Browsing by Author "Rood, Loren K."

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    Brief Toxicology Observation: What Kind of Burger Did This Patient Eat?
    (Springer, 2015-09) Rood, Loren K.; Rusyniak, Daniel E.; Department of Emergency Medicine, IU School of Medicine
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    Design and implementation of a basic and global point of care ultrasound (POCUS) certification curriculum for emergency medicine faculty
    (Springer, 2022-02-19) Russell, Frances M.; Kennedy, Sarah K.; Rood, Loren K.; Nti, Benjamin; Herbert, Audrey; Rutz, Matt A.; Palmer, Megan; Ferre, Robinson M.; Emergency Medicine, School of Medicine
    Point of care ultrasound (POCUS) use in the emergency department is associated with improved patient outcomes and increased patient satisfaction. When used for procedural guidance, it has been shown to increase first pass success and decrease complications. As of 2012, ultrasound has been identified as a core skill required for graduating emergency medicine (EM) residents. Despite this, only a minority of EM faculty who trained prior to 2008 are credentialed in POCUS. Half of all EM training programs in the United States have less than 50% of their faculty credentialed to perform and teach POCUS to learners. As the use of POCUS continues to grow in medicine, it is especially important to have a pathway for faculty to attain competence and become credentialed in POCUS. The goal of this paper was to outline an implementation process of a curriculum designed to credential EM faculty in POCUS.
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    Success of Implementation of a System-Wide Point of Care Ultrasound (POCUS) Training and Privileging Program for Emergency Physicians
    (Wiley, 2022-04) Kennedy, Sarah K.; Ferre, Robinson M.; Rood, Loren K.; Nti, Benjamin; Ehrman, Robert R.; Emergency Medicine, School of Medicine
    Objectives Point-of-care ultrasound (POCUS) is widely used in the emergency department (ED). Not all practicing emergency physicians (EPs) received POCUS training during residency, leaving a training gap that is reflected in POCUS privileging. The purpose of this study was to evaluate the success of meeting privileging criteria, as well as associated factors, following implementation of a basic POCUS training and privileging program within a large Department of Emergency Medicine. Methods We implemented a POCUS training and privileging program, based on national guidelines, for faculty physicians who worked at one of the following EDs staffed by the same Department of Emergency Medicine: a pediatric tertiary site, 2 tertiary academic sites, and 7 community sites. POCUS exams included aorta, cardiac, first-trimester obstetrics, and extended focused assessment with sonography in trauma. Pediatric emergency medicine faculty were taught soft tissue and thoracic ultrasound instead of aorta and obstetrics. Completion of the program required 16 hours of didactics, ≥25 quality assured ultrasound examinations by exam type and passing a series of knowledge-based exams. Descriptive statistics were calculated. Associations between physician characteristics and successfully becoming privileged in POCUS were modeled using Firth’s logistic regression. Results 176 faculty physicians were eligible. 145 (82.4%) achieved basic POCUS privileging during the study period. Different pathways were used including: 86 (48.9%) practice-based, 9 (5.1%) fellowship-based, and 82 (46.9%) residency-based. POCUS privileging was lower for those working in a community versus academic setting (OR 0.3, CI 0.1-0.9). A greater number of scans completed prior to the privileging program was associated with greater success. Conclusion Implementation of a POCUS training and privileging program can be successful in a large Department of Emergency Medicine that staffs hospitals in a large-scale healthcare system comprised of both academic and community sites. Faculty physicians with at least some prior exposure to POCUS were more successful.
