Department Blog

Sarah Dubbs, MD, has been invited to speak on oncologic emergency topics at the November 2019 Asian Conference on Emergency Medicine (ACEM), which is expected to draw at least 2,000 attendees to New Delhi, India. The themes of this year’s ACEM are affordable care, bridging gaps, and creating impact.

Michael Grasso, MD, PhD, FACP; Zachary Dezman, MD; and David Jerrard, MD, are among the authors of an abstract published in the Annals of Emergency Medicine, “Coding disparity and specificity during emergency department visits after transitioning to the tenth version of the International Classification of Disease [ICD-10]” (full text available), from the American College of Emergency Physicians’ 2019 Research Forum. The authors sought to evaluate whether the increased granularity inherent in ICD-10 has led to greater specificity in diagnosis and coding. They found that the distribution of diagnoses remained unchanged, but there were fewer encounters with multiple codes with ICD-10, and while the post-transition encounters used more unique codes, providers did not consistently exploit these to create more specific codes.

Kyle Fischer, MD, has had an article, “Prevention Professional for Violence Intervention: A Newly Recognized Health Care Provider for Population Health Programs,” accepted for publication in the February 2020 issue of Journal of Health Care for the Poor and Underserved. Keep an eye out for it!

Michael Bond, MD, is among the authors of “How Well Does the Standardized Video Interview Score Correlate with Traditional Interview Performance?” (full text available) published in the Western Journal of Emergency Medicine. The article reports on a study to determine whether a Standardized Video Interview score correlates with a traditional in-person interview score. Results suggest a small positive linear correlation.

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.”

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.

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.