Department Blog

Sarah B. Dubbs, MD, has authored an activity eligible for CME credit through Medscape: "Minimizing the Impact of imAEs and Maximizing Efficacy in the Emergency Department." The goal of this activity is to educate clinicians treating patients with cancer, including those in the emergency department, on how to recognize and manage immune-mediated adverse events (imAEs) related to the use of immune checkpoint inhibitors. Access is free with registration.


Daniel L. Lemkin, MD, Benoit Stryckman, MA, and Zachary D.W. Dezman, MD, among other authors, have an in-press article titled “Integrating a safety smart list into the electronic health record decreases intensive care unit length of stay and cost” prepublished online in the Journal of Critical Care.

Dr. Dezman writes, "This paper shows the impact of a preventative-care checklist for critically ill patients. It reminds physicians to administer prophylactic medications and remove lines and catheters as soon as it is safe for patients. The checklist will dynamically update to reflect the patient's status (e.g., it won't ask the physician to remove a central line that was already removed). It was designed to work in any type of critical care unit (adults or children, surgical and medical patients) and is integrated into our EHR.

 
The more that the clinicians used the checklist, the more likely the patient was to be downgraded sooner from the ICU compared to regular care. There was a decrease in days where the patient was on a breathing machine and a trend towards fewer cases of ventilator-associated pneumonia. There was a corresponding decrease in costs. There was no change in mortality associated with checklist use. 
 

We are currently working towards getting more clinician engagement and measuring the impact of the checklist as it is used more and more."


The results of two studies by Hannah Bach, MD, Siamak Moayedi, MD, Stephen Schenkel, MD, and Hong Kim, MD, MPH, with medical students Brenten Hurt, Atizaz Hussain, Valerie Jenkins, and Ilya Lazzeri, were presented at the 39th Congress of the European Association of Poison Centres and Clinical Toxicologists, held in Naples from May 21 to 24. Their presentations were titled “Access and Use of Bystander Naloxone Among Emergency Department Patients with Opioid Abuse in the Era of Adulterated Heroin with Fentanyl” and “Prevalence of Fentanyl Exposure Among Emergency Department Patients with History of Opioid Abuse.”


Posted 6/7/2019 by Linda Kesselring

Fentanyl Use Often Missed in ED Patient Evaluations

The article titled “Evidence of Fentanyl Use is Common and Frequently Missed in a Cross-Sectional Study of Emergency Department Patients in Baltimore, Maryland,” has been published at the website of Clinical Toxicology (doi: 10.1080/15563650.2019.1605078). The authors are Zachary Dezman, MD, MS, MS, Weaam Felemban, MBBS, and Laura Bontempo, MD, MEd, all from the Department of Emergency Medicine, and Eric D. Wish, PhD, from the Center for Substance Abuse Research at University of Maryland, College Park.

 


Posted 5/2/2019 by Linda Kesselring

Case Report on Subdural Hematoma

Lindsay Weiner, MD, Adam Richardson, DNP, ENP-C, and Semhar Tewelde, MD, published the case report titled “Spontaneous Intracranial and Lumbar Subdural Hematoma Presenting as Vaginal Pain” in the neurological emergencies section of the April issue of The Journal of Emergency Medicine.


Zachary Dezman, MD, MS, MS, has been awarded a Science to Systems Grant from the Center for Addition Research, Education, and Service (CARES) at UMB’s School of Social Work. The funding will be used to analyze data from the fentanyl-detection test that was recently added to the hospital’s drug panel. Dr. Dezman and his collaborators will examine the effect of illicit fentanyl use on the administration of buprenorphine, which is used to treat opioid use disorder in emergency department patients.


Stephen Thom, MD, PhD, Veena Bhopale, MPhil, PhD, and Ming Yang, MD, MS, published the article titled “Microparticle-Induced Vascular Injury in Mice Following Decompression is Inhibited by Hyperbaric Oxygen: Effects on Microparticles and Interleukin-1β” in the April issue of Journal of Applied Physiology.

 


Posted 4/28/2019 by Linda Kesselring

AEM ECG of the Month: Acute Coronary Occlusion

Amal Mattu, MD, is a co-author of the ECG of the Month in the April issue of Annals of Emergency Medicine (2019;73[4]:409-412). It portrays concordant ST-segment depression in one lead, indicative of acute coronary occlusion in a patient with left bundle branch block. Dr. Mattu’s co-authors are Brian Lin, MD, Kaiser Permanente San Francisco, William Brady, MD, University of Virginia School of Medicine, and Jeffrey Tabas, MD, University of California San Francisco.


Posted 4/26/2019 by Linda Kesselring

Dr. Tran and Dr. Chang Receive SCCM Award

A multidisciplinary research group led by Quincy K. Tran, MD, PhD, won the Silver Snapshot Abstract Award at the 2019 Annual Congress of the Society of Critical Care Medicine, held in San Diego in February. Their winning abstract was titled “Resuscitation Unit Transferred More While Providing Similar Outcomes for Patients with Stroke from Large Vessel Occlusion.” Dr. Tran’s collaborators in this project are Karen L. Yarbrough, DNP, CRNP, and Michael Phipps, MD, Department of Neurology; Wan-Tsu W. Chang, MD, Department of Emergency Medicine; Jay Menaker, MD, Department of Surgery; and Paul Capobianco, Amir Medic, Asim Shafique, Isabella Swafford, and Timothy Traynor, who were students at the University of Maryland, College Park, at the time of the study.


Posted 4/24/2019 by Linda Kesselring

Transport Destinations for Low-Acuity Patients

Roger Stone, MD, MS, was a co-presenter of “Alternative Transport Destinations for Your Lowest Acuity Patients” at EMS Today 2019, held at National Harbor in February. His collaborator was Alan Butsch, MA, NRP, Battalion Chief of the Montgomery County Fire and Rescue Service, for which Dr. Stone serves as medical director. EMS Today is an annual educational conference sponsored by JEMS. Its lectures, exhibits, and equipment demonstrations attract more than 4600 emergency medical services personnel from around the world. The presentation by Dr. Stone and Chief Butsch was one of three from EMS Today 2019 to be covered by EMS1.com, an online information resource for prehospital care personnel.