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    Success of implementation of a systemwide point-of-care ultrasound privileging program for emergency medicine faculty
    (Wiley, 2022-04-01) Kennedy, Sarah K.; Ferre, Robinson M.; Rood, Loren K.; Nti, Benjamin; Ehrman, Robert R.; Brenner, Daniel; Rutz, Matt A.; Zahn, Greg S.; Herbert, Audrey G.; Russell, Frances M.; Emergency Medicine, School of Medicine
    Objectives: Point-of-care ultrasound (POCUS) is widely used in the emergency department (ED). Not all practicing emergency physicians received POCUS training during residency, leaving a training gap that is reflected in POCUS privileging. The purpose of this study was to evaluate the success of meeting privileging criteria as well as associated factors, following implementation of a basic POCUS training and privileging program within a large emergency medicine department. Methods: We implemented a POCUS training and privileging program, based on national guidelines, for faculty physicians who worked at one of the following EDs staffed by the same emergency medicine department: a pediatric tertiary site, two tertiary academic sites, and seven community sites. POCUS examinations included aorta, cardiac, first-trimester obstetrics (OB), and extended focused assessment with sonography in trauma. Pediatric emergency medicine faculty were taught soft tissue and thoracic US instead of aorta and OB. Completion of the program required 16 h of didactics, ≥25 quality-assured US examinations by examination type, and passing a series of knowledge-based examinations. Descriptive statistics were calculated. Associations between physician characteristics and successfully becoming privileged in POCUS were modeled using Firth's logistic regression. Results: A total of 176 faculty physicians were eligible. A total of 145 (82.4%) achieved basic POCUS privileging during the study period. Different pathways were used including 86 (48.9%) practice-based, nine (5.1%) fellowship-based, and 82 (46.9%) residency-based. POCUS privileging was lower for those working in a community versus academic setting (odds ratio 0.3, 95% confidence interval 0.1-0.9). A greater number of scans completed prior to the privileging program was associated with greater success. Conclusions: Implementation of a POCUS training and privileging program can be successful in a large emergency medicine department that staffs hospitals in a large-scale health care system composed of both academic and community sites. Faculty physicians with at least some prior exposure to POCUS were more successful.
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    Superficial Temporal Artery Pseudoaneurysm Presenting as A Suspected Sebaceous Cyst
    (Elsevier, 2016-12) Rood, Loren K.; Department of Emergency Medicine, School of Medicine
    A 20-year-old man presented to the emergency department (ED) requesting to have a “cyst” on his scalp drained. The patient stated that he had first noticed the cyst about 1.5 years ago, which seemed to develop after he was hit on the head during an altercation. He reported that it was drained in this ED 6 to 8 months earlier but that it did not resolve. On examination, the left temporal scalp had a 2-cm indurated cystic subcutaneous lesion that was minimally tender, without any drainage or overlying erythema. The patient was advised that it appeared to be sebaceous cyst, which would likely recur until formally excised. Because of his mild discomfort, he opted for incision and drainage pending his clinic referral. After alcohol preparation and local anesthesia, the incision yielded only brisk bleeding that was easily controlled with fingertip pressure but required suture placement for complete hemostasis. The lesion was felt to be faintly pulsatile while holding pressure. Point of care (POC) ultrasound evaluation performed with a high frequency linear array probe revealed the cyst (Figure 1) to be a superficial temporal artery (STA) pseudoaneurysm. Standard B mode imaging clearly showed turbulent blood flow (Video 1). Color Doppler ultrasound imaging (Video 2) showed the typical swirling of blood within the aneurysm (the “yin-yang” sign). Vascular surgery was consulted and arrangements were made for outpatient excision of the lesion. At surgery approximately 1 month later, the lesion was confirmed to be a pseudoaneurysm.
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    Teaching Seasoned Doctors New Technology: An Intervention to Reduce Barriers and Improve Comfort With Clinical Ultrasound
    (Cureus, 2021-08-17) Kennedy, Sarah K.; Duncan, Taylor; Herbert, Audrey G.; Rood, Loren K.; Rutz, Matt A.; Zahn, Gregory S.; Welch, Julie L.; Russell, Frances M.; Emergency Medicine, School of Medicine
    Introduction: Although clinical ultrasound (CUS) is a core skill that is a requirement for emergency medicine (EM) residency graduation, only a fraction of EM practitioners who trained prior to this requirement are certified in CUS. The objective of the study was to implement a CUS workshop for practicing EM physicians, identify barriers to utilization, and assess comfort with the machine, obtaining and interpreting images, and incorporating CUS into clinical practice. Methods: This was a prospective descriptive cohort study of EM physician faculty who participated in an interactive 5-hour CUS workshop intervention that introduced four core CUS modalities via didactics and hands-on scanning stations. Pre- and post-surveys were administered to identify barriers to utilization and assess perceived comfort with CUS using a 5-point Likert scale. Results were analyzed using Fisher's exact and paired t-tests. Results: Thirty-five EM physicians participated with a 100% survey response rate. Only five of the physicians were ultrasound certified at the time of the workshop. On average, physicians were 16 years post-residency. Prior to the workshop, 29% had minimal ultrasound experience and 43% had not performed more than 50 ultrasounds. In the pre-course survey, every physician expressed at least one barrier to CUS utilization. Post-workshop, physicians felt significantly more comfortable using the ultrasound machine (p=0.0008), obtaining and interpreting images (p=0.0009 and p=0.0004), and incorporating CUS into clinical practice (p=0.002). Conclusion: This workshop is an effective tool to expose practicing physicians to core concepts of CUS, improve their comfort level, and reduce barriers to ultrasound utilization.