2021
Disparities in Accessing and Reading Open Notes in the Emergency Department Upon Implementation of the 21st Century CURES Act
Sangal RB, Powers E, Rothenberg C, Ndumele C, Ulrich A, Hsiao A, Venkatesh AK. Disparities in Accessing and Reading Open Notes in the Emergency Department Upon Implementation of the 21st Century CURES Act. Annals Of Emergency Medicine 2021, 78: 593-598. PMID: 34353651, DOI: 10.1016/j.annemergmed.2021.06.014.Peer-Reviewed Original ResearchConceptsProportion of patientsPatient portal accessEmergency departmentOpen notesClinical notesPortal accessPublic insuranceUrgent care centersCentury Cures ActDifferent patient demographicsSingle health systemPatient demographicsPrimary outcomeCures ActPatient utilizationPatient visitsCare centerObservational studyPatientsDigital health toolsAge 18Health systemHealth toolsUnique barriersNon-English speakers
2020
Association between patient-physician gender concordance and patient experience scores. Is there gender bias?
Chekijian S, Kinsman J, Taylor RA, Ravi S, Parwani V, Ulrich A, Venkatesh A, Agrawal P. Association between patient-physician gender concordance and patient experience scores. Is there gender bias? The American Journal Of Emergency Medicine 2020, 45: 476-482. PMID: 33069544, DOI: 10.1016/j.ajem.2020.09.090.Peer-Reviewed Original ResearchConceptsPatient satisfaction surveyFemale patientsProvider scoresOverall assessment scoreEmergency departmentPatient satisfactionPhysician genderPatient-physician gender concordanceFemale physiciansAssessment scoresGender concordancePatient satisfaction survey dataSatisfaction surveyEffect of patientFemale emergency physiciansPatient experience scoresLogistic regression modelsCross-sectional analysisElectronic health recordsPatients' oddsAdult patientsPatient genderEmergency physiciansLower oddsEmergency careClinical impact of rapid influenza PCR in the adult emergency department on patient management, ED length of stay, and nosocomial infection rate
Peaper DR, Branson B, Parwani V, Ulrich A, Shapiro MJ, Clemons C, Campbell M, Owen M, Martinello RA, Landry ML. Clinical impact of rapid influenza PCR in the adult emergency department on patient management, ED length of stay, and nosocomial infection rate. Influenza And Other Respiratory Viruses 2020, 15: 254-261. PMID: 32851793, PMCID: PMC7902247, DOI: 10.1111/irv.12800.Peer-Reviewed Original ResearchConceptsEmergency departmentInfluenza PCRPatient managementClinical redesignED lengthInfluenza seasonED workflowPCR testingBed transfersAnti-influenza medicationsDiverse emergency departmentsHospital-acquired influenzaInfluenza-positive patientsHA influenzaNosocomial infection ratesDiagnosis of influenzaAdult emergency departmentAnti-viral therapyCommon presenting concernPost-intervention periodPre-post studyED LOSED patientsSignificant morbidityTherapeutic guidelines
2018
Spontaneous rupture of the ascending aorta
Bin Mahmood SU, Ulrich A, Safdar B, Geirsson A, Mangi AA. Spontaneous rupture of the ascending aorta. Journal Of Cardiac Surgery 2018, 33: 107-114. PMID: 29405382, DOI: 10.1111/jocs.13535.Peer-Reviewed Original ResearchConceptsAortic ruptureAortic diameterSpontaneous ruptureHereditary connective tissue disordersHigh-risk patientsConnective tissue disordersOperating room timeRisk of ruptureOperative mortalityChest painMedian doorMost patientsAortic diseaseTissue disordersRoom timePatientsRapid diagnosisSuccessful managementMultidisciplinary approachEmergency protocolsAortaRuptureHypertensionPainEtiologyOpening of Psychiatric Observation Unit Eases Boarding Crisis
Parwani V, Tinloy B, Ulrich A, D'Onofrio G, Goldenberg M, Rothenberg C, Patel A, Venkatesh A. Opening of Psychiatric Observation Unit Eases Boarding Crisis. Academic Emergency Medicine 2018, 25: 456-460. PMID: 29266537, DOI: 10.1111/acem.13369.Peer-Reviewed Original ResearchConceptsED LOSLength of stayMedian ED LOSTotal LOSPsychiatric admission ratesCrisis intervention unitSecondary outcomesPrimary outcomeObservation unitAdmission ratesPrimary analysisTertiary care academic medical centerPsychiatric chief complaintsBehavioral health staffInpatient psychiatric bedsAcute psychiatric careAcademic medical centerHours of careEmergency department boardingAdult EDAdult patientsPreintervention periodChief complaintPediatric hospitalInpatient admissions
2017
