Recent ucd_ome_posters_em items

Lesion Localization: A Guided Lab

Wed, 25 Jun 2025 00:00:00 +0000

Lesion Localization: A Guided Lab

The Impact of Sustained Poor Air Quality Events on Ambulance Calls A Time-Stratified Case-Crossover Study

Mon, 25 Nov 2024 00:00:00 +0000

As wildfires and air pollution become more common across the United States, it is increasingly important to understand the burden they place on public health. Previous studies have noted relationships between air quality and use of emergency medical services (EMS), but until now these papers have focused on dayto-day air quality. Our goal is to investigate the effect of sustained periods of poor air quality on EMS call type and volume.

The Impact of COVID-19 on Violence Related Encounters in the Emergency Department

Mon, 18 Nov 2024 00:00:00 +0000

The COVID-19 pandemic has caused Americans to adjust to a new normal of quarantines, remote learning, and working from home. With nearly 45 million cases and 719,000 deaths since January 2020, the direct effects of the virus are more commonly known. Previous research has showed a positive correlation between societal and economic stressors and intimate partner violence. Related research has also found that rates of domestic violence increased significantly after environmental disasters. Recent articles have shown a significant increase in National Domestic Violence Hotline calls, as well as increases in selfreported intimate partner violence on surveys during the COVID-19 pandemic. Many have hypothesized that the societal and economic pressures of the COVID-19 pandemic would result in secondary effects that are less researched such as crime, interpersonal violence, and domestic violence. This study aims to investigate the incidence of violent injury encounters at the Community...

Delirium from the Emergency Department: How Does Waiting, Boarding and Multiple Bed Movements of Older Patients in the ED Contribute to the Development Of Delirium?

Thu, 7 Nov 2024 00:00:00 +0000

Delirium is an acute, fluctuating condition with an alteration in level of consciousness associated with inattention and disorganized thinking, significantly impacting mortality, morbidity and hospital length of stay. Delirium is the most common complication afflicting hospitalized patients ages 65 years and older, affecting more than 2.6 million older adults each year in the United States. 1 This study will evaluate the effects of the total time spent in the emergency department (ED), the number of times a patient is moved from one bed space to another during their ED stay, the number of hours a patient spends boarding after admission orders have been placed, on the development of delirium as an inpatient.

Self-obtained vaginal swabs are not inferior to provider-performed endocervical sampling for Emergency Department diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis

Thu, 7 Nov 2024 00:00:00 +0000

-Neisseria gonorrhaeae (NG) and Chlamydia trachomatis (CT) are the two most common sexually transmitted infections (STIs) in the United States and increasing steadily with over 500,000 and 1.7 million cases in 2018, respectively.

-Standard of care for NG/CT diagnosis is testing with a nucleic acid amplification test (NAAT) and sample collection via provider-performed endocervical sampling (PPES).

-PPES can add significant delay in a busy emergency department (ED) setting in which exam room and/or provider availability is limited.

-Prior research in non-emergency department settings on self-obtained vaginal swabs (SOVS), where the patient collects their own vaginal sample using the NAAT swab, has shown favorable results. However, another study has shown a patient preference for PPES over VSS.

-If VSS was found to have noninferior sensitivity compared to PPES in the ED, with good patient acceptability, this would allow for earlier collection...

Pediatric Emergency Medicine Physicians’ Confidence in Assessment And Management Of Opioid Use Among Adolescents

Mon, 4 Nov 2024 00:00:00 +0000

Adolescents with complications from opioid use disorder (OUD) regularly present to the emergency department (ED) for medical stabilization. Little data exists on pediatric emergency medicine (PEM) physicians’ confidence in caring for these patients. Investigate PEM physician confidence in assessing and managing opioid and/or substance use-related complaints among adolescents presenting to the ED. Assess barriers to prescribing buprenorphine to patients in the pediatric ED.

SMART Clearance: A Tool for Medical Clearance in the ED

Mon, 4 Nov 2024 00:00:00 +0000

Patients in Emergency Departments on involuntary psychiatric holds often undergo extensive routine laboratory tests as partof medical clearance for psychiatric hospitalization. However testing of all patients is frequently low yield.

ED visits for mental health complaints have steadily increased for over two decades, accounting for up to a quarter of alladult ED visits. Patients with mental health complaints have been shown to have longer ED length of stays, and higher rates of repeat visits and admissions.

