A5031848215- Emergency and Acute Care Studies
- Trauma and Emergency Care Studies
- Injury Epidemiology and Prevention
- Appendicitis Diagnosis and Management
- Abdominal Trauma and Injuries
- Diversity and Career in Medicine
- Traffic and Road Safety
- Intraperitoneal and Appendiceal Malignancies
- Healthcare Policy and Management
- Healthcare cost, quality, practices
- Innovations in Medical Education
- Cardiac, Anesthesia and Surgical Outcomes
- Immunotherapy and Immune Responses
- Respiratory viral infections research
- T-cell and B-cell Immunology
- Ethics in Clinical Research
- Ethics in medical practice
- Meta-analysis and systematic reviews
- Palliative Care and End-of-Life Issues
- Pneumonia and Respiratory Infections
- Hip and Femur Fractures
- Healthcare Decision-Making and Restraints
- Artificial Intelligence in Healthcare and Education
- Travel-related health issues
- COVID-19 and healthcare impacts
Harbor–UCLA Medical Center
2013-2024
UCLA Medical Center
2015-2024
University of California, Los Angeles
2014-2024
Los Angeles Medical Center
2014-2024
Collaborative Group (United States)
2022
University of Iowa
2021
Sutter Medical Center
2021
Duke University
2021
Yale University
2021
The Lundquist Institute
2014-2018
Regionalized trauma care has been widely implemented in the United States, with field triage by emergency medical services (EMS) playing an important role identifying seriously injured patients for transport to major centers. In this study we estimated hospital-level differences adjusted cost of acute transported 94 EMS agencies 122 hospitals 7 regions, overall and injury severity. Among 301,214 patients, average per episode was $5,590 higher a level 1 center than nontrauma hospital. We...
Use of antibiotics for the treatment appendicitis is safe and has been found to be noninferior appendectomy based on self-reported health status at 30 days. Identifying patient characteristics associated with a greater likelihood within days in those who initiate could support more individualized decision-making.To assess factors undergoing initiating appendicitis.In this cohort study using data from Comparison Outcomes Antibiotic Drugs Appendectomy (CODA) randomized clinical trial, among...
<h3>Importance</h3> In the Comparison of Outcomes Antibiotic Drugs and Appendectomy (CODA) trial, which found antibiotics to be noninferior, approximately half participants randomized receive had outpatient management with hospital discharge within 24 hours. If is safe, it could increase convenience decrease health care use costs. <h3>Objective</h3> To assess safety acute appendicitis. <h3>Design, Setting, Participants</h3> This cohort study, a secondary analysis CODA included 776 adults...
Basnyat Buddha, Jeffrey H. Gertsch, Peter S. Holck, E. William Johnson, Andrew M. Luks, Benjamin P. Donham, Ross J. Fleischman, Daniel W. Gowder, Jason Hawksworth, Brett T. Jensen, Richard Kleiman, Adam Loveridge, Elizabeth B. Lundeen, Sheri L. Newman, Jesse A. Noboa, Miegs, Kenneth O'Beirne, Kelly Philpot, Miriam N. Schultz, Matthew C. Valente, Mandie R. Wiebers, and Erik Swenson. Acetazolamide 125 mg BD is not significantly different from 375 in the prevention of acute mountain sickness:...
Antibiotics are commonly prescribed during emergency department (ED) and urgent care center (UCC) visits for viral acute respiratory infection (ARI). We evaluate the comparative effectiveness of an antibiotic stewardship intervention adapted ambulatory settings (adapted intervention) to a that additionally incorporates behavioral nudges (enhanced in reducing inappropriate prescriptions.This study was pragmatic, cluster-randomized clinical trial conducted three academic health systems...
For adults with appendicitis, several randomized clinical trials have demonstrated that antibiotics are an effective alternative to appendectomy. However, it remains unknown how the characteristics of patients in such compare those who select their treatment and whether outcomes differ.To participants Comparison Outcomes Antibiotic Drugs Appendectomy (CODA) trial (RCT) a parallel cohort study declined randomization self-selected treatment.The CODA was conducted 25 US medical centers....
Background. Fentanyl has several potential advantages for out-of-hospital analgesia, including rapid onset, short duration, and less histamine release. Objective. To compare the effectiveness safety of fentanyl with that morphine. Methods. This was a retrospective before-and-after study protocol change from morphine to in an advanced life support emergency medical services system January 2007. Charts nine months prior afterward were abstracted by two reviewers using standardized instrument....
Quick brain magnetic resonance imaging (QB-MRI) is a rapid, radiation-free technique to detect life-threatening CSF shunt malfunction. QB-MRI has not been widely studied or adopted. The primary objective of this study was evaluate the test characteristics for detecting Test computed tomography (CT) and were then compared. Secondary objectives included comparison time completion use sedatives both modalities, as well before after implementation Pediatric Emergency Department (PED) clinical...
Objective. To derive and validate a model that accurately predicts ambulance arrival time could be implemented as Google Maps web application. Methods. This was retrospective study of all scene transports in Multnomah County, Oregon, from January 1 through December 31, 2008. Scene destination hospital addresses were converted to coordinates. ArcGIS Network Analyst used estimate transport times based on street network speed limits. We then created linear regression improve the accuracy these...
