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  1. Article ; Online: Frontiers in Emergency Department Infectious Disease Management.

    Frazee, Bradley W / Pulia, Michael S / Colbert, Christopher M

    Emergency medicine clinics of North America

    2024  Volume 42, Issue 2, Page(s) xv–xvii

    MeSH term(s) Humans ; Emergency Service, Hospital ; Infection Control ; Disease Management
    Language English
    Publishing date 2024-02-23
    Publishing country United States
    Document type Editorial
    ZDB-ID 605637-4
    ISSN 1558-0539 ; 0733-8627
    ISSN (online) 1558-0539
    ISSN 0733-8627
    DOI 10.1016/j.emc.2024.02.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1919: Show issues Location:
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  2. Article ; Online: Optimizing Antimicrobial Stewardship in the Emergency Department.

    Sapozhnikov, Julia / Albarillo, Fritzie S / Pulia, Michael S

    Emergency medicine clinics of North America

    2024  Volume 42, Issue 2, Page(s) 443–459

    Abstract: Antibiotic stewardship is a core component of emergency department (ED) practice and impacts patient safety, clinical outcomes, and public health. The unique characteristics of ED practice, including crowding, time pressure, and diagnostic uncertainty, ... ...

    Abstract Antibiotic stewardship is a core component of emergency department (ED) practice and impacts patient safety, clinical outcomes, and public health. The unique characteristics of ED practice, including crowding, time pressure, and diagnostic uncertainty, need to be considered when implementing antibiotic stewardship interventions in this setting. Rapid advances in pathogen detection and host response biomarkers promise to revolutionize the diagnosis of infectious diseases in the ED, but such tests are not yet considered standard of care. Presently, clinical decision support embedded in the electronic health record and pharmacist-led interventions are the most effective ways to improve antibiotic prescribing in the ED.
    MeSH term(s) Humans ; Antimicrobial Stewardship ; Anti-Bacterial Agents/therapeutic use ; Communicable Diseases/drug therapy ; Emergency Service, Hospital ; Pharmacists
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2024-03-12
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 605637-4
    ISSN 1558-0539 ; 0733-8627
    ISSN (online) 1558-0539
    ISSN 0733-8627
    DOI 10.1016/j.emc.2024.02.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Being explicit about the uncertainty of clinical practice in training.

    Dilg, Stuart / Pulia, Michael S / Papanagnou, Dimitrios

    AEM education and training

    2023  Volume 7, Issue 3, Page(s) e10885

    Language English
    Publishing date 2023-06-22
    Publishing country United States
    Document type Journal Article
    ISSN 2472-5390
    ISSN (online) 2472-5390
    DOI 10.1002/aet2.10885
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  4. Article ; Online: Time to reimagine diagnosis in the acute care setting.

    Pulia, Michael S / Papanagnou, Dimitrios / Santhosh, Lekshmi

    Academic emergency medicine : official journal of the Society for Academic Emergency Medicine

    2023  Volume 30, Issue 7, Page(s) 786–788

    Language English
    Publishing date 2023-02-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1329813-6
    ISSN 1553-2712 ; 1069-6563
    ISSN (online) 1553-2712
    ISSN 1069-6563
    DOI 10.1111/acem.14693
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Dysphagia Is an Underrecognized Risk Factor for Viral Pneumonia Severity.

    Pulia, Michael S / Herrin, Rachelle / Robison, Raele Donetha / Gustafson, Sara / Broghammer, Charles / Grant, Rosemary / Schwei, Rebecca J / Rogus-Pulia, Nicole

    Dysphagia

    2024  

    Abstract: The aim of this study was to examine the role of pre-existing dysphagia as a risk factor for COVID-19 severity among adults ≥50 years of age presenting to the emergency department (ED). This was a retrospective cohort study that used electronic health ... ...

