Russ Braun - Academia.edu (original) (raw)
Papers by Russ Braun
The Journal of Emergency Medicine, 2015
Acute limb ischemia (ALI), although uncommon, can present with profound symptoms, including disab... more Acute limb ischemia (ALI), although uncommon, can present with profound symptoms, including disabling pain in the setting of acute vascular and neurologic deficits. The most appropriate diagnostic and therapeutic strategy has evolved with emerging technologies inclusive of less-invasive endovascular diagnostic and therapeutic options. We present a case of ALI to illustrate the diagnostic and therapeutic approaches with a summary of the most common literature. Utilizing the clinical findings applied to the Rutherford classification, the emergency physician, in consultation with a vascular surgeon and interventional radiologist, can strategize a methodical approach for better clinical outcomes, often with less-invasive endovascular interventions, ideally within 6 h of symptom onset. We present a case of ALI to illustrate the diagnostic and therapeutic approach with a summary of the most current literature. Emergency physicians should be aware of optimized clinical outcomes with the use of time-sensitive enhanced endovascular therapies as a recommended option for the best outcomes for the treatment of ALI.
Emergency Medicine Clinics of North America, 1997
This article reviews the pearls and pitfalls of high-altitude sickness, decompression sickness, a... more This article reviews the pearls and pitfalls of high-altitude sickness, decompression sickness, and barotrauma; new findings relevant to the near-drowning patient; continued controversies on hyperbaric oxygen for carbon monoxide poisoning; pitfalls in hypothermia management; and updates on the management of venomous snakebites.
Academic Emergency Medicine, 1999
To explore whether patients in a public ED had poorer health than patients in a private ED, the a... more To explore whether patients in a public ED had poorer health than patients in a private ED, the authors compared the physical and mental health statuses of patients seeking emergency care. A cross-sectional observational study of all adult patients, regardless of acuity, seen during two 24-hour periods in spring 1997 in an urban county trauma center (68,000 annual visits) and a private community ED (35,000 annual visits). Scores on the Physical Component Summary (PCS) and the Mental Component Summary (MCS) scales of the Medical Outcomes Study 12-Item Short-Form Health Survey (SF-12) were compared between sites, with published national norms, and with hospital admission. Of 571 eligible patients, 392 (69%) completed the SF-12. Patients in the public ED had a mean PCS score of 40.1, compared with 43.7 for patients in the private ED, for a difference of 3.6 points (p < 0.01; 95% CI = 0.9 to 6.1). After controlling for age, sex, ethnicity, triage acuity, ambulance arrival, and insurance status, this difference increased to 3.9 points (p = 0.02; 95% CI = 0.7 to 7.0). The mean MCS score among public ED patients was 44.1, compared with 46.5 in the private ED population, for a difference of 2.4 (p = 0.08; 95% CI = -0.3 to 5.0); after adjustment this difference increased to 2.5 (p = 0.15; 95% CI = -0.9 to 5.8), but remained statistically not significant. While all scores were significantly lower than national norms (mean PCS 50.1, mean MCS 50.0), patients in the public ED scored consistently lowest. PCS score was significantly inversely correlated with admission, with each point decrease in PCS score increasing the odds of admission by 0.05 (95% CI = 0.01 to 0.08), and conferring an odds ratio of 5.1 (95% CI = 1.2 to 21.1) for admission among the 25th percentile for PCS scores. Patients seeking care in the public ED had lower adjusted physical health status scores than comparable patients obtaining care in a private ED. The SF-12 is sufficiently responsive to detect hypothesized differences between ED populations, and correlates well with admission decisions.
The Journal of Emergency Medicine, 2015
Acute limb ischemia (ALI), although uncommon, can present with profound symptoms, including disab... more Acute limb ischemia (ALI), although uncommon, can present with profound symptoms, including disabling pain in the setting of acute vascular and neurologic deficits. The most appropriate diagnostic and therapeutic strategy has evolved with emerging technologies inclusive of less-invasive endovascular diagnostic and therapeutic options. We present a case of ALI to illustrate the diagnostic and therapeutic approaches with a summary of the most common literature. Utilizing the clinical findings applied to the Rutherford classification, the emergency physician, in consultation with a vascular surgeon and interventional radiologist, can strategize a methodical approach for better clinical outcomes, often with less-invasive endovascular interventions, ideally within 6 h of symptom onset. We present a case of ALI to illustrate the diagnostic and therapeutic approach with a summary of the most current literature. Emergency physicians should be aware of optimized clinical outcomes with the use of time-sensitive enhanced endovascular therapies as a recommended option for the best outcomes for the treatment of ALI.
Emergency Medicine Clinics of North America, 1997
This article reviews the pearls and pitfalls of high-altitude sickness, decompression sickness, a... more This article reviews the pearls and pitfalls of high-altitude sickness, decompression sickness, and barotrauma; new findings relevant to the near-drowning patient; continued controversies on hyperbaric oxygen for carbon monoxide poisoning; pitfalls in hypothermia management; and updates on the management of venomous snakebites.
Academic Emergency Medicine, 1999
To explore whether patients in a public ED had poorer health than patients in a private ED, the a... more To explore whether patients in a public ED had poorer health than patients in a private ED, the authors compared the physical and mental health statuses of patients seeking emergency care. A cross-sectional observational study of all adult patients, regardless of acuity, seen during two 24-hour periods in spring 1997 in an urban county trauma center (68,000 annual visits) and a private community ED (35,000 annual visits). Scores on the Physical Component Summary (PCS) and the Mental Component Summary (MCS) scales of the Medical Outcomes Study 12-Item Short-Form Health Survey (SF-12) were compared between sites, with published national norms, and with hospital admission. Of 571 eligible patients, 392 (69%) completed the SF-12. Patients in the public ED had a mean PCS score of 40.1, compared with 43.7 for patients in the private ED, for a difference of 3.6 points (p < 0.01; 95% CI = 0.9 to 6.1). After controlling for age, sex, ethnicity, triage acuity, ambulance arrival, and insurance status, this difference increased to 3.9 points (p = 0.02; 95% CI = 0.7 to 7.0). The mean MCS score among public ED patients was 44.1, compared with 46.5 in the private ED population, for a difference of 2.4 (p = 0.08; 95% CI = -0.3 to 5.0); after adjustment this difference increased to 2.5 (p = 0.15; 95% CI = -0.9 to 5.8), but remained statistically not significant. While all scores were significantly lower than national norms (mean PCS 50.1, mean MCS 50.0), patients in the public ED scored consistently lowest. PCS score was significantly inversely correlated with admission, with each point decrease in PCS score increasing the odds of admission by 0.05 (95% CI = 0.01 to 0.08), and conferring an odds ratio of 5.1 (95% CI = 1.2 to 21.1) for admission among the 25th percentile for PCS scores. Patients seeking care in the public ED had lower adjusted physical health status scores than comparable patients obtaining care in a private ED. The SF-12 is sufficiently responsive to detect hypothesized differences between ED populations, and correlates well with admission decisions.