2023
Association of Neighborhood-Level Socioeconomic Factors With Delay to Hospital Arrival in Patients With Acute Stroke
Forman R, Okumu R, Mageid R, Baker A, Neu D, Parker R, Peyravi R, Schindler J, Sansing L, Sheth K, de Havenon A, Jasne A, Narula R, Wira C, Warren J, Sharma R. Association of Neighborhood-Level Socioeconomic Factors With Delay to Hospital Arrival in Patients With Acute Stroke. Neurology 2023, 102: e207764. PMID: 38165368, PMCID: PMC10834135, DOI: 10.1212/wnl.0000000000207764.Peer-Reviewed Original ResearchMeSH KeywordsEmergency Medical ServicesHospitalsHumansIschemic StrokeSocioeconomic FactorsStrokeUnited StatesConceptsEmergency department arrival timesEmergency medical servicesLate presentationAcute ischemic stroke therapyYale-New Haven HospitalGuidelines-Stroke registryNeighborhood-level socioeconomic factorsPatient-level factorsRetrospective observational studyIschemic stroke therapyMixed-effects logistic regression modelNon-white patientsNon-white raceUnivariate logistic regressionNew Haven HospitalLogistic regression modelsHospital presentationTreatment ineligibilityStroke RegistryAcute strokeHospital arrivalStroke therapyUnivariate analysisObservational studyPatients
2020
Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic
Jasne AS, Chojecka P, Maran I, Mageid R, Eldokmak M, Zhang Q, Nystrom K, Vlieks K, Askenase M, Petersen N, Falcone GJ, Wira CR, Lleva P, Zeevi N, Narula R, Amin H, Navaratnam D, Loomis C, Hwang DY, Schindler J, Hebert R, Matouk C, Krumholz HM, Spudich S, Sheth KN, Sansing LH, Sharma R. Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic. Stroke 2020, 51: 2664-2673. PMID: 32755347, PMCID: PMC7446978, DOI: 10.1161/str.0000000000000347.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBetacoronavirusBrain IschemiaCohort StudiesComorbidityConnecticutCoronary Artery DiseaseCoronavirus InfectionsCOVID-19DyslipidemiasEmergency Medical ServicesEthnicityFemaleHumansHypertensionIncomeInsurance, HealthIntracranial HemorrhagesMaleMedically UninsuredMiddle AgedOutcome and Process Assessment, Health CarePandemicsPneumonia, ViralRetrospective StudiesSARS-CoV-2Severity of Illness IndexStrokeSubstance-Related DisordersTelemedicineThrombectomyThrombolytic TherapyTime-to-TreatmentConceptsComprehensive stroke centerStroke codePatient characteristicsStroke severityStroke code patientsHistory of hypertensionStroke-like symptomsCoronary artery diseaseCoronavirus disease 2019 (COVID-19) pandemicPatient-level dataLower median household incomePublic health initiativesDisease 2019 pandemicCOVID-19 pandemicRace/ethnicityCode patientsHospital presentationPublic health insuranceRankin ScaleStroke centersArtery diseaseReperfusion timeStroke symptomsEarly outcomesConnecticut hospitalsPrehospital Triage of Acute Stroke Patients During the COVID-19 Pandemic
Goyal M, Ospel JM, Southerland AM, Wira C, Amin-Hanjani S, Fraser JF, Panagos P, Committees O. Prehospital Triage of Acute Stroke Patients During the COVID-19 Pandemic. Stroke 2020, 51: 2263-2267. PMID: 32401680, DOI: 10.1161/strokeaha.120.030340.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAsymptomatic DiseasesBetacoronavirusCanadaCoronavirus InfectionsCOVID-19Delayed DiagnosisEmergency Medical ServicesEquipment ContaminationHealth WorkforceHumansInfectious Disease Transmission, Patient-to-ProfessionalInfectious Disease Transmission, Professional-to-PatientOccupational DiseasesPandemicsPneumonia, ViralProtective DevicesResource AllocationSARS-CoV-2StrokeSymptom AssessmentTime-to-TreatmentTransportation of PatientsTravelTriageUnconsciousnessWorkflowConceptsPatient triageAcute stroke patientsCoronavirus disease 2019 (COVID-19) pandemicEmergency medical services (EMS) providersDisease 2019 pandemicInfectious exposureStroke patientsPrehospital triageMedical service providersStatement paperPatientsTimely transferTriageCOVID-19COVID-19 pandemicHealthcare emergencyPandemic
