Center for Policy and Research in Emergency Medicine (CPR-EM)

Overview

The OHSU Center for Policy and Research in Emergency Medicine's breakthrough research leads to new standards of care and a better understanding of important issues involving emergency medicine, disaster preparedness, and toxicology.

At the OHSU Center for Policy and Research in Emergency Medicine (CPR-EM), our mission consists of reducing inequities, including, but not limited to, those based on race, ethnicity, gender, sexual orientation, gender identity, immigration status, religion, and disability. In particular, we acknowledge the legacy of racism that is embedded in American society and institutions, and we are actively working to be catalysts of change to dismantle these harmful structures. Our commitment involves reflecting principles of equity across all functions of our organization, including in its culture, governance, hiring practices, salaries, research areas of focus, and the conduct of our research.  

Read the full CPR-EM Equity Operating Guidelines Beliefs and Values Statement

In the Media

Dr. Esther Choo, Director of Equity and Inclusion in the Department of Emergency Medicine, OHSU

10/27/2020 - Congratulations to Dr. Esther Choo, who was appointed the first Director of Recruitment, Equity, and Inclusion (DREI) for the Department of Emergency Medicine.  In her new role, Dr. Choo will lead, coordinate, track, measure and assess the collective efforts of our team.  Dr. Choo will share her expertise to develop a diverse applicant pool when recruiting, and to ensure that the Department of Emergency Medicine (DEM) is one where a diverse faculty and staff can thrive and advance.  Dr. Choo will also promote continuous learning and education on diversity, anti-racism, unconscious bias, and equity.

The DEM and CPR-EM strive to support diversity, equity, and inclusion and foster a culture where everyone can operate at the top of their potential.

The CPR-EM faculty and staff are honored to have Dr. Choo as an integral member of our team, and are thrilled that Dr. Choo has been appointed to this new role within the department.  Dr. Choo has been and continues to be a strong advocate for equity, inclusion, and culture change, contributing to movements such as #TimesUpHealthCare.

C3PO - Clinical Trial of COVID-19 Convalescent Plasma of Outpatients

In August 2020, the OHSU ED began enrolling in the C3PO trial which is designed to confirm or refute the role of passive immunization as a safe and efficacious therapy in preventing the progression from mild to severe/critical COVID-19 illness and to understand the immunologic kinetics of anti-SARS-CoV-2 antibodies after passive immunization. 

What does that mean?  If you present to the OHSU ED, and are confirmed to have contracted COVID-19, you may be asked to participate in this trial.  Patients who participate will receive either Conalenscent Plaslma (CP) or a Placebo (saline and multi-vitamin infusion).  The study staff will talk with you before you are enrolled in this trial so you can decide if you would like to participate.  Participating in research is always voluntary, and the research team will give you the information you need to decide if you would like to participate. 

OHSU C3PO Press release

Survey of ED patients with COVID-like Symptoms

Drs. Newgard and Choo are leading a study to learn more about the clinical course and outcomes of patients with symptoms potentially consistent with a viral illness such as COVID-19, and to help guide health systems and emergency departments during the current pandemic.  If you visit the OHSU, Doernbecher, Tuality, or Columbia Memorial Hospital Emergency Departments and you are evaluated for COVID, or have any symptoms of a COVID-like illness, you may receive a request (via text or email) from the study team to complete a weekly survey for up to 30 days after your visit. To participate in this study, you DO NOT need to be COVID-19 positive, or even need to have been evaluated for COVID-19.   If you have questions about this study please contact cprem@ohsu.edu

This study is being overseen by the OHSU IRB (#21302).  You may also contact the IRB at irb@ohsu.edu

View Study Information Sheet

Due to the COVID-19 Pandemic, some of the ED research projects listed below are currently suspended from enrolling subjects, however our research teams continue to engage in research activities that can be accomplished.

