Association of Ultrasound and Electrodiagnostic Studies in Patients Evaluated for Ulnar Neuropathy.

Purpose: Our goal was to determine the association between the severity of electrodiagnostic (EDX) studies with the cross-sectional area (CSA) of the ulnar nerve at the cubital tunnel using diagnostic ultrasound. Based on our clinical experience, we hypothesized there would not be a positive correlation between the severity of EDX and ulnar nerve CSA.

Methods: This was a retrospective analysis of patients 18 years or older evaluated from May 1, 2020, to June 31, 2021, referred for an upper limb EDX and neuromuscular ultrasound to evaluate for an upper limb neuropathy.

Effect of a best practice advisory activated "kit in hand" naloxone distribution program in the emergency department.

Purpose: We implemented a "kit in hand" naloxone distribution program at emergency department (ED) discharge activated by electronic health record Best Practice Advisory (BPA). The purpose of this study was to evaluate naloxone kit distribution before and after implementation.

Methods: Retrospective observational study of adult ED patients with unintentional opioid overdose conducted over a six-month period.

Association between electrodiagnosis and neuromuscular ultrasound in the diagnosis and assessment of severity of carpal tunnel syndrome.

Background: Neuromuscular ultrasound plays an increasing role in diagnosing carpal tunnel syndrome (CTS). There are limited data supporting the correlation between the electrodiagnostic studies and ultrasound measurements in CTS.

Objective: To assess the association between different electrodiagnostic severities and ultrasound measurements of the median nerve in CTS.

Cost evaluation of continuation of therapy with dalbavancin compared to standard-of-care antibiotics alone in hospitalized persons who inject drugs with severe gram-positive infections.

Purpose: Persons who inject drugs (PWID) are at risk for severe gram-positive infections and may require prolonged hospitalization and intravenous (IV) antibiotic therapy. Dalbavancin (DBV) is a long-acting lipoglycopeptide that may reduce costs and provide effective treatment in this population.

Methods: This was a retrospective review of PWID with severe gram-positive infections.

Incidence of Fit Test Failure During N95 Respirator Reuse and Extended Use.

Importance: The COVID-19 pandemic resulted in a widespread acute shortage of N95 respirators, prompting the Centers for Disease Control and Prevention to develop guidelines for extended use and limited reuse of N95s for health care workers (HCWs). While HCWs followed these guidelines to conserve N95s, evidence from clinical settings regarding the safety of reuse and extended use is limited.

Objective: To measure the incidence of fit test failure during N95 reuse and compare the incidence between N95 types.

Diagnosis of Ulnar Neuropathy at the Elbow Using Ultrasound - A Comparison to Electrophysiologic Studies.

Purpose: Given the relatively high false negative rate of electrodiagnostic studies (EDX) in patients with clinically diagnosed ulnar neuropathy at the elbow (UNE), we sought to determine whether an alternative objective test could more effectively detect UNE. Additionally, we proposed to determine the relationship between the cross-sectional area (CSA) of the ulnar nerve on ultrasound (US), EDX, and clinical symptoms.

Methods: This was a retrospective study of patients presenting with symptomatic UNE.

Evaluation of hydroxocobalamin use for the treatment of suspected cyanide toxicity secondary to smoke inhalation.

Hydroxocobalamin is used for cyanide toxicity after smoke inhalation, but diagnosis is challenging. Retrospective studies have associated hydroxocobalamin with acute kidney injury (AKI). This is a retrospective analysis of patients receiving hydroxocobalamin for suspected cyanide toxicity.

Where Does Ultrasound Fit in the Diagnostic Algorithm for Cubital Tunnel Syndrome?

Background: Ultrasound (US) has emerged as a promising supplement to electrodiagnostic studies (EDX) in the diagnosis of cubital tunnel syndrome (CuTS) and has potential to be performed by novice operators. Our objective is to understand the discrepancies in assessment between the two modalities and to assess the utility of US in CuTS diagnosis by a novice operator.

Methods: Patients who presented to a single tertiary academic medical center and clinically diagnosed with CuTS were prospectively enrolled.

Accuracy of the American College of Surgeons Minimum Criteria for Full Trauma Team Activation for Children.

Objective: Pediatric trauma centers use reports from emergency medical service providers to determine if a trauma team should be sent to the emergency department to prepare to care for the patient. Little scientific evidence supports the current American College of Surgeons (ACS) indicators for trauma team activation. The objective of this study was to determine the accuracy of the ACS Minimum Criteria for Full Trauma Team Activation for children as well as the accuracy of the modified criteria used at the local sites for trauma activation.

Does Patient-Reported Outcome Measures Use at New Foot and Ankle Patient Clinic Visits Improve Patient Activation, Experience, and Satisfaction?

Background: Patient-reported outcome measures (PROMs) can help predict clinical outcomes and improve shared clinical decision-making discussions. There remains a paucity of research assessing how the use of PROMs may drive improved patient experience and patient activation.

Methods: New foot and ankle patients completed PROMIS physical function (PF), pain interference (PI), and depression assessments.

Quantifying Surgeon Intuition Using a Judgment Analysis Model: Surgeon Accuracy of Predicting Patient-Reported Outcomes in Patients Undergoing Hip Arthroscopy for Femoroacetabular Impingement Is Moderate at Best.

Purpose: To quantify surgeon intuition, determine whether a surgeon's prediction of outcomes after hip arthroscopy correlates with actual patient-reported outcomes (PRO), and identify differences in clinical judgment between expert and novice examiners.

