Research
The Research Division for the Department of Emergency Medicine at Highland Hospital is focused on social emergency medicine and health equity, substance use disorders, public health, ultrasound, EMS, and critical care/cardiology research. Highland residents have the opportunity to explore existing research projects, and contribute or lead mentored projects in their desired content areas. Highland research faculty have been supported by grants from the NIH, CDC, the California Department of Health Care Services, among others.
Current Research Content Areas
The Alameda Health System Emergency Departments at Highland Hospital and San Leandro Hospital are sites in an NIH/NIDA funded multi-center clinical trial ED-INNOVATION led by Yale University Department of Emergency Medicine. The trial compares two types of treatment for patients with opioid use disorder: standard sublingual buprenorphine vs a 7-day depot injection of buprenorphine. Dr. Andrew Herring is a Co-Investigator for the multi-center trial, and the site-PI for Highland. Dr. Erik Anderson is the site-PI for San Leandro Hospital, and the site co-I for Highland Hospital. Dr. Nikita Joshi is the site co-I for San Leandro, and Dr. Amarinder Singh is the IT support analyst for Alameda Health System clinical sites. There are several other additional ongoing projects related to patients with substance use disorders, including a multi-center evaluation of the California Bridge Program led by Dr. Herring, naltrexone for patients with alcohol use disorder, long acting injectable buprenorphine in the ED, and micro- and macro-dosing of buprenorphine for patients who use fentanyl.
Follow these links for more information about the Highland ED Bridge and the California Bridge Program.
Strayer RJ, Herring AA, Nelson LS. Balancing Benefits and Harms on the Frontier of Buprenorphine Initiation. Ann Emerg Med. 2019 Sep;74(3):433-435. doi: 10.1016/j.annemergmed.2019.04.024. PMID: 31229393.
Herring AA, Schultz CW, Yang E, Greenwald MK. Rapid induction onto sublingual buprenorphine after opioid overdose and successful linkage to treatment for opioid use disorder. Am J Emerg Med. 2019 Dec;37(12):2259-2262. doi: 10.1016/j.ajem.2019.05.053. PMID: 31239086.
Valdovinos EM, Frazee BW, Hailozian C, Haro DA, Herring A. A Nonopioid, Nonbenzodiazepine Treatment Approach for Intractable Nausea and Vomiting in the Emergency Department. J Clin Gastroent. 2019 Sep 17. doi: 10.1097/MCG.0000000000001258. PMID: 31567626.
Montoy JCC, Coralic Z, Herring AA, Clattenburg EJ, Raven MC. Association of default electronic medical record settings with health care professional patterns of opioid prescribing in emergency departments: A randomized quality improvement study. JAMA Intern Med. 2020 Jan 21. doi: 10.1001/jamainternmed.2019.6544. PMID: 31961377.
Strayer R, Hawk K, Hayes BD, Herring AA, Ketcham E, LaPietra AM, Lynch JJ, Motov S, Repanshek Z, Weiner SG, Nelson LS. Management of Opioid Use Disorder in the Emergency Department: A White Paper Prepared for the American Academy of Emergency Medicine. J Emerg Med. 2020 Mar 28. doi: https://doi.org/10.1016/j.jemermed.2019.12.034. PMID: 32234267.
Herring AA. Postoverdose Initiation of Buprenorphine After Naloxone-Precipitated Withdrawal Is Encouraged as a Standard Practice in the California Bridge Network of Hospitals. Ann Emerg Med. 2020 Apr;75(4):552-553. doi: 10.1016/j.annemergmed.2019.12.015. PMID: 32216889.
The HIV and HCV screening program is led by Douglas White, MD, a Highland Emergency Physician, Assistant Residency Director, and a Levitt Center Senior Scientist, who is an international authority on ED-based screening and linkage to care. Dr. White’s research and clinical care interests are centered on advancing the diagnosis of HIV and HCV infection through integrated and streamlined ED-based testing. The screening program has received grant support from a variety of funders, including the Centers for Disease Control and Prevention, California State Office of AIDS, Gilead Sciences, and the National Institutes of Health. This work has resulted in over 50 abstract presentations at national meetings and 30 peer-reviewed publications. Current research projects include a pilot program evaluating the role of pre-exposure prophylaxis (PrEP) for ED patients at risk of acquiring HIV; a multi-centered collaboration to further investigate rapid test diagnostics in the ED setting; capacity building projects to improve linkage to care for newly-diagnosed HIV positive patients in San Francisco and Oakland; and participation in a National Institutes of Health clinical trial evaluating HCV screening outcomes.