Craig Newgard

“Oregon Emergency Care Research Multidisciplinary Training Program”

Sponsor: National Heart, Lung, and Blood Institute (NHLBI), National Institute of Mental Health (NIMH), National Institute of Nursing Research (NINR) - 1K12HL133115

Award Dates: 08/15/16-06/30/21

Role: Principal Investigator

“The Value of Pediatric Readiness in the Emergency Care of Injured Children”

Sponsor: Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHHD) - 1R24HD085927

Award Dates: 09/30/17-06/30/22

Role: Principal Investigator

“A Multi-State Evaluation of Emergency Department Pediatric Readiness: Guideline Uptake and Association with Quality, Outcomes, and Cost”

Sponsor: Health Resources and Services Administration (HRSA) Maternal and Child Health Bureau - 1H34MC332430100

Award Dates: 09/01/19-08/31/23

Role: Principal Investigator

“Comparative Effectiveness of Trauma Center Care for Older Americans”

Sponsor: Brigham and Women's Hospital Inc (BWH) via National Institute on Aging (NIA) - 1R56AG048452-01A1

Award Dates: 09/30/17-08/31/19

Role: Site Principal Investigator / Co-Investigator

Additional emergency medicine research statistics can be found on the OHSU Research Expertise website. 
 

Esther Choo

“Implementation, Outcomes, and Cost of a Novel Medicaid Policy to Reduce
Opioids for Back Pain”

Sponsor: National Institute on Drug Abuse (NIDA) - 1R01DA044284

Award Dates: 08/15/18-05/31/23

Role: Principal Investigator

“Risk of Motor Vehicle Crashes from Cannabis Use in Emergency Department
Patients”

Sponsor: Insurance Institute for Highway Safety (IIHS)

Award Dates: 11/01/16-04/30/20

Role: Principal Investigator

“Virtual Coaching in Making Informed Choices on Elder Abuse/Neglect Self-Disclosure (VOICES)”

Sponsor: Yale University via NIA - 1R01AG060084

Award Dates: 09/01/18-08/31/22

Role: Site Principal Investigator / Co-Investigator

Matthew Hansen

“Improving the Safety and Efficacy of Out-of-Hospital Pediatric Airway Management”

Sponsor: National Heart, Lung, and Blood Institute - 1K23HL131440

Award Dates: 09/26/16-08/31/20

Role: Principal Investigator

“Charlotte, Houston, and Milwaukee Prehospital (CHaMP) Research Node”

Sponsor: Health Resources and Services Administration (HRSA) Bureau of Health Professions - 5H34MC26201

Award Dates: 09/01/17-08/31/20

Role: Site Principal Investigator / Co-Investigator

“The Charlotte, Houston, and Milwaukee Prehospital (CHaMP) Research Node”

Sponsor: Health Resources and Services Administration (HRSA) Maternal and Child Health Bureau - U03MC33154

Award Dates: 09/01/19-08/31/23

Role: Site Principal Investigator / Co-Investigator

Bory Kea

“Optimal Anticoagulation Strategies for Acute Atrial Fibrillation”

Sponsor: National Heart, Lung, and Blood Institute - 1K08HL140105

Award Dates: 12/15/17-11/30/20

Role: Principal Investigator

“Specimen Collection in the Emergency Department for the Assessment of Clinical Performance of the Siemens PBNP Assay”

Sponsor: Siemens Healthcare Diagnostics

Award Dates: 06/12/19-06/30/22

Role: Principal Investigator

“BUILD EXITO Y6”

Sponsor: EXITO Institutional Core

Award Dates: 11/01/19-06/30/20

Role: Principal Investigator

“VITROS® Immunodiagnostic Products hs Troponin I US Sample Collection Protocol”

Sponsor: Ortho-Clinical Diagnostics Inc

Award Dates: 06/18/18-06/30/21

Role: Principal Investigator

Brandon Maughan

“Sex-Based Differences in Risk Stratification and Diagnostic Imaging for Diagnosis of Pulmonary Embolism”

Sponsor: Oregon Emergency Care Research Multidisciplinary Training Program - National Heart, Lung, and Blood Institute - 5K12HL133115

Award Dates: 07/01/18-08/30/21

Role: Scholar

David Sheridan

“West Coast Consortium for Technology and Innovation in Pediatrics”

Sponsor: Children's Hospital Los Angeles (CHLA) via FDA - 1P50FD006425

Award Dates: 09/01/18-08/31/23

Role: Site Principal Investigator / Co-Investigator

“Solace: A Wearable Continuous Early Suicide Warning System for Adolescents”

Sponsor: Oregon Emergency Care Research Multidisciplinary Training Program

National Institute of Mental Health / National Heart, Lung, and Blood Institute - 5K12HL133115

Award Dates: 07/01/18-06/30/21

Role: Scholar

“SRA-19-145 ProMedix, Inc.”