Multiple Fentanyl Overdoses — New Haven, Connecticut, June 23, 2016
Tomassoni AJ, Hawk KF, Jubanyik K, Nogee DP, Durant T, Lynch KL, Patel R, Dinh D, Ulrich A, D’Onofrio G. Multiple Fentanyl Overdoses — New Haven, Connecticut, June 23, 2016. MMWR Morbidity And Mortality Weekly Report 2017, 66: 107-111. PMID: 28151928, PMCID: PMC5657834, DOI: 10.15585/mm6604a4.Peer-Reviewed Case Reports and Technical NotesConceptsIntensive care unitEmergency departmentYale-New Haven HospitalEmergency medical services (EMS) crewsInterviews of patientsContinuous naloxone infusionNew Haven HospitalPublic health alertsRespiratory failureCare unitNaloxone infusionEndotracheal intubationOpioid overdoseNaloxone distributionPatientsRoute of intoxicationSubsequent episodesHealth alertsOpioid antidoteFentanylHospitalPublic healthFamily membersCocaineRapid notification
2014
The Initial Response to the Boston Marathon Bombing
Gates JD, Arabian S, Biddinger P, Blansfield J, Burke P, Chung S, Fischer J, Friedman F, Gervasini A, Goralnick E, Gupta A, Larentzakis A, McMahon M, Mella J, Michaud Y, Mooney D, Rabinovici R, Sweet D, Ulrich A, Velmahos G, Weber C, Yaffe MB. The Initial Response to the Boston Marathon Bombing. Annals Of Surgery 2014, 260: 960-966. PMID: 25386862, PMCID: PMC5531449, DOI: 10.1097/sla.0000000000000914.Peer-Reviewed Original ResearchConceptsTrauma centerExcellent outcomesUrgent surgical interventionLower extremity soft tissueInitial responseExtremity soft tissueMultidisciplinary care deliveryMultiple casualty incidentsUnderwent amputationHospital mortalityBony injuriesSurgical interventionMedical responseLower extremitiesAdequate preparationPatientsCare deliveryField tourniquetsOperating roomOptimal outcomesSoft tissueImmediate fatalitiesOutcomesCasualty incidentsCentral database
2009
Abdominal 64-MDCT for suspected appendicitis: the use of oral and IV contrast material versus IV contrast material only.
Anderson SW, Soto JA, Lucey BC, Ozonoff A, Jordan JD, Ratevosian J, Ulrich AS, Rathlev NK, Mitchell PM, Rebholz C, Feldman JA, Rhea JT. Abdominal 64-MDCT for suspected appendicitis: the use of oral and IV contrast material versus IV contrast material only. American Journal Of Roentgenology 2009, 193: 1282-8. PMID: 19843742, DOI: 10.2214/ajr.09.2336.Peer-Reviewed Original ResearchMeSH KeywordsAbdominal PainAcute DiseaseAdministration, OralAdultAgedAged, 80 and overAppendicitisArea Under CurveContrast MediaDiagnosis, DifferentialFemaleHumansInjections, IntravenousMaleMiddle AgedRadiographic Image Interpretation, Computer-AssistedRadiography, AbdominalReference StandardsROC CurveSensitivity and SpecificityTomography, X-Ray ComputedTriiodobenzoic AcidsConceptsNontraumatic abdominal painDiagnosis of appendicitisAbdominal painContrast materialGroup 2Group 1Contrast mediumAcute nontraumatic abdominal painUrban academic emergency departmentDiagnostic accuracyPresence of appendicitisSmall bowel obstructionOral contrast materialGroup 2 subjectsAcademic emergency departmentGroup 1 subjectsAdult patientsClinical suspicionClinical outcomesEmergency departmentCT examinationsRadiologic diagnosisAppendicitisPatientsCases of disagreement
2006
Length of Stay by Route of Contrast Administration for Diagnosis of Appendicitis by Computed‐tomography Scan
Berg ER, Mehta SD, Mitchell P, Soto J, Oyama L, Ulrich A. Length of Stay by Route of Contrast Administration for Diagnosis of Appendicitis by Computed‐tomography Scan. Academic Emergency Medicine 2006, 13: 1040-1045. PMID: 16973641, DOI: 10.1197/j.aem.2006.06.047.Peer-Reviewed Original ResearchConceptsAbdominal computed tomographyLength of stayOral contrastRectal contrastComputed tomographyContrast administrationED lengthPatient satisfactionPhase 2 patientsUrban academic EDEmergency department lengthDiagnosis of appendicitisConfidence intervalsWilcoxon rank sum testPhase 1 subjectsRank sum testAdult patientsPrimary outcomeAcademic EDComputed-tomography scansPatient throughput timeAppendicitisPatientsCT orderStay
2005
Bench to Bedside: Pharmacogenomics, Adverse Drug Interactions, and the Cytochrome P450 System