Follow this link for more information about the HIV/HCV screening program.
Galbraith JW, Anderson ES, Hsieh Y, Franco RA, Donnelly JP, Rodgers JB, Schechter-Perkins EM, Thompson WW, Nelson NP, Rothman RE, White DAE. High Prevalence of Hepatitis C Infection Among Adult Patients at Four Urban Emergency Departments — Birmingham, Oakland, Baltimore, and Boston, 2015–2017. MMWR Morb Mortal Wkly Rep. 2020;69:569–574. doi: http://dx.doi.org/10.15585/mmwr.mm6919a1.
Anderson ES, Russell C, Basham K, Montgomery M, Lozier H, Crocker A, Zuluaga M, White DAE. High prevalence of injection drug use and blood-borne viral infections among patients in an urban emergency department. PLoS ONE. 2020 June 4;15(6): e0233927. https://doi.org/10.1371/journal.pone.0233927. PMID: 32497108
White, D. A., Todorovic, T., Petti, M. L., Ellis, K. H., & Anderson, E. S. (2018). A Comparative Effectiveness Study of Two Nontargeted HIV and Hepatitis C Virus Screening Algorithms in an Urban Emergency Department. Annals of emergency medicine, 72(4), 438-448.
Anderson, E. S., & White, D. A. (2018). Public health conditions for successful broad-scale integration of HIV and HCV screening in emergency departments. American journal of public health, 108(5), 591.
Anderson, E. S., Galbraith, J. W., Deering, L. J., Pfeil, S. K., Todorovic, T., Rodgers, J. B., … & White, D. A. (2017). Continuum of care for hepatitis C virus among patients diagnosed in the emergency department setting. Clinical Infectious Diseases, 64(11), 1540-1546.
The ultrasound research division has produced high quality research and have been national and international leaders in emergency ultrasound research for more than a decade. Ultrasound research is led by Ultrasound Director Arun Nagdev, Fellowship Director Daniel Mantuani, and ultrasound faculty Poornima Yechoor, Andrea Dreyfuss and David Martin. This group of faculty regularly publish ultrasound research with a focus on ultrasound-guided regional anesthesia, rapid diagnostic protocols, and international ultrasound development. Most recently, the team developed and disseminated the CASA ultrasound protocol for cardiac arrest, which was widely adopted across emergency departments, and have been leaders on the utility of ultrasound during the COVID-19 pandemic. Drs. Andrea Dreyfuss and David Martin founded the international emergency ultrasound group, and oversee research, development, and education for an ultrasound fellowship in Peru.
Follow this link for more information on the EM Ultrasound program and their research.
Mantuani D, Luftig J, Herring A, Dreyfuss A, Nagdev A. A Novel Technique to Reduce Reliance on Opioids for Analgesia from Acute Appendicitis: The Ultrasound-guided Erector Spinae Plane Block. Clin Pract Cases Emerg Med. 2019 May 29. doi: 10.5811/cpcem.2019.4.42117. eCollection 2019 Aug.
Shaahinfar A, Ghazi-Askar ZM, Siroker H, Nagdev A. Anomalous Left Coronary Artery From the Pulmonary Artery Presenting as Dilated Cardiomyopathy With Regional Wall Motion Abnormality on Point-of-Care Ultrasound. Pediatr Emerg Care. 2019 Jul;35(7):516-518. doi: 10.1097/PEC.0000000000001741. PMID: 30702648.
Mantuani D, Luftig J, Herring A, Mian M, Nagdev A. Successful emergency pain control for acute pancreatitis with ultrasound guided erector spinae plane blocks. Am J Emerg Med. 2020 Feb 5;S0735-6757(20)30078-4. doi: 10.1016/j.ajem.2020.02.005PMID: 32081553
Rider AC, Dreyfuss A, Inga R. Image to Fit the Clinical Picture: Point-of-care Ultrasound Assessment of Ebstein’s Anomaly in Peru. Clin Pract Cases Emerg Med. 2020 Feb 24;4(2):222-224. doi: 10.5811/cpcem.2019.12.44783. eCollection 2020 May. PMID: 32426677.
Farrow R 2nd, Becherer-Bailey G, Mantuani D, Nagdev A. Early Multi-organ Point-of-Care Ultrasound Evaluation of Respiratory Distress During SARS-CoV-2 Outbreak: Case Report. Clin Pract Cases Emerg Med. 2020 Apr 15;4(2):129-133. doi: 10.5811/cpcem.2020.4.47524. eCollection 2020 May. PMID: 32426653.