There is some discrepancy between medical clearance guidelines from different organizations including Psychiatry and Emergency Medicine. In an effort to standardize medical clearance and reduce unnecessary testing, a screening tool was established with the local medical society,Sacramento Sierra Valley Medical Center (SSVMS). The objective here is to characterize a screening tool utilized byour hospital that allows for medical clearances of mental health patients...

Pepper Spray and Tear Gas exposures reported to the California Poison Control System

Mon, 4 Nov 2024 00:00:00 +0000

Pepper spray and mace are common items used for personal protection and are common “less lethal” options for law enforcement use for crowd control. These agents are irritants with symptoms of exposure ranging from mild pain to potentially permanent ocular injury.

• The recent protests have increased attention on the use of these agents and their potential toxicity.

Presentation and Cardiac Outcomes in Women and Men Reporting to the ED with Chest Pain: Symptoms, ACS, 30 Day Cardiac Events

Wed, 30 Oct 2024 00:00:00 +0000

o Chest pain is the most frequent symptom that triggers consideration for acute coronary syndrome (ACS).

o It is controversial whether women and men with ACS have the same or different presenting symptoms.

o It is also unclear whether reports of differences in ACS presentation in women and men may be related to, sex, age, or type of ACS.

Screening of Chlamydia trachomatis in Pregnant Patients in the Emergency Department: A Pilot Study

Mon, 28 Oct 2024 00:00:00 +0000

The overall rate of Chlamydia trachomatis in pregnant women in the United States was found to be 1843 per 100,000 births from 2016 to 2018 and had a 2% increase from 2016 to 2018. Untreated Chlamydia infection of the cervix in pregnant women can be transmitted vertically and lead to preventable adverse birth outcomes including preterm delivery, low birth weight, neonatal conjunctivitis, and neonatal pneumonia. Current recommendations from the CDC include screening of all pregnant women. To determine if emergency department providers are screening patients with positive pregnancy tests for chlamydia according to CDC guidelines. To examine patient characteristics that may help lead to developing criteria for screening for chlamydia in pregnant patients in the ED setting

Impact of UCD UNITED on Medical Student Engagement with Health Systems Sciences

Tue, 22 Oct 2024 00:00:00 +0000

For over a century, undergraduate medical education (UME) has adhered to the “two-pillar” model focused mainly on the basic and clinical sciences. As a result, newly graduated medical students often state a lack of understanding of the structure and function of the U.S. health care delivery system. To bridge this gap, in 2016 the American Medical Association’s Accelerating Change in Medical Education Consortium introduced a new “third-pillar” of UME called Health Systems Science (HSS). HSS focuses on the broader context of health care delivery including organizational structures and processes, policy, economics and management, clinical informatics and health information technology, population health, value-based care, and health system improvement.

Utility of Asymptomatic COVID-19 Screening in the Emergency Department

Thu, 17 Oct 2024 00:00:00 +0000

Coronavirus of 2019 (COVID-19) is an infectious virus currently causing a pandemic. Evidence supports high rates of asymptomatic infections with COVID-19, leading to concerns that viral transmission may occur via these asymptomatic patients. Initially, the screening of asymptomatic patients was of low utility as only 2 of 1,342 ED patients tested positive. These findings were during a period of low COVID-19 prevalence in the community. Subsequently, COVID-19 infection rates increased in the community. During this increase in COVID-19, the rate of asymptomatic cases also increased.

Sex Differences in Evaluation for Acute Pulmonary Embolism Among Emergency Department Patients Aged 18-49

Wed, 16 Oct 2024 00:00:00 +0000

Acute pulmonary embolism (PE) occurs with approximately equal incidence in non-pregnant adult women and men. Although sex is not a risk factor in any validated clinical decision tool for predicting risk of PE, limited data suggest that women may be tested more frequently. We hypothesized that women are tested for PE in the ED at different rates than men.

Simple Cystitis: Does Urine Culture Change Management?

Wed, 16 Oct 2024 00:00:00 +0000

Simple cystitis, defined as a bladder infection in immunocompetent women of childbearing age without comorbidities/urological abnormalities, is the most common bacterial infection in women. Urine cultures are often sent in for these patients to ensure that the infective pathogen is sensitive to the antibiotic prescribed and to inform possible treatment modifications.

High-Sensitivity Cardiac Troponin and ED Length of Stay: A Before and After Study

Wed, 16 Oct 2024 00:00:00 +0000

In the United States, chest pain is the second most common chief complaint among patients presenting to the emergency department (ED), representing over 7.3 million annual visits.

