Department Blog - December 2019

Mike Winters, MD, Professor, Department of Emergency Medicine, was the lead author of “Combined Residency Programs in Emergency Medicine” (full text available), which was published in the Journal of Emergency Medicine on August 31.

Heidi Teague, MD, Assistant Professor, Department of Emergency Medicine, co-authored the article, “Use of Nebulized Naloxone to Reverse Methadone Overdose – A Case Report and Review of Literature” (full text available), recently published in the Journal of Community Hospital Internal Medicine Perspectives. The authors report on a case of methadone overdose reversed with naloxone nebulization, which they conclude can provide a needleless, noninvasive route of administration for the reversal of opioid overdose.

Jon Mark Hirshon, MD, MPH, FACEP, FAAEM, FACPM, Professor, and Laura Pimentel, MD, CPME, Clinical Professor, both in the Department of Emergency Medicine, are among the authors of the article, “Impact of Global Budget Revenue Policy on Emergency Department Efficiency in the State of Maryland” (full text available), recently published in the Western Journal of Emergency Medicine. The authors investigated the impact of the State of Maryland’s Global Budget Revenue program on length of stay for inpatients in emergency departments in Maryland.

Jon Mark Hirshon, MD, MPH, FACEP, FAAEM, FACPM, Professor, Department of Emergency Medicine, is among the authors of the American College of Emergency Physicians clinical policy, “Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Headache” (full text available), recently published in the Annals of Emergency Medicine. The policy is based on a systematic review of the literature to derive evidence-based recommendations, with evidence graded and recommendations made based on the strength of the available data.

Jon Mark Hirshon, MD, MPH, FACEP, FAAEM, FACPM, Professor, Department of Emergency Medicine, is among the authors of the article, “Survival Associated With Sirolimus Plus Tacrolimus Maintenance Without Induction Therapy Compared With Standard Immunosuppression After Lung Transplant” (full text available) published in JAMA Network Open. Their objective was to compare survival between patients receiving sirolimus plus tacrolimus vs mycophenolate mofetil plus tacrolimus (the most common maintenance therapy) and to identify the combination of induction and maintenance therapy associated with the highest survival. They found that sirolimus plus tacrolimus was associated with improved patient survival after lung transplant compared with mycophenolate mofetil plus tacrolimus, and that no antibody induction therapy with sirolimus plus tacrolimus was associated with maximal survival.

Jon Mark Hirshon, MD, MPH, FACEP, FAAEM, FACPM, Professor, Department of Emergency Medicine, is among the authors of the article, “Emergency Care Research Ethics in Low-Income and Middle-Income Countries” (full text available), published in BMJ Global Health. Their article examines the ethical and regulatory challenges to conducting emergency care research with human participants in low- and middle-income countries, presents potential solutions or frameworks for addressing these challenges, and identifies gaps.

Jon Mark Hirshon, MD, MPH, FACEP, FAAEM, FACPM, Professor, Department of Emergency Medicine, was among the authors of "Driving Behavior and Road Traffic Crashes Among Professional and Nonprofessional Drivers in South Egypt” (abstract available), which was published in the International Journal of Injury Control and Safety Promotion on July 8.

The authors aimed to investigate the correlates with driving behaviors and road traffic crashes (RTCs) among professional and nonprofessional drivers in South Egypt. They found that that professional drivers had more lapses, errors, and violations compared to nonprofessional drivers and female drivers were more likely to lapse than males. Driving lapses, errors, and violations did not significantly increase the risk of RTCs.

Jon Mark Hirshon, MD, MPH, FACEP, FAAEM, FACPM, Professor, and Laura Pimentel, MD, CPME, Clinical Professor, both from the Department of Emergency Medicine, were among the authors of the article, “Resource Utilization in Non-Academic Emergency Departments With Advanced Practice Providers” (full text available), which was published in the Western Journal of Emergency Medicine in July.

Their objectives were to compare resource utilization in emergency departments (EDs) that use advanced practice providers (APPs) in their staffing model with those that do not and to estimate costs associated with the utilized resources. They found that EDs staffing APPs were associated with modest increases in resource utilization as measured by admissions and imaging studies.

Mike Witting, MD, Professor; Mak Moayedi, MD, CDEM, Assistant Professor; Jon Mark Hirshon, MD, MPH, FACEP, FAAEM, FACPM, Professor; and Steve Schenkel, MD, Associate Professor, all from the Department of Emergency Medicine, were among the authors of “Predicting Failure of Intravenous Access in Adults: The Value of Prior Difficulty” (full text available), which was published in the Journal of Emergency Medicine in July.

Their objective was to validate prior need for an advanced technique to establish intravenous access as a predictor of failure to achieve access via traditional methods and to estimate the risk difference associated with this finding. They found that patients with a prior need for advanced techniques were 14% more likely to have failure of intravenous access by traditional methods than those without prior difficulty.