Department Blog

Steve Schenkel, MD, MPP, and Teresa Kostelec, BSN, from the ED at Mercy Medical Center; Laura Pimentel, MD, CPME, Chief Medical Officer of the Maryland Emergency Medicine Network; and Ivonne Berges, PhD, and Glenn Ostir, PhD, from the Department of Epidemiology and Public Health, published the article titled “Cognitive Health and Risk of ED Revisit in Underserved Older Adults” in the October issue of the American Journal of Emergency Medicine (34[10]:1973?1976). Their study group, mostly African-American women with an average age of 75 years, had overall cognitive scores lower than population norms. The investigators found a significant association between cognitive health and the odds of return to the ED in 60 or 90 days. Their observations hold implications for the format and content of discharge instructions, especially for patients with impaired cognitive function.

Jon Mark Hirshon, MD, MPH, PhD, published the article titled “Using Timely Survey-Based Information Networks to Collect Data on Best Practices for Public Health Emergency Preparedness and Response: Illustrative Case from the American College of Emergency Physicians' Ebola Surveys,” which was published in the August issue of Disaster Medicine and Public Health Preparedness (10[4]:681‒690). Through the electronic distribution of surveys that assessed medical facilities’ readiness to assess and treat people infected with the Ebola virus, Dr. Hirshon and his co-authors, members of ACEP's Ebola Expert Panel, demonstrated the ability to monitor the delivery of health care during public health emergencies and to implement “real-time” modifications in health care processes as warranted by survey results.

A case report by Zachary Dezman, MD, MS, and Jennifer Reifel Saltzberg, MD, MPH, has been published in the "Images in Emergency Medicine" column of Annals of Emergency Medicine (2016;68:e77‒8). It describes a diabetic man with blisters on his hands. The diagnosis was the rare condition of bullosis diabeticorum.

Larry D. Weiss, MD, JD, presented two Grand Rounds lectures at the Massachusetts General Hospital for the Department of Emergency Medicine of the Harvard University School of Medicine on September 20. His topics were "Risk Reduction in Emergency Medicine" and "Physician Practice Rights."

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.