Publications by authors named "J T Wrenn"
Background: Timely recognition of acute ischemic stroke (AIS) is essential to identify patients who may be eligible for acute intervention. Protocols to streamline systems-based care, such as "stroke alerts" in the emergency department (ED) can safely reduce time-to-care while enhancing safety. However, clinician adherence to stroke alert criteria is poorly described.
View Article and Find Full Text PDFBackground: Guidelines recommend using high-sensitivity troponin T (hsTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) to risk stratify hemodynamically stable patients with acute pulmonary embolism (PE). However, there are no evidence-based cutoff values defined for this clinical application.
Methods: We performed a single-center, retrospective cohort study of patients with imaging-confirmed PE and hsTnT and/or NT-proBNP (ElecsysTM, Roche) measured 12 h before or 24 h after PE Response Team (PERT) activation.
Creating a sustainable residency research program is necessary to develop a sustainable research pipeline, as highlighted by the recent Society for Academic Emergency Medicine 2024 Consensus Conference. We sought to describe the implementation of a novel, immersive research program for first-year emergency medicine residents. We describe the curriculum development, rationale, implementation process, and lessons learned from the implementation of a year-long research curriculum for first-year residents.
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- - The study aimed to understand patient attitudes toward participating in a trial comparing the use of antibiotics versus a placebo for treating acute diverticulitis, particularly since antibiotics may not be necessary for treatment.
- - Researchers conducted interviews and surveys to gauge patients’ willingness to participate, finding that many were motivated by a desire to help others, although they also expressed concerns about the effectiveness of non-antibiotic treatments.
- - The results revealed that 62% of surveyed patients were open to participating in the trial, with their decisions heavily influenced by their doctor's opinions and personal experiences with the condition, indicating the potential feasibility of the study.
Emergency department diagnosis and management of acute pulmonary embolism.
Br J Haematol
November 2024
Despite advances in clinical decision support, the diagnosis, prognostic risk stratification, treatment and disposition of emergency department patients with pulmonary embolism remain challenging. The use of diagnostic risk stratification tools and D-dimer can decrease unnecessary exposure to radiation and intravenous contrast; however, D-dimer is elevated in many conditions including normal pregnancy, so imaging is often indicated. Once diagnosed, prognostic risk stratification tools can inform treatment decisions across the risk spectrum, including identifying low-risk patients with pulmonary embolism who can safely be treated at home.
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