2024
Considering Adverse Effects of Common Antihypertensive Medications in the ED
Wira C, Kearns T, Fleming-Nouri A, Tyrrell J, Wira C, Aydin A. Considering Adverse Effects of Common Antihypertensive Medications in the ED. Current Hypertension Reports 2024, 26: 355-368. PMID: 38687403, DOI: 10.1007/s11906-024-01304-5.Peer-Reviewed Original Research
2023
Identification of White Matter Hyperintensities in Routine Emergency Department Visits Using Portable Bedside Magnetic Resonance Imaging
de Havenon A, Parasuram N, Crawford A, Mazurek M, Chavva I, Yadlapalli V, Iglesias J, Rosen M, Falcone G, Payabvash S, Sze G, Sharma R, Schiff S, Safdar B, Wira C, Kimberly W, Sheth K. Identification of White Matter Hyperintensities in Routine Emergency Department Visits Using Portable Bedside Magnetic Resonance Imaging. Journal Of The American Heart Association 2023, 12: e029242. PMID: 37218590, PMCID: PMC10381997, DOI: 10.1161/jaha.122.029242.Peer-Reviewed Original ResearchConceptsWhite matter hyperintensitiesMagnetic resonance imagingSevere white matter hyperintensitiesConventional magnetic resonance imagingResonance imagingRetrospective cohortEmergency departmentMatter hyperintensitiesVascular risk factorsProspective observational studyVascular cognitive impairmentTesla magnetic resonance imagingArea Deprivation IndexProspective cohortAdult patientsAcute careRisk factorsCardiovascular diseaseObservational studyCognitive impairmentPatientsCare magnetic resonance imagingIntermodality agreementCohortDeprivation index
2020
Research Protocol and Case Report of Emergency Department Endovascular Aortic Occlusion (REBOA) in Non-traumatic Cardiac Arrest
Daley J, Cannon K, Buckley R, Aydin A, Latich I, Perez Lozada J, Bonz J, Joseph D, Coughlin R, Belsky J, Sather J, Wira C, Liu R, Johnson A, Moore C. Research Protocol and Case Report of Emergency Department Endovascular Aortic Occlusion (REBOA) in Non-traumatic Cardiac Arrest. Journal Of Endovascular Resuscitation And Trauma Management 2020, 4 DOI: 10.26676/jevtm.v40i(2).140.Peer-Reviewed Original ResearchMean arterial pressureEmergency departmentEmergency physiciansAortic occlusionCardiac arrestCase reportResearch protocolNon-traumatic cardiac arrestFeasibility of REBOAFavorable neurologic outcomeInitial casesNon-traumatic OHCAFemoral arterial accessHospital cardiac arrestTidal carbon dioxideEndovascular aortic occlusionEarly human studiesNeurologic outcomeSecondary outcomesArterial pressureInitial patientsPrimary outcomeSpontaneous circulationHemodynamic changesArterial accessA Research Protocol and Case Report of Emergency Department Endovascular Aortic Occlusion (REBOA) in Non-traumatic Cardiac Arrest
Daley J, Cannon K, Buckley R, Aydin A, Latich I, Lozada J, Bonz J, Joseph D, Coughlin R, Belsky J, Van Tonder R, Sather J, Wira C, Liu R, Johnson A, Moore C. A Research Protocol and Case Report of Emergency Department Endovascular Aortic Occlusion (REBOA) in Non-traumatic Cardiac Arrest. Journal Of Endovascular Resuscitation And Trauma Management 2020, 4: 88-93. DOI: 10.26676/jevtm.v4i2.140.Peer-Reviewed Original ResearchAdvanced cardiac life supportCardiac life supportEmergency departmentEmergency physiciansAortic occlusionCardiac arrestCase reportNon-traumatic cardiac arrestLife supportResuscitative endovascular balloon occlusionResearch protocolFeasibility of REBOAFavorable neurologic outcomeMean arterial pressureNon-traumatic OHCAFemoral arterial accessEndovascular balloon occlusionHospital cardiac arrestTidal carbon dioxideEndovascular aortic occlusionEarly human studiesNeurologic outcomeSecondary outcomesArterial pressureInitial patients
2017
Neurology Concepts: Young Women and Ischemic Stroke—Evaluation and Management in the Emergency Department