Sponsor: ProMedix, Inc.

Award Dates: 08/01/19-07/31/20

Role: Principal Investigator

“Physiologic Parameters Related to Suicidality in Adolescent Mental Health”

Sponsor: Welch Allyn

Award Dates: 01/01/19-01/31/22

Role: Principal Investigator

Mohamud Daya

Strategies to Innovate EmeRgENcy Care Clinical Trials Network (SIREN) -
Network Clinical Center (Award Hub)”

Sponsor: National Institute of Neurological Disorders and Stroke (NINDS) - 1U24NS100657

Award Dates: 07/15/17-05/31/22

Role: Principal Investigator

“Characterizing Prehospital Delay and Outcomes in Patients Treated for Potential Acute Coronary Syndrome in the Emergency Department”

Sponsor: University of California, Los Angeles (UCLA) via National Heart, Lung, and Blood Institute - 1R21HL140277

Award Dates: 08/01/18-07/31/20

Role: Site Principal Investigator / Co-Investigator

2020 has seemed like the longest year ever and a lifetime ago since we last saw each other's smiles. And yet, your support of one another, resiliency in the face of crises, and continued efforts to ensure humanism in medicine makes me proud to be a part of our ED team. We're in this together. Stay strong. Thank you to every member of our healthcare team.

- Bory Kea, MD, MCR, FACEP - Director of Clinical Trial, Department of Emergency Medicine

Current Newsletter

Previous Study Updates

Interested in expanding your career to include Emergency Care Research? CPR-EM offers a variety of training programs for many experiential levels. Learn about all of our opportunities here, or click on a link below to be directed to that specific program. 

September

Toxicologic Confounders of Brain Death Determination: A Narrative Review. Murphy L, Wolfer H, Hendrickson RG. Neurocrit Care. 2020 Sep 30:1-18. doi: 10.1007/s12028-020-01114-y. Online ahead of print. PMID: 33000377

Exception From Informed Consent: How IRB Reviewers Assess Community Consultation and Public Disclosure. Chisolm-Straker M, Nassisi D, Daya MR, Cook JNB, Wilets IF, Clesca C, Richardson LD. AJOB Empir Bioeth. 2020 Sep 29:1-9. doi: 10.1080/23294515.2020.1818878. Online ahead of print. PMID: 32990501

Emergency department cardioversion of acute atrial fibrillation. Vinson DR, Kea B, Coll-Vinent B, Barrett TW. Lancet. 2020 Sep 26;396(10255):885. doi: 10.1016/S0140-6736(20)31314-3. PMID: 32979973 

Laboratory Reconstructions of Bicycle Helmet Damage: Investigation of Cyclist Head Impacts Using Oblique Impacts and Computed Tomography. Bland ML, McNally C, Cicchino JB, Zuby DS, Mueller BC, McCarthy ML, Newgard CD, Kulie PE, Arnold BN, Rowson S. Ann Biomed Eng. 2020 Sep 24. doi: 10.1007/s10439-020-02620-y. Online ahead of print. PMID: 32974755

Physical Examination Is Predictive of Cauda Equina Syndrome: MRI to Rule Out Diagnosis Is Unnecessary. Zusman NL, Radoslovich SS, Smith SBS, Tanski M, Gundle KR, Yoo JU. Global Spine J. 2020 Sep 16:2192568220948804. doi: 10.1177/2192568220948804. Online ahead of print. PMID: 32935582

