Research, QI and Patient Safety

Quality Improvement and Patient Safety

  • Monthly departmental M&M’s
  • Trauma M&M’s
  • Cardiovascular M&M’s

Awards

First Place for Oral Presentation of Original Research: Zachary E. Dewar, MD

First Place for Electronic Presentation in the William H. Spivey, MD, FACEP Research Abstract Competition: Jesse Dew, DO 2023

A comparison of hand-held ultrasound versus traditional ultrasound for acquisition of RUSH views in healthy volunteers
Joseph Wu, BA; Hunter Hughes, Anis Adnani, BA; Gregory Christiansen, DO; Lon Ovedovitz, MD; Jon C. Rittenberger, MD, MS
Stanley Conklin Annual Research Day 2020

Presentations

Stanley Conklin Annual Research Day 2020
A comparison of hand-held ultrasound versus traditional ultrasound for acquisition of RUSH views in healthy volunteers: Joseph Wu, BA; Hunter Hughes, Anis Adnani, BA; Gregory Christiansen, DO; Lon Ovedovitz, MD; Jon C. Rittenberger, MD, MS

Guthrie Research Day April 28th 2023

Oral Presentations:

  1. Pre-hospital End Tidal Capnography as a Predictor for In-hospital Resource Utilization and Mortality in Trauma Patients - A Systematic Review - Jesse Dew, DO; Jon Rittenberger, MD; Christopher L. Berry, MD
  2. A clinical pathway incorporating HsTn testing decreases chest pain admissions in a rural healthcare system - Alexis Oropallo DO, Jon Rittenberger MD

Research Posters:

  1. Does the use of Thrombolytics Delay Transfer of Large Vessel Occlusive Ischemic Stroke to Thrombectomy Capable Centers - Sean Cady DO, Jon Rittenberger MD, Christopher Berry MD
  2. Pre-hospital End Tidal Capnography as a Predictor for In-hospital Resource Utilization and Mortality in Trauma Patients - A Systematic Review - Jesse Dew, DO; Jon Rittenberger, MD; Christopher L. Berry, MD
  3. Prehospital Sepsis Care in a Rural Environment: Intravenous Fluid Delivery and Hemodynamic Impact on Patients with Septic Shock - Jared Dupree, DO; James Hughes, BS; Christopher Berry, MD
  4. Bedside E-point Septal Separation Test (BES²T) - Dean Licurgo, DO; Peter Fedyshin, MD; Jon Rittenberger, MD; Lon Ovedovitz, MD ; Daniel Singer, MD
  5. A clinical pathway incorporating HsTn testing decreases chest pain admissions in a rural healthcare system - Alexis Oropallo DO, Jon Rittenberger MD
     

Oral Presentations *Primary Presenter ** Faculty Advisor 

  • “Prehospital Thoracic Ultrasound for Safe and Accurate Needle Thoracostomy: A Pilot Educational Study”, Pennsylvania ACEP Scientific Assembly Platform Spivey Competition, April 2022** (Awarded Runner Up for Spivey Platform Competition). 
  • "In out-of-hospital cardiac arrest, longer on scene times are associated with higher survival rates: “scoop and run” may be deadly", NAEMSP Annual Meeting, January 2019* 
  • "EMS Agencies with High Rates of Field Termination of Cardiac Arrest Care Also Have High Rates of Survival", Geisinger Resident and Fellowship Scholarship Days, May 2018* 
  • "Rapid Cycle Deliberate Practice and Coaching of Specific Interventions Improves Cardiopulmonary Resuscitation Quality Measures in Teams of EMS Providers", Geisinger Resident and Fellowship Scholarship Days, May 2018*  

Poster Presentations *Primary Presenter **Faculty Advisor 

  • “Prehospital Thoracic Ultrasound for Safe and Accurate Needle Thoracostomy: A Pilot Educational Study”, Stanley Conklin Research Presentations, Sayre, PA, April 2022** (Awarded Second Place). 
  • Prehospital Thoracic Ultrasound for Safe and Accurate Needle Thoracostomy: A Pilot Educational Study”, National Association of EMS Physicians Annual Meeting, January 2022** 
  • "In out-of-hospital cardiac arrest, longer on scene times are associated with higher survival rates: “scoop and run” may be deadly", PACEP Spivey Competition, April 2019* 
  • "Rapid Cycle Deliberate Practice and Coaching of Specific Interventions Improves Cardiopulmonary Resuscitation Quality Measures in Teams of EMS Providers", National Association of EMS Physicians Annual Meeting, January 2018* 
  • “Relationship Between Time to Target Temperature and Neurologic Outcomes in Post Cardiac Arrest Patients Treated with TTM”, UCONN SOM, March 2014* 

