A5021359596- Ultrasound in Clinical Applications
- Radiology practices and education
- Hemodynamic Monitoring and Therapy
- Venous Thromboembolism Diagnosis and Management
- Acute Myocardial Infarction Research
- Radiation Dose and Imaging
- Emergency and Acute Care Studies
- Sepsis Diagnosis and Treatment
- Innovations in Medical Education
- Cardiac, Anesthesia and Surgical Outcomes
- Cardiac Arrest and Resuscitation
- Acute Ischemic Stroke Management
- Trauma Management and Diagnosis
- Trauma and Emergency Care Studies
- Traumatic Ocular and Foreign Body Injuries
- Medical History and Innovations
- Urinary Tract Infections Management
- Medical Education and Admissions
- Academic Publishing and Open Access
- Abdominal Trauma and Injuries
- Appendicitis Diagnosis and Management
- Geriatric Care and Nursing Homes
- Gun Ownership and Violence Research
- Acute Kidney Injury Research
- Viral Infections and Vectors
Vanderbilt University
2016-2025
Vanderbilt University Medical Center
2014-2024
VA Tennessee Valley Healthcare System
2019-2024
Beth Israel Deaconess Medical Center
2024
Harvard University
2024
Geriatric Research Education and Clinical Center
2024
Boise VA Medical Center
2023
Vanderbilt Health
2023
University of Pittsburgh Medical Center
2023
Washington Department of Social and Health Services
2021
Abstract Background Point‐of‐care ultrasound (POCUS) can reduce procedural complications and improve the diagnostic accuracy of hospitalists. Currently, it is unknown how many practicing hospitalists use POCUS, which applications are used most often, what barriers to POCUS exist. Objective This study aimed characterize current use, training needs, among hospital medicine groups (HMGs). Design, Setting, Participants A prospective observational all Veterans Affairs (VA) medical centers was...
BackgroundMore primary care providers (PCPs) have begun to embrace the use of point-of-care ultrasound (POCUS), but little is known about how PCPs are currently using POCUS and what barriers exist. In this prospective study, largest systematic survey among PCPs, we assessed current use, program management, training needs for in care.MethodsWe conducted a observational study all VA Medical Centers (VAMCs) between June 2019 March 2020 web-based sent VAMC Chiefs Staff clinics...
Abstract Background Lack of training is currently the most common barrier to implementation point-of-care ultrasound (POCUS) use in clinical practice, and in-person POCUS continuing medical education (CME) courses have been paramount improving this gap. Due travel restrictions physical distancing requirements during COVID-19 pandemic, were cancelled. Though tele-ultrasound technology has existed for several years, deliver hands-on a CME course not previously described. Methods We conducted...
This study sought to account for trends in medical student specialty choice by examining the importance of lifestyle factors. Emergency medicine (EM) is among several specialties classified as having a "controllable lifestyle." The primary objective this was determine if students choosing careers EM have different profile influences, values, and expectations from other or groups. Of secondary interest how much influenced compared controllable (CL) specialties. Using data 2005 2006...
BackgroundPoint-of-care ultrasound (POCUS) has become an integral part of critical care medicine for procedural guidance, bedside diagnostics, and assessing response to treatment. Multiple societies recommend POCUS use, training been a requirement fellowship since 2012. Yet, current practice patterns use in ICUs are not well known.Research QuestionThis study aimed characterize needs, barriers among intensivists.Study Design MethodsA prospective observational all Veterans Affairs (VA) medical...
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Point-of-care ultrasound (POCUS) can aid geriatricians in caring for complex, older patients. Currently, there is limited literature on POCUS use by geriatricians. We conducted a national survey to assess current use, training desired, and barriers among Geriatrics Extended Care ("geriatric") clinics at Veterans Affairs Medical Centers (VAMCs).We prospective observational study of all VAMCs between August 2019 March 2020 using web-based sent VAMC Chiefs Staff geriatric clinics.All (n=130)...