The Crisis and Transition Services (CATS) Model: A Program to Divert Youths in Mental Health Crisis From the Emergency Department. Ribbers A, Sheridan D, Jetmalani A, Magers J, Lin AL, Marshall R. Psychiatr Serv. 2020 Sep 16:appips201900597. doi: 10.1176/appi.ps.201900597. Online ahead of print. PMID: 32933412

A dangerous pandemic pair: Covid19 and adolescent mental health emergencies. Cloutier RL, Marshaall R. Am J Emerg Med. 2020 Sep 15:S0735-6757(20)30795-6. doi: 10.1016/j.ajem.2020.09.008. Online ahead of print. PMID: 32981811 

Association of Intra-arrest Transport vs Continued On-Scene Resuscitation With Survival to Hospital Discharge Among Patients With Out-of-Hospital Cardiac Arrest. Grunau B, Kime N, Leroux B, Rea T, Van Belle G, Menegazzi JJ, Kudenchuk PJ, Vaillancourt C, Morrison LJ, Elmer J, Zive DM, Le NM, Austin M, Richmond NJ, Herren H, Christenson J. JAMA. 2020 Sep 15;324(11):1058-1067. doi: 10.1001/jama.2020.14185. PMID: 32930759

Evaluating new paralysis, mortality, and readmission among subgroups of patients with spinal epidural abscess: A latent class analysis. Brown PCM, Phillipi GM, King C, Tanski M, Sullivan P. PLoS One. 2020 Sep 11;15(9):e0238853. doi: 10.1371/journal.pone.0238853. eCollection 2020. PMID: 32915861 

End-of-life orders, resource utilization and costs among injured older adults requiring emergency services. Lin AL, Newgard C, Caughey AB, Malveau S, Dotson A, Eckstrom E. J Gerontol A Biol Sci Med Sci. 2020 Sep 10:glaa230. doi: 10.1093/gerona/glaa230. Online ahead of print. PMID: 32914190

Characteristics of Anaphylactic Reactions: A Prospective Observational Study in Japan. Oya S, Kinoshita K, Daya M, Kinoshita H. J Emerg Med. 2020 Sep 8:S0736-4679(20)30685-5. doi: 10.1016/j.jemermed.2020.07.004. Online ahead of print. PMID: 32917450

Effect of Out-of-Hospital Tranexamic Acid vs Placebo on 6-Month Functional Neurologic Outcomes in Patients With Moderate or Severe Traumatic Brain Injury. Rowell SE, Meier EN, McKnight B, Kannas D, May S, Sheehan K, Bulger EM, Idris AH, Christenson J, Morrison LJ, Frascone RJ, Bosarge PL, Colella MR, Johannigman J, Cotton BA, Callum J, McMullan J, Dries DJ, Tibbs B, Richmond NJ, Weisfeldt ML, Tallon JM, Garrett JS, Zielinski MD, Aufderheide TP, Gandhi RR, Schlamp R, Robinson BRH, Jui J, Klein L, Rizoli S, Gamber M, Fleming M, Hwang J, Vincent LE, Williams C, Hendrickson A, Simonson R, Klotz P, Sopko G, Witham W, Ferrara M, Schreiber MA. JAMA. 2020 Sep 8;324(10):961-974. doi: 10.1001/jama.2020.8958. PMID: 32897344

Heart Rate Variability Analysis: How Much Artifact n We Remove? Sheridan DC, Dehart R, Lin A, Sabbaj M, Baker SD. Psychiatry Investig. 2020 Sep;17(9):960-965. doi: 10.30773/pi.2020.0168. Epub 2020 Sep 18. PMID: 33017533

Association of Medicare Mandatory Bundled Payment System for Hip and Knee Joint Replacement With Racial/Ethnic Difference in Joint Replacement Care. Kim H, Meath THA, Tran FW, Quiñones AR, McConnell KJ, Ibrahim SA. JAMA Netw Open. 2020 Sep 1;3(9):e2014475. doi: 10.1001/jamanetworkopen.2020.14475. PMID: 32960277 

July & August 2020

Seven more things organisations should be doing to combat racism. Olayiwola JN, Choo E. Lancet. 2020 Aug 29;396(10251):593. doi: 10.1016/S0140-6736(20)31718-9. PMID: 3286129