Chang BP, Wira C, Miller J, Akhter M, Barth BE, Willey J, Nentwich L, Madsen T. Neurology Concepts: Young Women and Ischemic Stroke—Evaluation and Management in the Emergency Department. Academic Emergency Medicine 2017, 25: 54-64. PMID: 28646558, PMCID: PMC6415947, DOI: 10.1111/acem.13243.Peer-Reviewed Original ResearchConceptsIschemic strokeYoung womenEmergency departmentRisk factorsSex-specific risk factorsIschemic stroke evaluationAcute ischemic strokeOral contraceptive useBoard-certified emergency physiciansPremenopausal womenAcute settingBroad differentialCerebral hemorrhageStroke evaluationVascular neurologistsNonpregnant individualsPostpartum periodLeading causeEmergency physiciansTimely diagnosisContraceptive useThrombolytic agentsCurrent evidenceStrokeOlder populationEvaluation of a novel 5-group classification system of sepsis by vasopressor use and initial serum lactate in the emergency department
Swenson KE, Dziura JD, Aydin A, Reynolds J, Wira CR. Evaluation of a novel 5-group classification system of sepsis by vasopressor use and initial serum lactate in the emergency department. Internal And Emergency Medicine 2017, 13: 257-268. PMID: 28132131, DOI: 10.1007/s11739-017-1607-y.Peer-Reviewed Original ResearchConceptsInitial serum lactate levelSerum lactate levelsEmergency departmentLactate elevationVasoplegic shockLactate levelsCryptic shockVasopressor useInfected patientsShock mortalityHigh-risk ED patientsGroup mortality rateInitial serum lactateVasopressor-dependent patientsIdentifiable risk factorsSepsis-3 definitionRisk-stratify patientsHigh-risk subgroupsInitial lactate levelProximal phaseVasopressor dependenceVasopressor requirementHospital outcomesED patientsSerum lactate
2016
Missed 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 ResearchConceptsEmergency 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
2015
Lactate Clearance Predicts Survival Among Patients in the Emergency Department with Severe Sepsis
Bhat SR, Swenson KE, Francis MW, Wira CR. Lactate Clearance Predicts Survival Among Patients in the Emergency Department with Severe Sepsis. Western Journal Of Emergency Medicine 2015, 16: 1118-1126. PMID: 26759665, PMCID: PMC4703153, DOI: 10.5811/westjem.2015.10.27577.Peer-Reviewed Original ResearchConceptsSevere sepsisSeptic shockLactate clearanceClearance groupLactate levelsPredictors of mortalityEmergency department patientsInitial lactate levelCross-sectional studySepsis registryVasopressor supportED stayDepartment patientsHospital interventionsMechanical ventilationEmergency departmentLactate changesSepsisPatientsMortality rateHigh mortalityHospital floorMortalityClearanceED
2014
Gender Differences in Neurologic Emergencies Part I: A Consensus Summary and Research Agenda on Cerebrovascular Disease
Madsen TE, Seigel TA, Mackenzie RS, Marcolini EG, Wira CR, Healy ME, Wright DW, Gentile NT. Gender Differences in Neurologic Emergencies Part I: A Consensus Summary and Research Agenda on Cerebrovascular Disease. Academic Emergency Medicine 2014, 21: 1403-1413. PMID: 25422086, DOI: 10.1111/acem.12528.Peer-Reviewed Original ResearchConceptsNeurologic emergencySubarachnoid hemorrhageEmergency departmentCause of deathPathophysiologic differencesHemorrhagic strokeCerebrovascular diseaseED providersOverall management planPatient evaluationED diagnosisEmergency physiciansGender differencesRole of sexNominal group techniqueOutcomes pertinentConsensus summaryDiagnosisMigraineSexStrokeEmergencyFuture research prioritiesTreatmentResearch prioritiesEarly Identification and Management of Patients with Severe Sepsis and Septic Shock in the Emergency Department
Keegan J, Wira CR. Early Identification and Management of Patients with Severe Sepsis and Septic Shock in the Emergency Department. Emergency Medicine Clinics Of North America 2014, 32: 759-776. PMID: 25441033, DOI: 10.1016/j.emc.2014.07.002.Peer-Reviewed Original ResearchThe Shock Index as a Predictor of Vasopressor Use in Emergency Department Patients with Severe Sepsis