Abstract Objectives: While hospital length of stay (LOS) has been used as a surrogate injury outcome when more detailed outcomes are unavailable, it not validated. This project sought to validate LOS proxy measure severity and resource use in heterogeneous populations. Methods: observational study four retrospective cohorts: patients presenting 339 California emergency departments (EDs) with primary International Classification Diseases, Ninth Revision (ICD‐9), diagnosis (years 2005–2006);...
We sought to identify and characterize areas with high rates of major trauma events in 9 diverse cities counties the United States Canada.We analyzed a prospective, population-based cohort injured individuals evaluated by 163 emergency medical service agencies transporting patients 177 hospitals across study sites between December 2005 April 2007. Locations injuries were geocoded, aggregated census tract, assessed for geospatial clustering, matched sociodemographic measures. Negative...
Objective The objective of the study was to identify past experiences, present needs, barriers, and desired methods training for urban rural emergency medical technicians. Methods This 62-question pilot-tested written survey administered at 2008 Oregon EMS 2009 Children conferences. Respondents were compared with registration lists state services (EMS) database assess nonresponder bias. Agencies more than 10 miles from a population 40,000 defined as rural. Results Two hundred nineteen (70%)...
OBJECTIVES: To compare mortality rates of hospitalized injured aged 67 and older across commonly used follow‐up periods (e.g., in‐hospital, 30‐day, 1‐year) to determine the postinjury time after which stabilize. DESIGN: Retrospective analysis Medicare claims. SETTING: Oregon Washington patients. PARTICIPANTS: Patients admitted 171 facilities during 2001/02 with injuries identified according International Classification Diseases, Ninth Revision , code followed for 1 year. MEASUREMENTS: The...
BACKGROUND: "Emergency medical services (EMS) provider judgment" was recently added as a field triage criterion to the national guidelines, yet its predictive value and real world application remain unclear. We examine use independent of EMS judgment in identifying seriously injured persons. METHODS: analyzed population-based retrospective cohort, supplemented by qualitative analysis, children adults evaluated transported 47 agencies 94 hospitals five regions across Western United States...
The Injury Severity Score (ISS) is a measure of injury severity widely used for research and quality assurance in trauma. Calculation ISS requires chart abstraction, so it often unavailable patients cared nontrauma centers. Whether can be accurately calculated from International Classification Diseases, Ninth Revision (ICD-9) codes remains unclear. Our objective was to compare derived ICD-9 with those coded by trauma registrars. This retrospective study entered into 9 U.S. registries January...
Characteristics of outstanding graduating surgical residents are currently undefined. Identifying these qualities may be important in guiding resident selection and education.To determine characteristics that most strongly associated with being rated as an resident.The multi-institutional study had 3 phases. First, expert panel developed a list embodied by top residents. Second, groups faculty from 14 US general-surgery residency programs ranked 2017 through 2020 graduates into quartiles...
National benchmarks for trauma triage sensitivity (≥95%) and specificity (≥50%) have not been rigorously evaluated across broad populations of injured patients. We the impact different field schemes identifying seriously patients a range values. Impact metrics included number undertriaged overtriaged compared with current practices.
Abstract Objectives The Broselow tape is a length‐based tool used for the rapid estimation of pediatric weight and was developed to reduce dosage‐related errors during emergencies. This study seeks assess accuracy age‐based formulas in predicting weights South Sudanese children varying nutritional status. Methods retrospective, cross‐sectional using data from existing acute malnutrition screening programs less than 5 years age Sudan. Using anthropometric measurements, actual were compared...
Research in acute illness often requires an exception from informed consent. Few studies have assessed the views of patients enrolled consent trials. This study was designed to assess and their surrogates enrollment within context a randomized, placebo-controlled trial investigational agent for traumatic brain injury.
This study aimed to determine the test characteristics of a pathway for pediatric appendicitis and its effects on emergency department (ED) length stay, imaging, admissions.Children age 3 18 years with suspicion at 1 tertiary care ED were prospectively enrolled, using validated low- high-risk scoring systems incorporating history, physical examination, white blood cell count. Low-risk patients discharged or observed in ED. High-risk admitted. Those meeting neither low-risk nor criteria...
During emergency medicine (EM) training, residents are exposed to a wide spectrum of patient complaints. We sought determine how resident clinical experience changes based on training level in relation the acuity levels, chief complaints, and dispositions.We performed retrospective chart review patients seen at safety-net, academic hospital Los Angeles from July 1, 2015, June 30, 2016. Resident postgraduate year (PGY) specialty, (based Emergency Severity Index), complaint one 30 categories),...
A patient's belief in the likely success of a treatment may influence outcomes, but this has been understudied surgical trials.To examine association between patients' baseline beliefs about likelihood with outcomes antibiotics for appendicitis Comparison Outcomes Antibiotic Drugs and Appendectomy (CODA) trial.This was secondary analysis CODA randomized clinical trial. Participants from 25 US medical centers were enrolled May 3, 2016, February 5, 2020. Included participants who randomly...
purpose. Dendritic cells and macrophages are phagocytic antigen-presenting that bridge the innate acquired immune systems. The coexistence of subtypes dendritic with overlapping properties complicates resolution their precise roles in an response within a given tissue. This report documents method to identify observe these over time living animal thereby visualize them during dynamic response. methods. To label potential cells, fluorescently tagged ovalbumin was injected into anterior...