TXA Administration in the Field Does Not Affect Admission TEG after Traumatic Brain Injury. Dixon AL, McCully BH, Rick EA, Dewey E, Farrell DH, Morrison LJ, McMullan J, Robinson BRH, Callum J, Tibbs B, Dries DJ, Jui J, Gandhi RR, Garrett JS, Weisfeldt ML, Wade CE, Aufderheide TP, Frascone RJ, Tallon JM, Kannas D, Williams C, Rowell SE, Schreiber MA, McKnight B, Meier EN, May S, Sheehan K, Bulger EM, Idris AH, Christenson J, Bosarge PL, Colella MR, Johannigman J, Cotton BA, Richmond NJ, Zielinski MD, Schlamp R, Klein L, Rizoli S, Gamber M, Fleming M, Hwang J, Vincent LE, Hendrickson A, Simonson R, Klotz P, Ferrara M, Sopko G, Witham W. J Trauma Acute Care Surg. 2020 Aug 28. doi: 10.1097/TA.0000000000002932. Online ahead of print. PMID: 32868544

Where Have All the Emergency Pediatric Mental Health Patients Gone During COVID19? Sheridan DC, Cloutier R, Johnson K, Marshall R. Acta Paediatr. 2020 Aug 16:10.1111/apa.15537. doi: 10.1111/apa.15537. Online ahead of print. PMID: 32799399 

Gyromitra Mushroom Toxicity. Horowitz KM, Kong EL, Horowitz BZ. 2020 Aug 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 29262102 

Phenytoin Toxicity. Iorga A, Horowitz BZ. 2020 Aug 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 29494051 

Racial disparities in out-of-hospital cardiac arrest interventions and survival in the Pragmatic Airway Resuscitation Trial. Lupton JR, Schmicker RH, Aufderheide TP, Blewer A, Callaway C, Carlson JN, Colella MR, Hansen M, Herren H, Nichol G, Wang H, Daya MR. Resuscitation. 2020 Oct;155:152-158. doi: 10.1016/j.resuscitation.2020.08.004. Epub 2020 Aug 11. PMID: 32795597

Prospective evaluation of airway management in pediatric out-of-hospital cardiac arrest. Hansen M, Wang H, Le N, Lin A, Idris A, Kornegay J, Schmicker R, Daya M. Resuscitation. 2020 Aug 11:S0300-9572(20)30311-7. doi: 10.1016/j.resuscitation.2020.08.003. Online ahead of print. PMID: 32795596

Outpatient Treatment of Low-Risk Pulmonary Embolism in the Era of Direct Oral Anticoagulants: A Systematic Review. Maughan BC, Frueh L, McDonagh MS, Casciere B, Kline JA. Acad Emerg Med. 2020 Aug 11. doi: 10.1111/acem.14108. Online ahead of print. PMID: 32779290

A comparison of trends in opioid dispensing patterns between Medicaid pharmacy claims and prescription drug monitoring program data. El Ibrahimi S, Hallvik S, Johnston K, Leichtling G, Choo E, Hartung DM. Pharmacoepidemiol Drug Saf. 2020 Sep;29(9):1168-1174. doi: 10.1002/pds.5097. Epub 2020 Aug 10. PMID: 32939909

Association of Implementing an Incentive Metric in the Oregon Medicaid Program With Effective Contraceptive Use. Rodriguez MI, Meath T, Huang J, Darney BG, McConnell KJ. JAMA Netw Open. 2020 Aug 3;3(8):e2012540. doi: 10.1001/jamanetworkopen.2020.12540. PMID: 32756928 

Medical Education Scholarship During a Pandemic: Time to Hit the Pause Button, or Full Speed Ahead? Sullivan GM, Simpson D, Artino AR Jr, Deiorio NM, Yarris LM. J Grad Med Educ. 2020 Aug;12(4):379-383. doi: 10.4300/JGME-D-20-00715. PMID: 32879670 