Liu RB, Tayal VS, Panebianco NL, Tung-Chen Y, Nagdev A, Shah S, et al. Ultrasound on the Frontlines of COVID-19: Report from an International Webinar. Acad Emerg Med. 2020 Apr 29. doi: 10.1111/acem.14004. PMID: 32348585.
Luftig J, Dreyfuss A, Mantuani D, Howell K, White A, Nagdev A. A new frontier in pelvic fracture pain control in the ED: Successful use of the pericapsular nerve group (PENG) block. Am J Emerg Med. 2020 May 28;S0735-6757(20)30447-2. doi: 10.1016/j.ajem.2020.05.085. PMID: 32532621
Drs. Amandeep Singh and Martha Montgomery lead an active group of researchers who explore cardiology and resuscitation in emergency medicine. Their work has led to multiple recent publications, including the CASA protocol, and presentations and local, national and regional conferences.
Visit the Emergency Cardiology and Resuscitation Fellowship page for more information.
Clattenburg EJ, Wroe PC, Gardner K, Schultz C, Gelber J, Singh A, Nagdev A. Implementation of the Cardiac Arrest Sonographic Assessment (CASA) protocol for patients with cardiac arrest is associated with shortened CPR pulse checks. Resuscitation 2018;131:69-73. PMID 30071262.
Gardner KF, Clattenburg EJ, Wroe P, Singh A, Mantuani D, Nagdev A. The Cardiac Arrest Sonographic Assessment (CASA) exam – A standardized approach to the use of ultrasound in PEA. Am J Emerg Med 2018;36:729-731. PMID 28851499.
Gelber J, Montgomery M, Singh A. A Prospective Study of the Incidence of Intracranial Hemorrhage in Survivors of Out of Hospital Cardiac Arrest. Am J Emerg Med 2020: accepted, pending publication.
Hoang, A., Singh, A., & Singh, A. (2020). Comparing physicians and experienced advanced practice practitioners on the interpretation of electrocardiograms in the emergency department. The American Journal of Emergency Medicine.
Singh A. ACS Mimics Part II: Non-ACS causes of ST-segment depression and T-wave abnormalities. In Mattu A, Tabas J, and Brady W (eds) Electrocardiography in Emergency, Acute, and Critical Care. 2nd ed. ACEP publisher 2019;pp 159-170.
Tafoya C, Singh A. Cardiac Memory: A Case Report and Review of Literature. J Emerg Med. 2019 Jul;57(1):85-93. doi: 10.1016/j.jemermed.2019.02.018. PMID: 31047746.
Wroe PC, Clattenburg EJ, Gardner K, Gelber J, Schultz C, Singh A, Nagdev A. Emergency department use of a mechanical chest compression device frequently causes unanticipated interruptions in cardiopulmonary resuscitation. Resuscitation 2018;133:e3-e4. PMID 30244046.
Dr. Bradley Frazee leads research focused on infectious diseases in the acute care setting. He is the principal investigator and has published multiple articles regarding antibiotic-resistant skin and soft tissue infections, antibiotic-resistant bacterial infections, diagnostic testing for influenza, and procalcitonin for predicting bacterial pneumonias in patients with COPD exacerbations.
Breyre, A., & Frazee, B. W. (2018). Skin and soft tissue infections in the emergency department. Emergency Medicine Clinics, 36(4), 723-750.
Mantuani, D., Frazee, B. W., Fahimi, J., & Nagdev, A. (2016). Point-of-care multi-organ ultrasound improves diagnostic accuracy in adults presenting to the emergency department with acute dyspnea. Western Journal of Emergency Medicine, 17(1), 46.
Frazee, B. W., de la Guardia, A. R. H., Alter, H., Chen, C. G., Fuentes, E. L., Holzer, A. K., … & Dekker, C. L. (2018). Accuracy and discomfort of different types of intranasal specimen collection methods for molecular influenza testing in emergency department patients. Annals of Emergency Medicine, 71(4), 509-517.
Dr. Gene Hern is an active researcher in EMS and along with Dr. Charlotte Wills and David Duong on medical education related topics. The focus of EMS research most recently has been on the capacity, assessment and treatment of patients with opioid use disorders in the prehospital setting. This work continues to inform local and state policies, and has led to protocols integrating naloxone distribution and buprenorphine administration in the prehospital setting, as well as organizing Alameda County into Opioid Receiving Center Emergency Departments. Medical Education research has focused on the effectiveness and acceptability of various interview techniques, as well as interdisciplinary training programs.