Invited Regional Speaking Engagements 

  • “Mechanism of Injury and Trauma Triage” Bradford County EMS Association EMS Teaching Day 4/2022 
  • “Management of the Entrapped Patient” Bradford County EMS Association EMS Teaching Day 4/2022 
  • “Prehospital ETCO2 for Trauma Patients” Lancaster General Hospital Trauma Grand Rounds. 2/2022 
  • “The Agitated Patient in the Prehospital Environment” Concepts in Trauma 2021. 12/2021 
  • “Pediatric Medical Myths Exposed” New York Tactical Officers Association/Medicine in Bad Places EMS Tactical Conference. 8/2021 
  • “Important Lessons You Didn’t Learn in Fellowship: My First Year as An EMS Medical Director” Penn State Milton S. Hershey Medical Center EMS Fellowship Lecture. 4/2021 
  • “The Crashing Trauma Patient” Concepts in Trauma 2020. 10/2020 
  • “PACEP Fellowship Discussion Panel” PACEP Central PA Resident Day. 9/2020 
  • “End Tidal CO2 Monitoring for EMS” Life Lion Fall Frolic Conference. 10/2019 

Guthrie EM Resident Awarded at PACEP Scientific Assembly

Congratulations to Zachary E. Dewar, MD, emergency medicine resident, and Christopher Berry, MD, Director of Emergency Medical Services, for their presentation success at the Pennsylvania College of Emergency Physician (PACEP) Scientific Assembly in Pocono Manor, Pa.

Dr. Dewar presented his research work titled, “Prehospital Portable Ultrasound for Safe and Accurate Prehospital Needle Thoracostomy: A Pilot Educational Study” and was awarded Runner Up in the Abstract Oral Presentation category.

Dr. Zachary Dewar, PGY-3 EM Resident

Dr. Zachary Dewar, PGY-3 EM Resident, presented a poster at the NAEMSP conference in San Diego this past January on Prehospital Portable Thoracic Ultrasound for Safe and Accurate Needle Thoracostomy: A Pilot Educational Study. He was also chosen for the Spivey Best of the Best Oral Research Presentation and will be presenting April 1st at PACEP in the Poconos. 

Emergency Department Utilization within a Rural Health Network in Northeastern Pennsylvania and Upstate New York during the Novel Coronavirus Pandemic
Clinton J. Hobson, MD; Laura Walker, DO; Morgan Perry, BS; Jon C. Rittenberger, MD
Society for Academic Emergency Medicine Annual Conference- May 2021

ED Utilization within Guthrie Health System during Early COVID-19 Pandemic​
Laura Walker, DO; Clinton J. Hobson, MD; Morgan Perry; Jon C. Rittenberger, MD
Stanley Conkin Annual Research Day April 23, 2021

Risk factors for unplanned ICU admission after emergency department holding orders
Dewar, Z. E., Kirchner, H. L., & Rittenberger, J. C.
Stanley Conkin Annual Research Day April 23, 2021

Publications

Laura J Walker ; Clinton Hobson; Morgan N Perry; Jon C Rittenberger . Emergency Department Utilization within a Rural Health System during Early COVID-19 Pandemic. Guthrie J. 2023; 75(1). https://doi.org/10.3138/guthrie.75.1.05

Laura Walker ; Jon C. Rittenberger. Point-of-Care Naloxone Distribution in the ED Increases Provider Prescription Rate. Guthrie J. 2023; 75(1). https://doi.org/10.3138/guthrie.75.1.07

Dewar, Z.E., Ko, S., Rogers, C., Oropallo, A., Augustine, A., Pamula, A., Berry, C.L. Prehospital portable ultrasound for safe and accurate prehospital needle thoracostomy: a pilot educational study. Ultrasound J 14, 23 (2022). https://doi.org/10.1186/s13089-022-00270-w PMID: 35698007

