Health Challenges at Sea: An interactive, case-based discussion
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A cruise ship emergency medical evacuation triggered by handheld ultrasound findings and directed by tele-ultrasound
3
Development of a telehealth intervention to promote care‐seeking among transgender women of color in Washington, DC
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Defining emergency telehealth
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Can Emoji's assess patients' mood and emotion in the emergency department? An emoji based study.
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DynaMed Plus App Review
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Virtual Reality-Assisted Pain, Anxiety, and Anger Management in the Emergency Department
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Social Media and Suicide: A Review of Technology-Based Epidemiology and Risk Assessment
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A Mobile Prenatal Care App to Reduce In-Person Visits: Prospective Controlled Trial
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Feasibility and Usability of Tele-interview for Medical Residency Interview
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Date
GW EMED Authors
Notes
Link
Topics
Location
10/1/2020
Francis O'Connell, MD
Neal Sikka, MD
Derek Andresen
Christopher Faircloth
Three decades ago, emergency physicians at The George Washington University were approached by a maritime shipping company with a unique proposal. The company wanted to provide their vessels the ability to consult with a physician when the crew had medical questions at sea. While passage of the Merchant Marine and Death on the High Seas acts in 1920 sought to improve the welfare and safety of U.S. mariners, it did not provide guidance on how to best accomplish that task. The company hoped to leverage the expertise of an emergency physician to aid the crew in discerning the severity of medical complaints, support the crew in providing the most appropriate care on board, and assist them in determining whether the mariner needed further care ashore. Emergency medicine, a specialty with a broad base of medical knowledge is, at its core, a specialty designed to identify life-threatening conditions while separating them from the more mundane. Its practitioners, who work in resource-constrained environments, were the ideal group to provide medical support to ships at sea. And while the practice of medicine has become more advanced and subspecialized, the need for providing prompt, broad-based care for patients in resource-constrained environments is just as important today as it was 30 years ago. In this three-part article, we present topics and concepts highly relevant to the maritime community including providing medical care at sea, preventative and occupational healthcare, and identification of serious medical problems at sea. Each topic includes clinical vignettes based on real cases providing context to each theme. The information contained in this article is meant to provide general information on complex topics and is pertinent to the organizations and individuals who rely on the sea for their livelihood, whether they operate four weeks, four days, or four hours from the next port. There is this delicate balance between the desires of ships’ crews to work and achieve the mission with that of the responsibility of ships’ captains and their respective organizations to oversee their crews’ health and well-being.
Proceedings: The Coast Guard Journal of Safety and Security at Sea
3/21/2020
Keith Boniface, MD
Neal Sikka, MD
Hamid Shokoohi, MD
ABSTRACT
Cruise ships travel far from shoreside medical care and present a unique austere medical environment.
For the cruise ship physician, decisions regarding emergency medical evacuation can be challenging. In
the event that a passenger or crew member becomes seriously ill or is injured, the use of point-of-care
ultrasound may assist in clarifying the diagnosis and stratifying the risk of a delayed care, and at times
expedite an emergent medical evacuation. In this report we present the first case reported in the literature
of an emergency medical evacuation from a cruise ship triggered by handheld ultrasound. A point-of-care
ultrasound performed by a trained cruise ship physician, reviewed by a remote telemedical consultant with
experience in point-of-care ultrasound, identified an ectopic pregnancy with intraabdominal free fluid in
a young female patient with abdominal pain and expedited emergent helicopter evacuation from a cruise
ship to a shoreside facility, where she immediately underwent successful surgery. The case highlights
a medical evacuation that was accurately triggered by utilising a handheld ultrasound and successfully
directed via a tele-ultrasound consultation. American College of Emergency Physicians (ACEP) health care
guidelines for cruise ship medical facilities should be
http://doi.org/10.5603/IMH.2020.0010
cruise ship
maritime
Point-of-care Ultrasound
ectopic pregnancy
tele-ultrasound
International Maritime Health
2/3/2020
Neal Sikka, MD
Background
Transgender women of color (TWC) are an underserved population who often experience high rates of HIV and barriers to care including stigma, violence, and trauma. Few health information technology interventions are tailored to serve TWC. The purpose of this study was to inform the development of a TWC‐specific telehealth intervention to increase access to care.
https://doi.org/10.1111/phn.12709
access to care
transgender health
tailored intervention
Public Health Nursing
12/11/2019
Neal Sikka, MD
The American College of Emergency Physicians Emergency Telehealth Section was charged with development of a working definition of emergency telehealth that aligns with the College’s definition of emergency medicine. A modified Delphi method was used by the section membership who represented telehealth providers in both private and public health-care delivery systems, academia and industry, rural and urban settings. Presented in this manuscript is the final definition of emergency telehealth developed with an additional six clarifying statements to address the context of the definition.
https://doi.org/10.1177/1357633X19891653
Telehealth
telemedicine
Journal of Telemedicine and Telecare
10/31/2019
Ali Pourmand, MD, MPH
Neal Sikka, MD
Interpersonal communication has been drastically altered due to innovations in technology. Emojis are currently an undeniable part of the world’s communication language. Emojis are pictographs commonly used in Internet, electronic, and text messages and they are utilized by 92% of the online population. They represent emotional and personality nuances which would be present in face-to-face communication. Emojis may be a tool that can effectively and efficiently evaluate a patient’s mood in a busy ED setting. This was a prospective study performed at the ED of an urban academic center. The study protocol was reviewed and approved by the institutional review board. Patients 18 years of age or above with lower acuity level at arrival (an Emergency Severity Index (ESI) between 3 and 5) were prospectively enrolled.
https://doi.org/10.1016/j.ajem.2019.09.008
emoji
Mood
emotion
Emergency Severity Index
The American Journal of Emergency Medicine
8/19/2019
Ali Pourmand, MD, MPH
http://dx.doi.org/10.1007/s10278-019-00263-7
App Review
DynaMed
mobile applications
Journal of Digital Imaging
2/20/2019
Neal Sikka, MD
Ali Pourmand, MD, MPH
Study Objective: Pain management in emergency department (ED) patients is challenging. Although both pharmacological and nonpharmacological therapies exist, they are often suboptimal. Immersive virtual reality (VR) uses distraction and possible other methods to reduce perceptions of pain. The purpose of the study is to evaluate the usability and acceptability of VR applications in ED patients by assessing patient-reported changes in pain, anger, and anxiety levels.
https://doi.org/10.1089/tmj.2018.0273
Virtual Reality-Assisted Management
Pain Management
Anxiety Management
Anger Management
Telemedicine and e-Health
10/26/2018
Ali Pourmand, MD, MPH
Amy Caggiula, MD
Introduction: Suicide is a significant public health problem among teenagers and young adults in the United States, placing significant stress on emergency departments (EDs) to effectively screen and assess for the presence of suicidality in a rapid yet efficient manner.
https://doi.org/10.1089/tmj.2018.0203
Social Media
Suicide
Risk Assessment
Technology-Based Epidemiology
Telemedicine and e-Health
3/28/2018
Andrew Meltzer, MD, MS
Background: Risk-appropriate prenatal care has been asserted as a way for the cost-effective delivery of prenatal care. A virtual care model for prenatal care has the potential to provide patient-tailored, risk-appropriate prenatal educational content and may facilitate vital sign and weight monitoring between visits. Previous studies have demonstrated a safe reduction in the frequency of in-person prenatal care visits among low-risk patients but have noted a reduction in patient satisfaction.