BCMS Medical Record Fall 2020 - 36

Student Summer Research Projects
continued from page 35

Use of Electronic Medical
Record Data to Predict if a
Patient Suffering from an Out of
Hospital Cardiac Arrest Would
Benefit from Going to the
Catherization Laboratory
by Adam Sigal, MD; Traci Deaner, MSN, RN;
Aarika Ferko, Medical Student,
Department of Emergency Medicine,
Reading Hospital Tower Health
INTRODUCTION: Heart disease is one of the leading causes of
death in the United States, with recent statistics stating that, in
2017 alone, over 350,000 Americans suffered from out of hospital
cardiac arrests (Benjamin et al.). It is unknown to healthcare
providers what criteria should be used to determine if a patient who
experiences an out of hospital cardiac arrest should be sent to the
catherization laboratory for intervention. Catherizations can lead
to stent placement, balloon dilation, and placement of coronary
artery bypass grafts, which can help treat the cause of a patient's
cardiac arrest. However, not all patients should be sent to the lab
as there are some risks to catherization and an intervention will not
be achievable for all patients. This paper serves to describe what
factors, identified in past medical history and ambulance trip sheets,
can help physicians dictate if their patients should be sent to the
catherization laboratory or not.
METHODS: All adult patients suffering from an atraumatic out
of hospital cardiac arrest in February of 2013 through June of 2020
who were transported by ambulance to Reading Hospital Tower
Health and able to be resuscitated were selected for this retrospective
cohort study. A total of 294 patients were enrolled in this study,
where 88 patients were sent to the catherization laboratory.
Information provided in each patient's past medical history and
ambulance trip sheets was then extracted and placed into REDCap,
a HIPPA compliant data collection tool (REDCap). Currently, the
information for 115 out of 294 patients has been extracted. Upon
completion, this information will go to a statistician to be analyzed.
RESULTS: As this research is ongoing, statistically verified results
have not yet been found. So far, we have noticed that there
seems to be a correlation with patients that show ST-Elevation
Myocardial Infarction (STEMI) on their EKG and being sent to
the catherization lab where an intervention was appropriate. 29
out of 114 patients experienced a STEMI. Seventy-five percent of
these patients (22/29) were sent to the catherization laboratory and
seventy-two percent of these patients (16/22) were able to have an
intervention completed.

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CONCLUSION: Some patients greatly benefit from an urgent
catherization post cardiac arres, however, the identification of these
patients is difficult. There is a current knowledge gap in what criteria
dictate sending a patient to the catherization laboratory. Additionally,
there are few, if any, completed studies published on this topic.
This paper serves to identify the pretest probability that a patient
who suffers an out of hospital cardiac arrest will be sent to the
catherization laboratory and have an intervention performed.
SOURCES:
1. Benjamin, EJ, et al. "AHA 2019 Heart Disease and Stroke Statistics."
American College of Cardiology, 31 Jan. 2019, www.acc.org/latest-incardiology/ten-points-toremember/2019/02/15/14/39/aha-2019-heartdisease-and-stroke-statistics.
2. REDCap, www.project-redcap.org/software/.
Aarika Ferko is a graduate of Clemson University who is
currently a second-year medical student at the University
of Louisville School of Medicine in Louisville, Kentucky.
Aarika is an active member of the AMA ULSOM Chapter
and represented the chapter at the Physicians of the Future
Summit. She is a volunteer for the Parkinson's Support
Center of Kentuckiana and in the NICU of the Norton
Children's Hospital.

Validity of PECARN Clinical
Prediction Tool in Non-Pediatric
Community Hospitals
by Alexis Schoener, The Pennsylvania State University -
Berks Campus, Student Research Intern; McKenna Brower,
Syracuse University, Student Research Intern; Adam
Sigal, MD. Department of Emergency Medicine, Reading
Hospital, Reading, Pennsylvania. Christopher Valente, MD.
Department of Emergency Medicine, Reading Hospital,
Reading, Pennsylvania. Adrian Ong, MD. Department
of Emergency Medicine, Reading Hospital, Reading,
Pennsylvania. Samuel Wood, DO. Department of Emergency
Medicine, Reading Hospital, Reading, Pennsylvania.
Elizabeth Mannarelli, DO. Department of Emergency
Medicine, Reading Hospital, Reading, Pennsylvania.
Anthony Martin, BSN RN. Department of Emergency
Medicine, Reading Hospital, Reading, Pennsylvania.
Camilla Nettleton, BSN RN. Department of Emergency
Medicine, Reading Hospital, Reading, Pennsylvania. Traci
Deaner, MSN RN. Department of Emergency Medicine,
Reading Hospital, Reading, Pennsylvania. Alison Muller,
MLS (ASCP) MSPH. Department of Emergency Medicine,
Reading Hospital, Reading, Pennsylvania.

http://www.acc.org/latest-in http://www.project-redcap.org/software/ http://www.berkscms.org

BCMS Medical Record Fall 2020

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