The Story of #GetMePPE and GetUsPPE.org to Mobilize Health Care Response to COVID-19 : Rapidly Deploying Digital Tools for Better Health Care. He S, Ojo A, Beckman AL, Gondi S, Gondi S, Betz M, Faust JS, Choo E, Kass D, Raja AS. J Med Internet Res. 2020 Jul 20;22(7):e20469. doi: 10.2196/20469. PMID: 32530813 

Seven things organisations should be doing to combat racism. Choo E. Lancet. 2020 Jul 18;396(10245):157. doi: 10.1016/S0140-6736(20)31565-8. PMID: 32682470 

Pivotal Role in the Community Response to Cardiac Arrest: The Smart Bystander. Chugh SS, Jui J, Salvucci A. J Am Coll Cardiol. 2020 Jul 7;76(1):54-56. doi: 10.1016/j.jacc.2020.05.034. PMID: 32616163 

A Medicaid Alternative Payment Model Program In Oregon Led To Reduced Volume Of Imaging Services. Lindner S, Kaufman MR, Marino M, O'Malley J, Angier H, Cottrell EK, McConnell KJ, DeVoe JE, Heintzman JR. Health Aff (Millwood). 2020 Jul;39(7):1194-1201. doi: 10.1377/hlthaff.2019.01656. PMID: 32634361

The impact of ventilation rate on end-tidal carbon dioxide level during manual cardiopulmonary resuscitation. Ruiz de Gauna S, Gutiérrez JJ, Ruiz J, Leturiondo M, Azcarate I, González-Otero DM, Corcuera C, Russell JK, Daya MR. Resuscitation. 2020 Jul 1:S0300-9572(20)30243-4. doi: 10.1016/j.resuscitation.2020.06.007. Online ahead of print. PMID: 32622015

Why the United States failed to contain COVID-19. Nowroozpoor A, Choo EK, Faust JS. J Am Coll Emerg Physicians Open. 2020 Jun 30:10.1002/emp2.12155. doi: 10.1002/emp2.12155. Online ahead of print. PMID: 32838383

Practice Gap in Atrial Fibrillation Oral Anticoagulation Prescribing at Emergency Department Home Discharge. Kea B, Waites BT, Lin A, Raitt M, Vinson DR, Ari N, Welle L, Sill A, Button D, Sun BC. West J Emerg Med. 2020 Jun 29;21(4):924-934. doi: 10.5811/westjem.2020.3.45135. PMID: 32726266 

Ventilation in Simulated Out-of-Hospital Cardiac Arrest Resuscitation Rarely Meets Guidelines. Neth MR, Benoit JL, Stolz U, McMullan J. Prehospital Emergency Care. 2020. Pages: 1-13 DOI: 10.1080/10903127.2020.1822481    

Can hands-on defibrillation be performed safely? Adler D, Helming A, Lupton J. Emerg Med J. 2020;37(9):585-586. doi:10.1136/emermed-2020-210497.2 

Dana Zive

It is with a heavy heart that we announce the passing of our esteemed colleague,  Dana Zive, Sunday, September 30, 2018.

 Dana was the Director of the Oregon POLST Registry, Associate Director of the OHSU Center for Ethics in Health Care, and a Research Assistant Professor in the OHSU Department of Emergency Medicine and CPR-EM.  She earned her B.S. in Environmental Chemistry and Toxicology at the University of Nevada, Reno, and her M.P.H. in Public Health Education and Biostats/Epidemiology from San Jose State University.  Dana joined OHSU in 2004, and her areas of focus included end-of-life care and emergency care research. 

 Dana was integrally involved in many DEM research efforts, including the Resuscitation Outcomes Consortium (many out-of-hospital interventional trials in cardiac arrest and trauma) and the Physician Orders for Life-Sustaining Treatment Program (POLST).  She was key in developing and implementing the Oregon electronic POLST registry, including legislated state funding. Dana has been a fundamental member of CPREM throughout our years of building infrastructure and growth.  She had a true research mind and a passion for data. She was our colleague and friend and will be dearly missed. 

Dana is survived by her husband and daughter (Lola, 8).   If you have a story about Dana you would like to share with her family, please send your thoughts to cookjen@ohsu.edu