    Abstract The aim of this study was to examine the role of pre-existing dysphagia as a risk factor for COVID-19 severity among adults ≥50 years of age presenting to the emergency department (ED). This was a retrospective cohort study that used electronic health record data from two Midwestern EDs in the same health care system. The sample included patients ≥50 years of age who tested positive for SARS-COV-2 during an ED visit between March 15, 2020 and November 19, 2020. Patients were dichotomized based on documented history of dysphagia. The primary outcome was the highest World Health Organization COVID-19 clinical severity score within 30-days of ED arrival. Patients with a score of <4 were classified as non-severe whereas a score ≥4 was considered severe. Chi-square tests were used to assess differences in clinical severity scores between patients with and without dysphagia. A logistic regression model was created to estimate the odds of a severe COVID-19 clinical score. The sample included 126 patients without dysphagia and 40 patients with dysphagia. Patients with a history of dysphagia were more likely to develop severe COVID-19 disease compared to patients without (65.0% vs. 41.3%, p = 0.015). In multivariable analysis, patients with preexisting dysphagia (OR 2.38, 95% CI: 1.05-5.42; p = 0.038) and diabetes (OR 2.42 95% CI: 1.15-5.30; p = 0.021) had significantly increased odds of developing severe COVID-19. This study showed that a pre-existing diagnosis of dysphagia was independently associated with COVID-19 severity in adults ≥50 years of age.
    Language English
    Publishing date 2024-04-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632764-3
    ISSN 1432-0460 ; 0179-051X
    ISSN (online) 1432-0460
    ISSN 0179-051X
    DOI 10.1007/s00455-024-10697-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2130: Show issues Location:
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  6. Article ; Online: Web Exclusive. Annals for Hospitalists Inpatient Notes - A Critical Look at Procalcitonin Testing in Pneumonia.

    Pulia, Michael S / Lindenauer, Peter K

    Annals of internal medicine

    2021  Volume 174, Issue 6, Page(s) HO2–HO3

    Language English
    Publishing date 2021-06-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 336-0
    ISSN 1539-3704 ; 0003-4819
    ISSN (online) 1539-3704
    ISSN 0003-4819
    DOI 10.7326/M21-1913
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Risk Factors for Dysphagia in Patients Hospitalized with COVID-19.

    Holdiman, Anna / Rogus-Pulia, Nicole / Pulia, Michael S / Stalter, Lily / Thibeault, Susan L

    Dysphagia

    2022  Volume 38, Issue 3, Page(s) 933–942

    Abstract: Patients hospitalized with COVID-19 may be at risk for dysphagia and vulnerable to associated consequences. We investigated predictors for dysphagia and its severity in a cohort of patients hospitalized with COVID-19 at a single hospital center. A large ... ...

    Abstract Patients hospitalized with COVID-19 may be at risk for dysphagia and vulnerable to associated consequences. We investigated predictors for dysphagia and its severity in a cohort of patients hospitalized with COVID-19 at a single hospital center. A large level I trauma center database was queried for all patients hospitalized with COVID-19. Demographics, medical information associated with COVID-19, specific to dysphagia, and interventions were collected. 947 patients with confirmed COVID-19 met the criteria. 118 (12%) were seen for a swallow evaluation. Individuals referred for evaluation were significantly older, had a lower BMI, more severe COVID-19, and higher rates of intubation, pneumonia, mechanical ventilation, tracheostomy placements, prone positioning, and ARDS. Pneumonia (OR 3.57, p = 0.004), ARDS (OR 3.57, p = 0.029), prone positioning (OR 3.99, p = 0.036), ventilation (OR 4.01, p = 0.006), and intubation (OR 4.75, p = 0.007) were significant risk factors for dysphagia. Older patients were more likely to have more severe dysphagia such that for every 1-year increase in age, the odds of severe dysphagia were 1.04 times greater (OR 1.04, p = 0.028). Patients hospitalized with COVID-19 are at risk for dysphagia. We show predictive variables that should be considered when referring COVID-19 patients for dysphagia services to reduce time to intervention/evaluation.
    MeSH term(s) Humans ; COVID-19/complications ; Deglutition Disorders/epidemiology ; Deglutition Disorders/etiology ; Pneumonia/complications ; Respiration, Artificial/adverse effects ; Respiratory Distress Syndrome ; Risk Factors
    Language English
    Publishing date 2022-09-15
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 632764-3
    ISSN 1432-0460 ; 0179-051X
    ISSN (online) 1432-0460
    ISSN 0179-051X
    DOI 10.1007/s00455-022-10518-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2130: Show issues Location:
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  8. Article ; Online: A Perfect Storm: COVID-19 and Antimicrobial Resistance.

