Medical Student Research Fellowship for Summer 2010

Mentor: Kurt Kleinschmidt
Department: Department of Surgery; Division of Emergency Medicine
Room number: Parkland - North Texas Poison Center (Emergency Room Parking Garage; Basement level)
Mail Code: 8579
Phone number: 214-590-1354
E-mail: kurt.kleinschmidt@utsouthwestern.edu
Project title: Outcomes of patients who present to an emergency department with
severe hypertension

Human subjects IRB approved project number (where applicable): Pending

Animal subjects IRB approved project number (where applicable): Not Applicable

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects) Patient Based

Brief Description of Project:

Among patients who present to the emergency room with a systolic blood pressure ? 180 mmgHg or diastolic blood pressure ? 110 mmHg; what are the 30-day outcomes and how do they relate to various demographic factors and the evaluation, management, and discharge plan done during the index visit.
We will conduct a prospective, observational study with a convenience sample from May 1, 2010 to October 1, 2010 in the Emergency Services Department (ESD) at Parkland Memorial Hospital in Dallas, Texas. Observations will be made and data recorded on a preformed, hardcopy case report form (CRF) by one research assistant (RA). The RA will be trained on the background of the study and on the use of the CRF. However, he will be blinded to primary investigator's opinions on this topic.
Patients interested in participating in the study will be consented by the RA. During the index visit, the RA will complete the index CRF by both talking directly with the patient and by using the health information technology including EPIC and OACIS. The RA will confirm contact numbers with the patient. The RA will do the preceding actions for 4 weeks; after which no new patients will be enrolled. During these four weeks, the RA will do varied times of-the-day around the clock and varied days of the week to optimize sampling diversity.
The RA will then use the remaining time of the summer research period to do the follow-up portion of the study. The RA will contact the patient ~ 30 days after the index ER visit. The RA will document answers to predetermined questions onto a follow-up CRF. If the patient had obtained any healthcare at Parkland since the index ER visit, the RA will obtain further information from EPIC and document it on a predetermined, hard copy CRF. The RA will input the data from the CRF into an Excel spreadsheet.
The outcomes are delineated in the CRF. However, they include (1) occurrence of a follow-up visit with a primary care provider, (2) number of times the blood pressure has been checked, (3) the actual filling of prescriptions, (4) the actual taking of the prescribed medications, (5) the occurrence of any ED visits and the diagnosis if done, and (6) the occurrence of hospitalizations and the diagnosis if done.

Previous Research Activities or Publications with Medical Students:

Use of the Triage Cardio ProfilER in the Evaluation of Chest Pain Patients in an Urban Emergency Department. 2004.

The Management of Acute Undifferentiated Agitation in the Emergency Department - An Observational Study. 2008.