Glober N, Hern G, McBride O, Mercer MP. Variations in the California Emergency Medical Services Response to Opioid Use Disorder. West J Emerg Med. 2020 Apr 16;21(3):671-676. doi: 10.5811/westjem.2019.12.45189. PMID: 32421518.
Bird SB, Hern HG, Blomkalns A, Deiorio NM, Haywood Y, Hiller KM, Dunleavy D, Dowd K. Innovation in Residency Selection: The AAMC Standardized Video Interview. Acad Med. 2019 Oct;94(10):1489-1497. doi: 10.1097/ACM.0000000000002705. PMID: 30870151.
Gallahue FE, Hiller KM, Bird SB, Calderone Haas MR, Deiorio NM, Hern HG, Jarou ZJ, Pierce A, Geiger T, Fletcher L. The AAMC Standardized Video Interview: Reactions and Use by Residency Programs During the 2018 Application Cycle. Acad Med. 2019 Oct;94(10):1506-1512. doi: 10.1097/ACM.0000000000002714. PMID: 30893064.
Sorge R, Li-Sauerwine S, Fernandez J, Hern G. How well do core faculty understand the emergency medicine milestones? West J Emerg Med. 2019 Dec 19;21(1):160-162. doi: 10.5811/westjem.2019.11.44289. PMID: 31913838.
Rider AC, Anaebere TC, Nomura M, Duong D, Wills CP. A Structured Curriculum for Interprofessional Training of Emergency Medicine Interns. West J Emerg Med. 2019 Dec 18;21(1):149-151. doi: 10.5811/westjem.2019.11.44139. PMID: 31913836.
Healthy equity informs much of the work being done at Highland Hospital, but there are also a dedicated team of researchers that focus on health disparities and health equity research. Drs. Berenice Perez and Jocelyn Freeman Garrick have pioneered diversity as a priority for residents education selection. Dr. Jocelyn Freeman Garrick is a leader in health professions pipeline programs and directs a non-profit called Mentoring in Medicine and Science, which has been highlighted in Annals of Emergency Medicine. Dr. Perez helps to lead a multidisciplinary team of researchers who are exploring health disparity and equity issues during the COVID-19 pandemic; this work has led to collaborations with county public health departments specifically examining high rates of disease in the Latinx population and the Maya Mam community in Oakland.
Garrick, J. F., Perez, B., Anaebere, T. C., Craine, P., Lyons, C., & Lee, T. (2019). The Diversity Snowball Effect: The Quest to Increase Diversity in Emergency Medicine: A Case Study of Highland’s Emergency Medicine Residency Program. Annals of Emergency Medicine, 73(6), 639-647.
Garrick JF. Commentary: Screening, Education, and Advocacy on Social Determinants of Health: The Complete Package for Treating the Whole Patient. Ann Emerg Med. 2019 Nov;74(5S):S25-S27. doi: 10.1016/j.annemergmed.2019.08.437. PMID: 31655668.
Boatright, Dowin, Jeremy Branzetti, David Duong, Marquita Hicks, Joel Moll, Marcia Perry, Ava Pierce et al. “Racial and ethnic diversity in academic emergency medicine: how far have we come? Next steps for the future.” AEM Education and Training 2 (2018): S31-S39.
Anderson E, Bernstein E, Xuan Z, Alter HJ. Inventing Social Emergency Medicine: Summary of Common and Critical Research Themes Using a Modified Haddon Matrix. Ann Emerg Med. 2019 Nov;74(5S):S74-S77. doi: 10.1016/j.annemergmed.2019.08.464. PMID: 31655685.
Caetano R, Cunradi CB, Alter HJ, Mair C, Yau RK. Drinking and Intimate Partner Violence Severity Levels Among U.S. Ethnic Groups in an Urban Emergency Department. Acad Emerg Med. 2019 Aug;26(8):897-907. doi: 10.1111/acem.13706. PMID: 30706610.
Anderson ES, Greenwood-Ericksen M, Wang NE, Dworkis DA. Closing the gap: Improving access to trauma care in New Mexico (2007-2017). Am J Emerg Med. 2019 Nov;37(11):2028-2034. doi: 10.1016/j.ajem.2019.02.030. PMID: 30824273.