    Redwood, Robert / Schulz, Lucas T / Pop-Vicas, Aurora / Pulia, Michael S

    EMJ. Microbiology & infectious diseases

    2022  Volume 2022

    Language English
    Publishing date 2022-09-05
    Publishing country England
    Document type Journal Article
    ISSN 2732-5326
    ISSN (online) 2732-5326
    DOI 10.33590/emjmicrobiolinfectdis/22-00082
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Characterizing barriers to antibiotic stewardship for skin and soft-tissue infections in the emergency department using a systems engineering framework.

    Pulia, Michael S / Schwei, Rebecca J / Hesse, Steven P / Werner, Nicole E

    Antimicrobial stewardship & healthcare epidemiology : ASHE

    2022  Volume 2, Issue 1, Page(s) e180

    Abstract: Objective: Skin and soft-tissue infections (SSTIs) account for 3% of all emergency department (ED) encounters and are frequently associated with inappropriate antibiotic prescribing. We characterized barriers and facilitators to optimal antibiotic use ... ...

    Abstract Objective: Skin and soft-tissue infections (SSTIs) account for 3% of all emergency department (ED) encounters and are frequently associated with inappropriate antibiotic prescribing. We characterized barriers and facilitators to optimal antibiotic use for SSTIs in the ED using a systems engineering framework and matched them with targeted stewardship interventions.
    Design and participants: We conducted semistructured interviews with a purposefully selected sample of emergency physicians.
    Methods: An interview guide was developed using the Systems Engineering Initiative for Patient Safety (SEIPS) framework. Interviews were recorded, transcribed, and analyzed iteratively until conceptual saturation was achieved. Themes were identified using deductive directed content analysis guided by the SEIPS model.
    Results: We conducted 20 interviews with physicians of varying experience and from different practice settings. Identified barriers to optimal antibiotic prescribing for SSTIs included poor access to follow-up (organization), need for definitive diagnostic tools (tools and technology) and fear over adverse outcomes related to missed infections (person). Identified potential interventions included programs to enhance follow-up care; diagnostic aides (eg, rapid MRSA assays for purulent infections and surface thermal imaging for cellulitis); and shared decision-making tools.
    Conclusions: Using a systems engineering informed qualitative approach, we successfully characterized barriers and developed targeted antibiotic stewardship interventions for SSTIs managed in the ED work system. The interventions span multiple components of the ED work system and should inform future efforts to improve antibiotic stewardship for SSTIs in this challenging care setting.
    Language English
    Publishing date 2022-11-07
    Publishing country England
    Document type Journal Article
    ISSN 2732-494X
    ISSN (online) 2732-494X
    DOI 10.1017/ash.2022.316
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  10. Article ; Online: Man With Throat Pain.

    Pulia, Michael S / Reopelle, Kestrel R

    Annals of emergency medicine

    2017  Volume 69, Issue 4, Page(s) 514–528

    Language English
    Publishing date 2017-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603080-4
    ISSN 1097-6760 ; 0196-0644
    ISSN (online) 1097-6760
    ISSN 0196-0644
    DOI 10.1016/j.annemergmed.2016.10.022
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