Sonnier MS, Walker LJ, Berry CL. Geriatric man with a mass in the chest. J Am Coll Emerg Physicians Open. 2022 Jan 27;3(1):e12635. doi: 10.1002/emp2.12635. PMID: 35128531; PMCID: PMC8795213 PMID: 35128531

Berry CL, Olaf MF, Kupas DF, Berger A, Knorr AC; CARES Surveillance Group. EMS agencies with high rates of field termination of resuscitation and longer scene times also have high rates of survival. Resuscitation. 2021 Dec;169:205-213. doi: 10.1016/j.resuscitation.2021.09.039. Epub 2021 Oct 16. PMID: 34666123. PMID: 34666123

Berry CL, Corsetti MC, Mencl F. Helicopter Emergency Medical Services Transport of COVID-19 Patients in the "First Wave": A National Survey. Cureus. 2021 Aug 6;13(8):e16961. doi: 10.7759/cureus.16961. PMID: 34373827; PMCID: PMC8346337. PMID: 34373827

Kupas DF, Berry CL. “Understanding the Association of Survival, Length of Time on Scene, and Rate of Field Termination Using CARES Data”. CARES 2021 Annual Report.  
 
Berry C. “An Overview of the PA Department of Health 2021 EMS Protocol Updates” PACEP Newsletter Fall 2021. 
 
Berry C. “EMS at the crossroads” PACEP Newsletter Summer 2022. 

Rittenberger JC, Weissman A, Flickinger KL, Guyette FX, Repine M, Dezfulian C, Doshi AA, Elmer JE, Sawyer K, Callaway CW. Glycopyrrolate does not ameliorate hypothermia associated bradycardia in healthy individuals: a randomized crossover trial. 2021. Resuscitation. 2021 Jul;164:79-83. PMID: 34087418

Horowitz JM, Owyang C, Perman SM, Mitchell OJL, Sawyer KN, Blewer AL, Rittenberger JC, Ciullo A, Hsu CH, Kotini-Shah P, Johnson N, Morgan RW, Moskowitz A, Dainty KN, Fleitman J, Uzendu AI, Abella BS, Teran F. The Latest in Resuscitation Research: Highlights from the 2020 American Heart Association’s Resuscitation Science Symposium. J Am Heart Assoc. 2021 Aug 17;10(16):e021575. doi: 10.1161/JAHA.121.021575. Epub 2021 Aug 7. PMID: 34369175

Flickinger KL, Jaramillo S, Repine MJ, Koller AC, Holm M, Skidmore E, Callaway C, Rittenberger JC. One-year outcomes in individualized domains of the cerebral performance category extended. Resuscitation Plus 2021 Dec6:8:100184. PMID: 34934994.

Nassal MMJ, Nichols D, Demasi S, Rittenberger JC, Panchal AR, Kurz MC. External validation of Pittsburgh Cardiac Arrest Category Illness Severity Score. Resuscitation 2021 Dec 27;S0300-9572(21)00530-X. PMID: 34968531.

Owyang C, Abualsaud R, Agarwal S, DelRios M, Grossestreuer A, Horowitz J, Johnson N, Kotini-Shah P, Mitchell O, Morgan R, Moskowitz A, Perman S, Rittenberger J, Sawyer K, Yuriditsky E, Abella B, Teran F. The latest in resuscitation research: Highlights from the 2021 American Heart Association’s Resuscitation Science Symposium. JAHA 2022.
 

Sonnier MS, Walker LJ, Berry CL. Geriatric man with a mass in the chest. JACEP Open. 2022;3:e12635. https://doi.org/10.1002/emp2.12635

Berry C, Olaf MF, Kupas DF, Berger A, Knorr A; CARES Surveillance Group. EMS Agencies with High Rates of Field Termination of Resuscitation and Longer Scene Times Also Have High Rates of Survival. Resuscitation. 2021 Oct 16:S0300-9572(21)00398-1. doi: 10.1016/j.resuscitation.2021.09.039. Epub ahead of print. PMID: 34666123.

