richard Vara, Kathryn Seiler, Troy W Pennington, Joe Powell, Chris Yoshida-McMath, Shanna Kissel, Katharine Schulz-Costello, Jamish Mistry, Matthew S Surrusco, Karen R O'Bosky, Daved Van Stralen, Daniel Ludi, Karl Sporer, Peter Benson, Eugene Kwong, Richard Pitts, John T Culhane, Rodney Borger
INTRODUCTION: The California Prehospital Antifibrinolytic Therapy (Cal-PAT) study seeks to assess the safety and impact on patient mortality of tranexamic acid (TXA) administration in cases of trauma-induced hemorrhagic shock. The current study further aimed to assess the feasibility of prehospital TXA administration by paramedics within the framework of North American emergency medicine standards and protocols. METHODS: This is an ongoing multi-centered, prospective, observational cohort study with a retrospective chart-review comparison...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611887/derivation-and-validation-of-the-prehospital-difficult-airway-identificationtool-predait-a-predictive-model-for-difficult-intubation
#15
Jestin N Carlson, David Hostler, Francis X Guyette, Mark Pinchalk, Christian Martin-Gill
INTRODUCTION: Endotracheal intubation (ETI) in the prehospital setting poses unique challenges where multiple ETI attempts are associated with adverse patient outcomes. Early identification of difficult ETI cases will allow providers to tailor airway-management efforts to minimize complications associated with ETI. We sought to derive and validate a prehospital difficult airway identification tool based on predictors of difficult ETI in other settings. METHODS: We prospectively collected patient and airway data on all airway attempts from 16 Advanced Life Support (ALS) ground emergency medical services (EMS) agencies from January 2011 to October 2014...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611886/managing-acute-behavioural-disturbances-in-the-emergency-department-using-the-environment-policies-and-practices-a-systematic-review
#16
Tracey J Weiland, Sean Ivory, Jennie Hutton
INTRODUCTION: Effective strategies for managing acute behavioural disturbances (ABDs) within emergency departments (EDs) are needed given their rising occurrence and negative impact on safety, psychological wellbeing, and staff turnover. Non-pharmacological interventions for ABD management generally fall into four categories: environmental modifications; policies; practice changes; and education. Our objective was to systematically review the efficacy of strategies for ABD management within EDs that involved changes to environment, architecture, policy and practice...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611885/american-association-for-emergency-psychiatry-task-force-on-medical-clearance-of-adult-psychiatric-patients-part-ii-controversies-over-medical-assessment-and-consensus-recommendations
#17
REVIEW
Michael P Wilson, Kimberly Nordstrom, Eric L Anderson, Anthony T Ng, Leslie S Zun, Jennifer M Peltzer-Jones, Michael H Allen
INTRODUCTION: The emergency medical evaluation of psychiatric patients presenting to United States emergency departments (ED), usually termed "medical clearance," often varies between EDs. A task force of the American Association for Emergency Psychiatry (AAEP), consisting of physicians from emergency medicine, physicians from psychiatry and a psychologist, was convened to form consensus recommendations for the medical evaluation of psychiatric patients presenting to U.S.EDs. METHODS: The task force reviewed existing literature on the topic of medical evaluation of psychiatric patients in the ED and then combined this with expert consensus...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611884/emergency-medical-services-professionals-attitudes-about-community-paramedic-programs
#18
Robert J Steeps, Denise A Wilfong, Michael W Hubble, Daniel L Bercher
INTRODUCTION: The number of community paramedic (CP) programs has expanded to mitigate the impact of increased patient usage on emergency services. However, it has not been determined to what extent emergency medical services (EMS) professionals would be willing to participate in this model of care. With this project, we sought to evaluate the perceptions of EMS professionals toward the concept of a CP program. METHODS: We used a cross-sectional study method to evaluate the perceptions of participating EMS professionals with regard to their understanding of and willingness to participate in a CP program...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611883/altitude-related-change-in-endotracheal-tube-cuff-pressures-in-helicopter-ems
#19
Stacy N Weisberg, Jonathan C McCall, Joseph Tennyson
INTRODUCTION: Over-inflation of endotracheal tube (ETT) cuffs has the potential to lead to scarring and stenosis of the trachea.1, 2,3, 4 The air inside an ETT cuff is subject to expansion as atmospheric pressure decreases, as happens with an increase in altitude. Emergency medical services helicopters are not pressurized, thereby providing a good environment for studying the effects of altitude changes ETT cuff pressures. This study aims to explore the relationship between altitude and ETT cuff pressures in a helicopter air-medical transport program...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611882/difference-in-r01-grant-funding-among-osteopathic-and-allopathic-emergency-physicians-over-the-last-decade
#20
Martina Antony, Jennifer Savino, John Ashurst
INTRODUCTION: Receiving an R01 grant from the National Institutes of Health (NIH) is regarded as a major accomplishment for the physician researcher and can be used as a means of scholarly activity for core faculty in emergency medicine (EM). However, the Accreditation Council for Graduate Medical Education requires that a grant must be obtained for it to count towards a core faculty member's scholarly activity, while the American Osteopathic Association states that an application for a grant would qualify for scholarly activity whether it is received or not...
June 2017: Western Journal of Emergency Medicine
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