Wira CR, Francis MW, Bhat S, Ehrman R, Conner D, Siegel M. The Shock Index as a Predictor of Vasopressor Use in Emergency Department Patients with Severe Sepsis. Western Journal Of Emergency Medicine 2014, 15: 60-66. PMID: 24696751, PMCID: PMC3952891, DOI: 10.5811/westjem.2013.7.18472.Peer-Reviewed Original ResearchConceptsSevere sepsisEmergency departmentVasopressor useCardiovascular collapseOrgan failureElevation groupEscalation of careEmergency department patientsCross-sectional studySepsis registryVasopressor dependenceED admissionDepartment patientsInitial presentationShock indexED patientsRisk stratificationLeading causeUseful modalityPatientsSepsisDisease escalationEarly identificationMean numberHigh rateMeta-analysis of Protocolized Goal-Directed Hemodynamic Optimization for the Management of Severe Sepsis and Septic Shock in the Emergency Department
Wira CR, Dodge K, Sather J, Dziura J. Meta-analysis of Protocolized Goal-Directed Hemodynamic Optimization for the Management of Severe Sepsis and Septic Shock in the Emergency Department. Western Journal Of Emergency Medicine 2014, 15: 51-59. PMID: 24696750, PMCID: PMC3952890, DOI: 10.5811/westjem.2013.7.6828.Peer-Reviewed Original Research
2012
Missed Opportunities for Recognition of Ischemic Stroke in the Emergency Department
Lever NM, Nyström KV, Schindler JL, Halliday J, Wira C, Funk M. Missed Opportunities for Recognition of Ischemic Stroke in the Emergency Department. Journal Of Emergency Nursing 2012, 39: 434-439. PMID: 22633790, DOI: 10.1016/j.jen.2012.02.011.Peer-Reviewed Original ResearchConceptsNontraditional symptomsIschemic strokeEmergency departmentSymptom presentationDiagnostic accuracyYale-New Haven HospitalComprehensive neurological evaluationGeneralized weaknessNeurological evaluationStroke symptomsMedical recordsMental statusEmergency nursesPatientsAppropriate managementSymptomsStrokeDiagnosisStrong associationSymptom typeHospitalPresentationMissed opportunityDescriptive statisticsAssociation
2011
Cardiac Complications in Acute Ischemic Stroke
Wira CR, Rivers E, Martinez-Capolino C, Silver B, Iyer G, Sherwin R, Lewandowski C. Cardiac Complications in Acute Ischemic Stroke. Western Journal Of Emergency Medicine 2011, 12: 414-420. PMID: 22224130, PMCID: PMC3236132, DOI: 10.5811/westjem.2011.2.1765.Peer-Reviewed Original ResearchHospital mortality rateCardiac complicationsTroponin elevationIschemic changesAtrial fibrillationAIS patientsEmergency departmentMortality rateSystolic dysfunctionAcute ischemic stroke patientsRetrospective cross-sectional studyActive atrial fibrillationAcute ischemic strokeHours of admissionIschemic stroke patientsUrban emergency departmentCross-sectional studySerum troponin elevationAcute presentationIschemic strokeSymptom onsetEjection fractionStroke patientsSubgroup analysisAdjunctive role
2007
Effective lactate clearance is associated with improved outcome in post-cardiac arrest patients
Donnino MW, Miller J, Goyal N, Loomba M, Sankey SS, Dolcourt B, Sherwin R, Otero R, Wira C. Effective lactate clearance is associated with improved outcome in post-cardiac arrest patients. Resuscitation 2007, 75: 229-234. PMID: 17583412, DOI: 10.1016/j.resuscitation.2007.03.021.Peer-Reviewed Original ResearchConceptsPost-cardiac arrest patientsHigher lactate clearanceArrest patientsLactate clearanceAPACHE II scoreCardiac arrest patientsInitial lactate levelUrban emergency departmentPre-hospital providersEmergency medical servicesHospital mortalityTraumatic arrestHospital courseHospital survivalII scorePrimary endpointHospital dischargeImproved mortalityOverall mortalityMean lactateMultivariable analysisSuccessful resuscitationCardiac arrestEmergency departmentMean age