2019
Guiding Cardiopulmonary Resuscitation with Focused Echocardiography: A Report of Five Cases
Liu R, Bogucki S, Marcolini EG, Yu CY, Wira CR, Kalam S, Daley J, Moore CL, Cone D. Guiding Cardiopulmonary Resuscitation with Focused Echocardiography: A Report of Five Cases. Prehospital Emergency Care 2019, 24: 297-302. PMID: 31150302, DOI: 10.1080/10903127.2019.1626955.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCardiopulmonary ResuscitationEchocardiographyEmergency Medical ServicesFemaleHeart ArrestHumansMaleMiddle AgedConceptsCardiopulmonary resuscitationCardiac arrestEchocardiography studyFocused echocardiographyAdvanced cardiac life support algorithmLeft ventricular compressionCardiac arrest patientsEnd-tidal carbon dioxide valuesHospital cardiac arrestTransthoracic echocardiography studyFocused transthoracic echocardiographyTidal carbon dioxide valuesTransthoracic echocardiographyVentricular compressionArrest patientsPatient outcomesHemodynamic parametersPulse checksEchocardiographyInadequate compressionResuscitationCarbon dioxide valuesUltrasound timingPhysical performanceUltrasound performance
2017
Sex as a Biological Variable in Emergency Medicine Research and Clinical Practice: A Brief Narrative Review
McGregor AJ, Beauchamp GA, Wira CR, Perman SM, Safdar B. Sex as a Biological Variable in Emergency Medicine Research and Clinical Practice: A Brief Narrative Review. Western Journal Of Emergency Medicine 2017, 18: 1079-1090. PMID: 29085541, PMCID: PMC5654878, DOI: 10.5811/westjem.2017.8.34997.Peer-Reviewed Original ResearchConceptsClinical practiceAcute ischemic strokeAcute myocardial infarctionEmergency medicineBrief narrative reviewSex-based researchEmergency medicine researchIschemic strokeTherapy administrationPatient sexMyocardial infarctionEmergency carePatient careNarrative reviewEvidence-based researchCase-based scenariosNational InstituteBiological variablesCareSexMedicine researchSABVInfarctionBody of literatureStroke
2016
When to Stop CPR and When to Perform Rhythm Analysis
Giberson B, Uber A, Gaieski D, Miller JB, Wira C, Berg K, Giberson T, Cocchi MN, Abella B, Donnino MW. When to Stop CPR and When to Perform Rhythm Analysis. Journal Of Intensive Care Medicine 2016, 31: 537-543. PMID: 25542192, DOI: 10.1177/0885066614561589.Peer-Reviewed Original ResearchConceptsAdvanced cardiac life supportMajority of respondersUrban tertiary care centerTertiary care centerMinutes of CPRUninterrupted chest compressionsCardiac arrest managementCardiac life supportHealth care providersAdditional therapyCardiac medicationsPalpable pulseRhythm checkCardiac arrestCare centerObservational studyPulse checksCare providersChest compressionsACLS algorithmsResponse rateACLS certificationAdult staff membersMedical providersWeb-based surveyMissed Ischemic Stroke Diagnosis in the Emergency Department by Emergency Medicine and Neurology Services
Arch AE, Weisman DC, Coca S, Nystrom KV, Wira CR, Schindler JL. Missed Ischemic Stroke Diagnosis in the Emergency Department by Emergency Medicine and Neurology Services. Stroke 2016, 47: 668-673. PMID: 26846858, DOI: 10.1161/strokeaha.115.010613.Peer-Reviewed Original ResearchMeSH KeywordsAgedBrain IschemiaDiagnostic ErrorsEmergency Medical ServicesEmergency MedicineFemaleHumansMaleNeurologyRetrospective StudiesStrokeConceptsEmergency departmentLarge community hospitalCommunity hospitalIschemic strokeStroke diagnosisAcademic hospitalNausea/vomitingSecondary prevention therapiesAcute ischemic strokeRetrospective chart reviewIschemic stroke diagnosisAcademic teaching hospitalEndovascular considerationsChart reviewPrompt treatmentSymptom onsetPosterior circulationPrevention therapyNeurology serviceAcute interventionAnterior strokeAtypical symptomsStroke historyPosterior strokeTeaching hospital