Horowitz JM, Owyang C, Perman SM, Mitchell OJL, Sawyer KN, Blewer AL, Rittenberger JC, Ciullo A, Hsu CH, Kotini-Shah P, Johnson N, Morgan RW, Moskowitz A, Dainty KN, Fleitman J, Uzendu AI, Abella BS, Teran F. The Latest in Resuscitation Research: Highlights from the 2020 American Heart Association’s Resuscitation Science Symposium. J Am Heart Assoc. 2021 Aug 17;10(16):e021575. doi: 10.1161/JAHA.121.021575. Epub 2021 Aug 7. PMID: 34369175

Rittenberger JC, Weissman A, Flickinger KL, Guyette FX, Repine M, Dezfulian C, Doshi AA, Elmer JE, Sawyer K, Callaway CW. Glycopyrrolate does not ameliorate hypothermia associated bradycardia in healthy individuals: a randomized crossover trial. 2021. Resuscitation. 2021 Jul;164:79-83. doi: 10.1016/j.resuscitation.2021.05.020. Epub 2021 Jun 1. PMID: 34087418

Dewar, ZE, Wu, J, Hughes, H, Adnani, A, Christiansen, G, Ovedovitz, L, Rittenberger, JC
A Comparison of Handheld Ultrasound versus Traditional Ultrasound for Acquisition of RUSH Views in Healthy Volunteers
Journal of the American College of Emergency Physicians Open
2020 Nov https://doi.org/10.1002/emp2.12322

Yeung E, Kumar V, Dewar Z, Behm R.
Rare aetiology of abdominal pain: contained abscess secondary to perforated jejunal diverticulitis.
BMJ Case Rep. 2020 Sep 2;13(9):e235974. doi: 10.1136/bcr-2020-235974.PMID: 32878834

Panchal AR, Bartos JA, Cabanas JG, Donnino MW, Drennan IR, Hirsch KG, Kudenchuk PJ, Kurz MC, Lavonas EJ, Morley PT, O’Neil BJ, Peberdy MA, Rittenberger JC, Rodriguez AJ, Sawyer KN, Berg KM. 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 3: Adult and Basic and Advanced Life Support. Circulation 2020;142:S366-S468.

Moskowitz A, Andersen LW, Rittenberger JC, Swor R, Seethala RR, Kurz MC, Berg KM, Chase M, Cocchi MN, Grossestreuer AV, Liu X, Holmberg MJ, Callaway CW, Donnino MW.
Continuous Neuromuscular Blockade Following Successful Resuscitation From Cardiac Arrest: A Randomized Trial.
J Am Heart Assoc. 2020 Sep;9(17):e017171. doi: 10.1161/JAHA.120.017171. Epub 2020 Aug 27.PMID: 32851921

Lee BK, Callaway CW, Coppler PJ, Rittenberger JC; Pittsburgh Post-Cardiac Arrest Service.
The prognostic performance of brain ventricular characteristic differ according to sex, age, and time after cardiac arrest in comatose out-of-hospital cardiac arrest survivors.
Resuscitation. 2020 Sep;154:69-76. doi: 10.1016/j.resuscitation.2020.05.031. Epub 2020 Jun 3.PMID: 32504766

Elmer J, Coppler PJ, May TL, Hirsch K, Faro J, Solanki P, Brown M, Puyana JS, Rittenberger JC, Callaway CW.
Unsupervised learning of early post-arrest brain injury phenotypes.
Resuscitation. 2020 Aug;153:154-160. doi: 10.1016/j.resuscitation.2020.05.051. Epub 2020 Jun 9.PMID: 32531403

Dewar, Z. E., Kirchner, H. L., & Rittenberger, J. C.
Risk factors for unplanned ICU admission after emergency department holding orders
Journal of the American College of Emergency Physicians Open
2020 July, 1–7. https://doi.org/10.1002/emp2.12203

Dewar ZE, Christiansen G.
Contact chemical burn of the hand caused by xylene: A case report.
J Am Coll Emerg Physicians Open. 2020 May 8;1(3):289-291. doi: 10.1002/emp2.12079. eCollection 2020 Jun.PMID: 33000046

Sonnier M, Rittenberger JC.
State-of-the-art considerations in post-arrest care.
J Am Coll Emerg Physicians Open. 2020 Mar 8;1(2):107-116. doi: 10.1002/emp2.12022. eCollection 2020 Apr.PMID: 33000021 .