Browsing by Author "Lee, J. Austin"

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    Emergency Department Physician Attitudes, Practices, and Needs Assessment for the Management of Patients with Chest Pain Secondary to Anxiety and Panic
    (Office of the Vice Chancellor for Research, 2016-04-08) Lee, J. Austin; Musey Jr., Paul I.
    Background Chest pain is a common medical complaint, accounting for 7 million annual visits to US Emergency Departments (EDs) [1]. Most research and clinical resources are focused on the management of the life-threatening acute coronary syndrome (ACS); however, about 80% of all patients presenting to EDs with chest pain do not have a cardiopulmonary emergency [2-4]. Non-ACS chest pain can be caused by anxiety or a panic disorder, and such etiologies remain undiagnosed in almost 90% of cases, and frequently have worse outcomes [5-9]. Objective and Methods The study objective was to assess ED physician’s attitudes, practices, and needs in managing chest pain related to anxiety and panic. A REDCap survey of 15 Likert-style questions was constructed using expert consensus to ensure content validity then administered to all faculty and resident physicians in the IU Department of Emergency Medicine (113 individuals, 65.5% response-rate). Results ED providers believe a significant proportion (31.5%) of patients with chest pain at low risk for ACS are due to panic/anxiety. Providers give such patients instructions on how to manage their panic/anxiety only 34.8% of the time, while even fewer (19.0%) make a diagnosis of anxiety or panic disorder in their documentation. Most providers (77.0%) would welcome a narrative to aid in discussing anxiety/panic as a cause of chest pain and nearly all (85.1%) would find it helpful to have specific clinic information available to aid in follow-up. Conclusions A significant number of ED patients with chest pain are likely due to anxiety, and a majority of physicians report not having the resources necessary to manage these patients. Further work to develop relevant resources would aim to improve provider confidence in treating these patients, and would hope to improve management of anxiety or panic as a cause of chest pain in the ED.
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    Emergency Medicine Around the World: Updates from the 2023 American College of Emergency Physicians International Ambassador Country Reports
    (Elsevier, 2025-03-28) Lee, J. Austin; Friedman, Brandon; Alberts, Halley; Kivlehan, Sean M.; DeVos, Elizabeth L.; Patiño, Andrés M.; Emergency Medicine, School of Medicine
    Objectives: The specialty of emergency medicine (EM) is in varying stages of development around the world. Members of the American College of Emergency Physicians (ACEP) international ambassador program were surveyed to document the growth and current state of emergency medicine around the world. Methods: This was a descriptive, cross-sectional survey with 66 items covering EM specialty development, training, and working conditions. Data were collected digitally from January to September 2023. We performed a descriptive statistical analysis and analyzed categorical data using chi-squared and Fisher's exact test. Results: Responses were obtained from 69/77 countries with ACEP ambassadors (90%). EM was a recognized specialty in 63/69 (91%) responding countries. Fifty-nine responding countries (86%) have a national EM society. A total of 113,254 EM residency-trained physicians (EMRTPs) were reported working in 77,563 emergency departments, caring for a total population of 6.05 billion. Sixty countries (87%) report EM residencies, totaling 1790 programs; 1 in 3 respondents have only 1 EM training program. Countries with higher income levels had more EMRTPs per capita; of those with at least 1 EMRTP per 100,000 population, 27 were upper-middle or high income, whereas only 1 was lower-middle or low income. Conclusion: The field of EM continues to gain traction globally, and the number of countries recognizing EM as a specialty is increasing. Most countries surveyed recognized EM as a specialty and many more EMRTPs were reported compared with 2019. The number of EM residency programs and EMRTPs in practice continues to grow. The 2023 ACEP ambassador reports highlight growth, expansion in EM training, and specialty professionalization around the world.
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    Utilisation of WhatsApp for Emergency Medical Services in Garissa, Kenya
    (Elsevier, 2024) Lee, J. Austin; Wachira, Benjamin W.; Kennedy, John; Asselin, Nicholas; Mould-Millman, Nee-Kofi; Emergency Medicine, School of Medicine
    Garissa county, Kenya is a geographically large county with a mobile pastoralist population that has developed a method for emergency medical services (EMS) coordination using the WhatsApp communication platform. This work was based on a site visit, to better understand and describe the current operations, strengths, and weaknesses of the EMS communication system in Garissa. The use of WhatsApp in Garissa county seems to work well in the local context and has the potential to serve as a cost-effective solution for other EMS systems in Kenya, Africa, and other LMICs.