High-sensitivity (hs) cardiac troponin (cTn )has the potential to improve the care of patients with chest pain. Hs-cTn assays have superior diagnostic accuracy in patients with chest pain compared to conventional cardiac troponin (c-cTn) assays.

Large multi-center European studies have shown that use of hs-cTn is associated with decreased ED length-of-stay (LOS), decreased hospital admissions and decreased cardiac stress testing, providing promising evidence to refute these concerns.

Little data are available regarding the effects of hs-cTn assays on ED operational metrics and patient diagnoses in an American population.

Traumatic Findings on C-spine MRI Following Negative CT Scans in Older Patients following a Fall

Fri, 11 Oct 2024 00:00:00 +0000

Computed tomography (CT) has long been the standard for evaluating head trauma after a fall. The efficiency and lower cost of performing a CT scan has made it the more practical choice for most emergent situations. However, the soft tissue detail in MRI may show injuries in the brain or spinal cord that would be missed on a CT scan1. Early detection of brain or spinal injuries after trauma is critical and has large impacts on patient outcomes2. Additionally, an unstable injury that is missed on CT but found on MRI may have legal implications.

Predictors of Clinically Important Traumatic Brain Injuries Following Minor Blunt Head Trauma in Children: A Failure of the Machine Learning Approach

Fri, 11 Oct 2024 00:00:00 +0000

• The Pediatric Emergency Care Applied Research Network (PECARN) conducted a study of ~42,000 children with minor blunt head trauma and developed and validated a clinical prediction rule to identify those at low risk of clinically-important traumatic brain injuries (ciTBIs) .1

• Prior studies have relied on traditional multivariable statistical methods,1-2 but more recent research regarding prediction rules has used machine learning (ML). 3-6

• In a previous study, investigators created a ML algorithm analyzing the PECARN dataset using a single decision tree that fits all nodes simultaneously, a complicated model at risk of over fitting. 6

• In this study, we created multiple algorithms (see Table 2) using ML for classification of children at risk for ciTBIs via the PECARN head trauma public use dataset. The model predictions were statistically compared to no information rates, the error rate when the input and output are independent.

Screening of Chlamydia trachomatis in Pregnant Patients in the Emergency Department: A Pilot Study

Tue, 10 Sep 2024 00:00:00 +0000

The overall rate of Chlamydia trachomatis in pregnant women in the United States was found to be 1843 per 100,000 births from 2016 to 2018 and had a 2% increase from 2016 to 2018. Untreated Chlamydia infection of the cervix in pregnant women can be transmitted vertically and lead to preventable adverse birth outcomes including preterm delivery, low birth weight, neonatal conjunctivitis, and neonatal pneumonia. Current recommendations from the CDC include screening of all pregnant women <25 years of age and older pregnant women at increased risk for infection at the first prenatal visit, in addition to rescreening in the third trimester if <25 years of age or if the patient is at continued high risk. The emergency department (ED) is a point of contact for prenatal care, especially for many patients whohave not yet seen a provider or may be unable to; however, no formal guidelines from the American College of Emergency Physicians (ACEP) exist as to when to screen for...

Accuracy and Reliability of Noxious Stimuli Delivery in Altered Patients

Thu, 29 Aug 2024 00:00:00 +0000

There is significant variability in methods used to perform neurological examination in poorlyresponsive patients. Inconsistent and poor inter-examiner reliability may lead to poor,consequential clinical decision-making and care. Noxious stimuli are routinely administered to elicit motoric responses to determine the depth of unresponsiveness in comatose patients. However, no study has tested the reliability of noxious stimuli delivery (NSD) method or quantified applied force that elicit motor responses in patients with coma.

Physician Gender and Emergency Department Press Ganey Survey Comments

Tue, 27 Aug 2024 00:00:00 +0000

Patient experience in healthcare is of growing importance and is the heart of a patient-centered care. Positive patient experience correlates with betterhealth outcomes.

Press Ganey (PG) surveys are a common measure of patient satisfaction often used in physician performance and promotions. Patients may have unconscious biases when filling out surveys. Few studies exist on the free-text comments about physicians in Press Ganey Surveys.

The Influence of Emergency Physician Gender on Quantitative and Qualitative Patient Experience Surveys

Fri, 23 Aug 2024 00:00:00 +0000

Patient experience surveys (PES) may be used to evaluate emergency department (ED) physician performance PES quantitative scores may be subject to gender biasFew studies have evaluated PES free-text comments.