Department Blog - September 2016

An article by Ben Lawner, DO, MS, EMT-P, and medical students Megan Halliday and Andrew Bouland, was published in this month's issue of Western Journal of Emergency Medicine. “The Medical Duty Officer: An Attempt to Mitigate the Ambulance At-Hospital Interval” describes their study, designed to improve communications within the local EMS system and decrease the amount of time ambulances spent at hospitals between transports*.* They collaborated with Angela Comer, MPH, from the National Study Center for Emergency Medical Systems and Trauma, Daniel Ramos, from the Baltimore City Department of Social Services, and Mark Fletcher, a paramedic with the Baltimore City Fire Department on the study and the analysis of its results.

Amal Mattu, MD, was the keynote speaker at Emergency Cardiology Update 2016, held in Melbourne, Australia, on September 10 and 11. He presented lectures on the electrocardiographic indications of cardiac ischemia, ST-elevation myocardial infarction, wide and narrow complex dysrhythmias, heart block, and acute cardiac syndrome as well as a review of recent cardiology articles, a case conference, and a concluding ECG quiz. The conference was designed for health care practitioners specializing in emergency medicine, general practitioners practicing in rural settings, and physicians seeking to refresh their expertise in emergency cardiology.

Benjamin Lawner, DO, MS, EMT-P, was the guest on a recent Urgent Matters podcast produced at George Washington University, an interview series focused on the interface between emergency medicine and public health. Dr. Lawner was interviewed by Jesse Pines, MD, MBA, Director of GWU’s Center for Health Care Quality and Assurance, on the topic of sobering centers and the role of EMS in health care access. Their conversation can be heard at http://smhs.gwu.edu/urgentmatters. In addition to his faculty position, Ben is the Deputy EMS Director for the Baltimore City Fire Department.

Laura Bontempo, MD, along with colleagues from the Departments of Medicine and Pediatrics, published the article titled “Core Entrustable Professional Activities: A Survey of the Confidence of Fourth-Year Medical Students and Residency Program Directors” in the September issue of Medical Science Educator. Their analysis of surveys completed by 168 UMSoM graduates and 12 residency program directors revealed shared confidence regarding interns' ability to perform most of the professional activities expected of interns. Students expressed lowest confidence in their ability to take a history and perform a physical exam, to give or receive patient handoffs, and to identity system failures and thereby contribute to a culture of safety and improvment. These findings can be used to refine medical school curricula so as to address the 13 CEPAs, with consideration of specialty differences. The article is available at the journal's website: http://link.springer.com/article/10.1007/s40670-016-0264-5?no-access=true

Jon Mark Hirshon, MD, MPH, PhD, is a site principal investigator for two recently funded studies. As a subcontractor on an award received by Johns Hopkins University from the Health Resources and Services Administration, Dr. Hirshon will participate in the development and testing of a triage tool that will assist EMS personnel with transport decisions for sick and injured children. The project is intended to elucidate reasons for secondary transports of pediatric patients and thus decrease their frequency. He is also a subcontractor on a study funded by the Centers for Medicare & Medicaid Services, through which he will collect data that will be used to assess quality of care and patient safety at dialysis centers.

Zachary Dezman, MD, MS, Thomas Scalea, MD, Jon Mark Hirshon, MD, MPH, PhD, and Gordon Smith, MBChB, MPH, published the article titled “Alcohol Consumption Decreases Lactate Clearance in Acutely Injured Patients” in the September issue of the journal Injury. Based on their study involving 3910 trauma patients, the investigators concluded that having alcohol “on board” decreases lactate clearance in a dose-dependent manner. They surmised that the effect is caused by diversion of metabolites needed for the conversion of lactate to pyruvate in the alcohol metabolic pathway. This work was supported by a Resident Research Grant from the Maryland Emergency Medicine Network.

Mak Moayedi, MD, and Lisa Babin, BS, a 2016 graduate of the University of Maryland School of Medicine, published a case report, “Pneumorrhachis Secondary to a Sacral Decubitus Ulcer,” in the July issue of the Western Journal of Emergency Medicine. It describes the rare finding of gas in the spinal canal, produced as direct extension from organisms causing vertebral osteomyelitis.