Methods: This prospective, longitudinal study was conducted at an academic medical center on adults undergoing primary hip arthroscopy for treatment of femoroacetabular impingement. A Surgeon Intuition and Prediction (SIP) score was completed preoperatively by an attending surgeon (expert) and physician assistant (novice).

Scalar Assessment of the Family Caregiver Activation in Transitions Tool: An Exploratory Factor Analysis.

The Family Caregiver Activation in Transitions (FCAT) tool in its current, non-scalar form is not pragmatic for clinical use as each item is scored and intended to be interpreted individually. The purpose of the current study was to create a scalar version of the FCAT to facilitate better care communications between hospital staff and family caregivers. We also assessed the scale's validity by comparing the scalar version of the measure against patient health measures.

Coaching older adults discharged home from the emergency department: The role of competence and emotion in following up with outpatient clinicians.

Objective: Motivating older adults to follow up with an outpatient clinician after discharge from emergency departments (ED) is beneficial yet challenging. We aimed to answer whether psychological needs for motivation and discrete emotions observed by care transition coaches would predict this behavioral outcome.

Methods: Community-dwelling older adults following ED discharge were recruited from three EDs in two U.

Racial differences in treatment among patients with acute headache evaluated in the emergency department and discharged home.

Background: Prior research has demonstrated the widespread presence of racial disparities in emergency department (ED) care and analgesia. We hypothesized that racial disparities continue to exist in ED analgesic prescribing patterns, time to analgesia, and time to provider in the treatment of headache.

Methods: We performed a retrospective cohort study of patients presenting to a large tertiary academic ED with chief complaint of headache.

Multimethod Process Evaluation of a Community Paramedic Delivered Care Transitions Intervention for Older Emergency Department Patients.

Objective: We assessed fidelity of delivery and participant engagement in the implementation of a community paramedic coach-led Care Transitions Intervention (CTI) program adapted for use following emergency department (ED) visits.

Methods: The adapted CTI for ED-to-home transitions was implemented at three university-affiliated hospitals in two cities from 2016 to 2019. Participants were aged ≥60 years old and discharged from the ED within 24 hours of arrival.

Development and implementation of pharmacy department and pharmacy resident well-being programs.

Purpose: Burnout in healthcare can have serious consequences, as it decreases patient care quality. Recent studies have found pharmacy employees have high rates of burnout, but formalized pharmacy well-being programs are not reported in the literature.

Methods: We developed a departmental pharmacy well-being program and focused residency well-being program in October and July 2020, respectively.

Evaluation of fixed-dose versus variable-dose prothrombin complex concentrate for warfarin reversal.

Introduction: The purpose was to compare hemostatic efficacy rates for fixed- and variable-dose four-factor prothrombin complex concentrate (4F-PCC) for warfarin reversal.

Material And Methods: Retrospective study of patients with non-intracranial major bleeding or undergoing emergent surgery/procedure who received 4F-PCC for warfarin reversal from September 2013 through August 2020. Hemostatic efficacy at 48 h following fixed- or variable-dose 4F-PCC was evaluated using modified International Society on Thrombosis and Hemostasis (ISTH) criteria for major bleeding.

Identification of Clinical and Demographic Predictors for Treatment Modality in Patients With Carpal Tunnel Syndrome.

Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. There are multiple treatment modalities for CTS. This study examines both clinical and demographic predictors for initial treatment modality of CTS.

Sports Bra Preferences by Age and Impact of Breast Size on Physical Activity among American Females.

For many females, sports bras are an essential piece of equipment for participation in sports and physical activity. Breast pain or discomfort from lack of support may be a contributing factor to the noted gender disparity in physical activity of females compared to males. Our objective was to evaluate sports bra usage and characterize sports bra preferences of an active female cohort.

Segmental and Circumferential Acetabular Labral Reconstruction Have Comparable Outcomes in the Treatment of Irreparable or Unsalvageable Labral Pathology: A Systematic Review.

Purpose: To perform a systematic review comparing outcomes of segmental versus circumferential arthroscopic labral reconstruction as a treatment for symptomatic irreparable or unsalvageable acetabular labral pathology.

Methods: A systematic review was conducted according to PRISMA guidelines using defined inclusion and exclusion criteria. The study groups were divided into segmental and circumferential labral reconstructions.

Machine learning-assisted screening for cognitive impairment in the emergency department.

Background/objectives: Despite a high prevalence and association with poor outcomes, screening to identify cognitive impairment (CI) in the emergency department (ED) is uncommon. Identification of high-risk subsets of older adults is a critical challenge to expanding screening programs. We developed and evaluated an automated screening tool to identify a subset of patients at high risk for CI.

Effectiveness of a care transitions intervention for older adults discharged home from the emergency department: A randomized controlled trial.

Background: Improving care transitions following emergency department (ED) visits may reduce post-ED adverse events among older adults (e.g., ED revisits, decreased function).

Emergency Medicine Intern Education for Best Practices in Opioid Prescribing.

Introduction: Opioid exposure has been identified as a contributing factor to the opioid epidemic. Reducing patient exposure, by altering heavy opioid prescribing patterns but appropriately addressing patient pain, may represent one approach to combat this public health issue. Our goal was to create and implement an opioid education program for emergency medicine (EM) interns as a means of establishing foundational best practices for safer and more thoughtful prescribing.