Abstract Objective Ultrasound‐guided intravenous catheter ( USGIV ) insertion is increasingly being used for administration of IV contrast computed tomography CT scans. The goal this investigation was to evaluate the risk extravasation among patients receiving through catheters. Methods A retrospective observational study adult who underwent a contrast‐enhanced scan at tertiary care emergency department during recent 64‐month period conducted. unadjusted prevalence compared between with an...
Develop and validate a prognostic model for clinical deterioration or death within days of pulmonary embolism (PE) diagnosis using point-of-care criteria.We used prospective registry data from six emergency departments. The primary composite outcome was (respiratory failure, cardiac arrest, new dysrhythmia, sustained hypotension, rescue reperfusion intervention) 5 days. Candidate predictors included laboratory imaging right ventricle (RV) assessments. developed 935 PE patients. Univariable...
We sought to determine associations of early electrocardiogram (ECG) patterns with clinical deterioration (CD) within 5 days and RV abnormality (abnlRV) by echocardiography in pulmonary embolism (PE).In this prospective, multicenter study newly confirmed PE patients, initial ECG were examined. Initial included lead-specific ST-segment elevation (STE) or depression (STD), T-wave inversion (TWI), supraventricular tachycardia (SVT), sinus tachycardia, right bundle branch block as complete...
Background Point-of-care ultrasound (POCUS) has been disruptive to many experienced emergency physicians as it requires competence in a new physical skill, real-time image interpretation, and navigation of novel software for submission the electronic health record (EHR). Incomplete documentation performed POCUS study used clinical decision-making represents potential medicolegal liability, may expose patient repetitive or potentially unnecessary imaging, is missed opportunity reimbursement....
Abstract Objectives Identifying right ventricle (RV) abnormalities is important to stratifying pulmonary embolism (PE) severity. Disposition decisions are influenced by concerns about early deterioration. Triaging strategies, like the Simplified Pulmonary Embolism Severity Index (sPESI), do not include RV assessments as predictors or deterioration outcome(s). We aimed (1) determine if assessment variables add prognostic accuracy for 5‐day clinical in patients classified low risk sPESI, and...
Emergency ultrasound (EUS) is a critical component of emergency medicine (EM) resident education. Currently, there no consensus list competencies for EUS training, and graduating residents have varying levels skill comfort. The objective this study was to define widely accepted comprehensive EM through modified Delphi method.
Numerous medical conditions require timely medication administration in the emergency department (ED). Automated dispensing systems (ADSs) store premixed common doses at point-of-care to minimize time administration, but use of such automation improved has not been studied. Since vancomycin is a commonly used empiric antimicrobial, we sought quantify effect using an ADS on drug delivery patients presenting ED. The study aimed determine efficacy utilizing improve and any negative effects...
Abstract Objectives Existing pulmonary embolism (PE) risk scores were developed to predict death within weeks, but not more proximate adverse events. We determined the ability of 3 PE stratification tools (simplified severity index [sPESI], 2019 European Society Cardiology guidelines [ESC], and short‐term clinical outcomes estimation [PE‐SCORE]) 5‐day deterioration after emergency department (ED) diagnosis PE. Methods analyzed data from six EDs on ED patients with confirmed Clinical was...
Objectives Incomplete documentation and submission to the electronic health record of performed point-of-care ultrasound (POCUS) studies is problematic from a patient care, medicolegal, billing standpoint. Positive negative financial incentives may be used motivate physicians complete workflow. The most efficacious route improve POCUS workflow completion remains determined. Materials methods A retrospective analysis in an academic emergency department during four distinct six-month blocks...
Incarcerated gravid uterus (IGU) is a rare condition that associated with urinary obstruction, sepsis, peritonitis, and ultimately maternal death. IGU occurs when the retroverted in patient becomes trapped pelvis during second trimester. We present case of nulliparous female who came to our emergency department (ED) at 14 weeks five days gestation new onset intermittent hesitancy rectal pressure starting approximately 10 prior presentation. was diagnosed based on pelvic examination...