Sikka R, Magauran B, Ulrich A, Shannon M. Bench to Bedside: Pharmacogenomics, Adverse Drug Interactions, and the Cytochrome P450 System. Academic Emergency Medicine 2005, 12: 1227-1235. PMID: 16282513, DOI: 10.1197/j.aem.2005.06.027.Peer-Reviewed Original ResearchConceptsAdverse drug interactionsDrug interactionsCytochrome P450 familyCytochrome P450 systemPreventable medical errorsClinical effectsTherapeutic implicationsHealth careP450 systemPharmaceutical agentsMedical errorsCytochrome P450P450 familyPharmacogenomicsCYP2C19PopulationBasic biochemistryCYP2E1CYP2C9CYP3A4CYP2D6PhysiciansCYP1A2BedsideCare
2004
Blunt Abdominal Trauma: Performance of CT without Oral Contrast Material
Stuhlfaut JW, Soto JA, Lucey BC, Ulrich A, Rathlev NK, Burke PA, Hirsch EF. Blunt Abdominal Trauma: Performance of CT without Oral Contrast Material. Radiology 2004, 233: 689-94. PMID: 15516605, DOI: 10.1148/radiol.2333031972.Peer-Reviewed Original ResearchMeSH KeywordsAbdominal InjuriesAdolescentAdultAgedContrast MediaFemaleHematomaHemoperitoneumHumansInjections, IntravenousIntestine, LargeIntestine, SmallIohexolLaparotomyMaleMesenteryMiddle AgedPeritoneal DiseasesPneumoperitoneumPredictive Value of TestsRetrospective StudiesSensitivity and SpecificityTomography, X-Ray ComputedWounds, NonpenetratingConceptsOral contrast materialMesenteric injurySolid organ injuryCT findingsNegative predictive valuePositive predictive valueContrast materialPredictive valueMesenteric hematomaOrgan injurySurgical repairFree fluidMulti-detector row scannersBowel wall abnormalitiesBlunt abdominal traumaMulti-detector row CTInvestigational Review BoardMulti-detector rowPerformance of CTHospital courseIntraabdominal injuriesAbdominal traumaAbdominopelvic CTBowel wallFalse-positive results
2002
Etiology and Weekly Occurrence of Alcohol‐related Seizures
Rathlev NK, Ulrich A, Shieh TC, Callum MG, Bernstein E, D'Onofrio G. Etiology and Weekly Occurrence of Alcohol‐related Seizures. Academic Emergency Medicine 2002, 9: 824-828. DOI: 10.1197/aemj.9.8.824.Peer-Reviewed Original ResearchConceptsAlcohol-related seizuresAlcohol withdrawal seizuresAlcohol withdrawalIdentifiable causeWithdrawal seizuresRetrospective chart reviewWeeks of presentationAlcohol-dependent patientsGreater frequencyChart reviewConsecutive patientsSix-month periodIndividual patientsPatientsSeizuresPast historyWithdrawalWeekly occurrenceCauseDecreased availabilityMondayEtiologyPeriodPrevalenceWeeksEtiology and weekly occurrence of alcohol-related seizures.
Rathlev N, Ulrich A, Shieh T, Callum M, Bernstein E, D'Onofrio G. Etiology and weekly occurrence of alcohol-related seizures. Academic Emergency Medicine 2002, 9: 824-8. PMID: 12153888, DOI: 10.1111/j.1553-2712.2002.tb02171.x.Peer-Reviewed Original ResearchConceptsAlcohol-related seizuresAlcohol withdrawal seizuresAlcohol withdrawalIdentifiable causeWithdrawal seizuresGreater frequencyRetrospective chart reviewWeeks of presentationAlcohol-dependent patientsChart reviewConsecutive patientsSix-month periodIndividual patientsPatientsSeizuresPast historyWithdrawalWeekly occurrenceCauseDecreased availabilityMondayEtiologyPeriodPrevalenceWeeks
2000
Clinical Characteristics as Predictors of Recurrent Alcohol‐related Seizures
Rathlev N, Ulrich A, Fish S, D'Onofrio G. Clinical Characteristics as Predictors of Recurrent Alcohol‐related Seizures. Academic Emergency Medicine 2000, 7: 886-891. PMID: 10958128, DOI: 10.1111/j.1553-2712.2000.tb02066.x.Peer-Reviewed Original ResearchConceptsAlcohol-related seizuresClinical characteristicsBlood pressureEthanol levelsRecurrent seizuresLower riskLower-risk clinical characteristicsPlacebo-treated patientsDiastolic blood pressureSubset of patientsSystolic blood pressureRetrospective secondary analysisDaily ethanol consumptionRecurrent alcoholPlacebo armRandomized trialsPrevious seizuresEmergency departmentEthanol abuseClinical dataDrug treatmentHeart rateEthanol consumptionSeizuresRespiratory rate
1999
Lorazepam for the Prevention of Recurrent Seizures Related to Alcohol
D'Onofrio G, Rathlev N, Ulrich A, Fish S, Freedland E. Lorazepam for the Prevention of Recurrent Seizures Related to Alcohol. New England Journal Of Medicine 1999, 340: 915-919. PMID: 10094637, DOI: 10.1056/nejm199903253401203.Peer-Reviewed Original ResearchConceptsPlacebo groupRecurrent seizuresSecond seizureLorazepam groupEmergency departmentNormal salineAlcohol abusePrimary end pointDouble-blind studyChronic alcohol abuseYears of ageIntravenous lorazepamHospital dischargeConsecutive patientsGeneralized seizuresEntry criteriaCommon causePatientsSeizuresEnd pointLorazepamObservation periodSignificant reductionHospitalSaline