Research & Scholarship
We are translating experience into evidence-based knowledge for the advancement of critical patient care.
Large patient volumes and a phenomenal array of state-of-the-art resources allow innovation to thrive in the Emergency Department at UT Southwestern. Our passion and curiosity perpetually raise the bar and set new standards in care across the full spectrum of subspecialties within our field.
Cardiac Arrest and Resuscitation
- Erik Kulstad leads as site principal investigator for the AWARE-II study investigating quality of brain resuscitation, cognition, and functional recovery in cardiac arrest. He also has significant expertise in temperature management associated with electrophysiology/critical care and medical device development.
- Early in our history, UTSW Emergency Medicine has led critical research in cardiac arrest and resuscitation medicine. This continues to be a main area of focus of active publications and grants. This team is led by Dr. Ahamed Idris, who also serves as the Department’s research director.
“In the last two decades, measurement of the quality of CPR has led to improvements in critical aspects of chest compression (fraction, rate, and depth) that are associated with improved survival. For the first time we have developed machine-learning methods to measure quality of ventilation during CPR, which we think will lead to additional improvements in survival. We are also developing methods to automate cardiac arrest registries that will contribute fundamental knowledge to resuscitation science.”
Association of ventilation with outcomes from out-of-hospital cardiac arrest, Resuscitation 2019
Automatic Detection of Ventilations During Mechanical Cardiopulmonary Resuscitation. IEEE J Biomed Health Inform 2020
Effect of a Strategy of Initial Laryngeal Tube Insertion vs Endotracheal Intubation on 72-Hour Survival in Adults With Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial, JAMA 2018
Variation in Bystander Cardiopulmonary Resuscitation Delivery and Subsequent Survival From Out-of-Hospital Cardiac Arrest Based on Neighborhood-Level Ethnic Characteristics, Circulation 2020
Survival After Intravenous Versus Intraosseous Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Shock-Refractory Cardiac Arrest. Circulation 2020
Effect of Out-of-Hospital Tranexamic Acid vs Placebo on 6-Month Functional Neurologic Outcomes in Patients With Moderate or Severe Traumatic Brain Injury. JAMA 2020
Dr. Deborah Diercks and Dr. Mark Courtney have a long track record in conducting federal- and industry-sponsored research trials investigating cardiac ischemia, congestive heart failure, and venous thromboembolism. They are leading national experts in disease detection, evaluation of diagnostic testing, risk stratification, and treatment trials.
“Patients come to the ED to be reassured or to have a critical disease discovered and treated appropriately. Efforts to discover how we best implement the right test for the right patients, at the right time, in a manner that optimizes accuracy, safety, and efficiency is key to much of what we do 24/7.”
Comparison of 4 Acute Pulmonary Embolism Mortality Risk Scores in Patients Evaluated by Pulmonary Embolism Response Teams. JAMA Network Open 2020
Risk Stratification of Older Adults Who Present to the Emergency Department With Syncope: The FAINT Score. Annals of Emergency Medicine 2019
Using High Sensitivity Troponins to Rule Out Acute Coronary Syndrome and Lower Admission Rates Cardiology in Review Nov/Dec. 2019
Emergency Disaster and Global Health
“Over the next one to three years, we will continue to develop international multidisciplinary collaborations to advance the science of disaster medicine and global health. Our collaborative grant with Rabin Medical Center is addressing what the evidence is supporting medical and health system preparedness for mass casualties from limited nuclear and radiologic incidents.”
Environmental health workforce - essential for interdisciplinary solutions to the COVID-19 pandemic. Disaster Med Public Health Prep. 2020
Protocols for personal protective equipment in a COVID-19 medical shelter. Disaster Med Public Health Prep. 2020
COVID-19 Contact tracing solutions for mass gatherings. Disaster Med Public Health Prep. 2020
COVID-19 Community Stabilization and Sustainability Framework: An Integration of the Maslow Hierarchy of Needs and Social Determinants of Health. Disaster Med Public Health Prep. 2020
Emergency Medical Services (EMS)
The Emergency Medical Services Division of the Department of Emergency Medicine is actively involved in studying critical areas of science related to improving the care of the acutely ill and injured in the prehospital setting.
One recent area of interest has involved linking EMS medical records to hospital records in patients with out-of-hospital cardiac arrest, a project conducted in collaboration with the American Heart Association.
Current efforts also include the minimum requirement for training in dispatch centers to provide instructions for cardiac arrest management, and a focus on electrocardiographic changes that are predictive for sudden death.
Opioid vs. non-opioid pain medication
Another recent effort brought focus on the use of opioid versus non-opioid pain medication in the field, including obstacles to the use of non-opioid treatment.
In times of need, the ED is the destination for persons at risk from life-threatening pathogens. Joby Thoppil, M.D. and Sam McDonald, M.D. are working together to bring efficiency to the evaluation of sepsis and to better understand the unique patient subtypes and pathogen/metabolic/host factors most predictive of outcome.
- Deborah Diercks, M.D. has brought her expertise in disease detection and lab testing to the domain of COVID and leads multiple studies analyzing the disease prevalence rate, development of immunity and overall scope of the problem among high risk populations out of the ED. This has included over $500,000 to test over 1,000 people for COVID who are followed over time. These projects are ongoing in EMS, police frontline providers, and most recently, childcare workers.
- Mark Courtney, M.D. has led efforts in support of the RECOVER multicenter ED-based COVID registry that seeks to develop prediction rules for who is likely to have a positive test as well as who is likely to have an adverse outcome of death, ICU care, or mechanical ventilation.
- Ahamed Idris, M.D. has led our efforts as a site for the COVERED study analyzing exposure, transmission and impact of COVID among ED personnel. He is also leading the INSPIRE study funded by the Centers for Disease Control and Prevention.
- Sam McDonald, M.D. is participating in a leadership role within our institution on the PRESTO study using signals from the EMR, blood and other sources to predict severity of illness, funded by Verily.
“With the abundance of resources at UTSW and large patient volumes in our emergency departments, we are an ideal location to study emerging pathogens. We aim to translate experience into evidence-based knowledge to best serve our patients.”
Informatics and Health Services Research
We are growing expertise in our capacity to access, analyze, and aggregate large quantities of data from the electronic medical record to systematically understand the complex processes of acute emergent care and provide real time intelligence to support and direct the management of our patients. We can further our scope by coupling with other health systems such as Texas Health Resources in order to understand what happens to our patients when they leave not just our ED but our health system.
Dr. Sam McDonald has led efforts to utilize the EHR and our patients’ data to implement knowledge management systems that enable our clinicians to provide the highest quality of care for patients. His work has helped automate serial testing with a novel high-sensitivity troponin assay used when evaluating patients for possible cardiac ischemia, a test UTSW and Parkland were among the first EDs in the United States to implement. Additionally, he has utilized the EHR to provide automated decision support to streamline sepsis care pathways and now supplement COVID testing and risk stratification.
"With the increasing complexity and volume of patients attending the ED, the cost of decisions made with inadequate information becomes detrimental. With the advancement of the EHR, realizing its capacity for not only knowledge management and care delivery but also knowledge generation is the future of medicine and a goal of not only this department but also UT Southwestern."
Impact of High-sensitivity Troponin Testing on Operational Characteristics of an Urban Emergency Department. Acad Emerg Med 2020
Possible Missed Acute Coronary Syndrome Rate in North Texas: Is There Room to Improve? Crit Pathw Cardiol. 2019
- Kurt Kleinschmidt is the site-PI for a NIH HEAL Initiative, ED-INNOVATION, to implement buprenorphine initiation out of emergency departments and to assess the efficacy of extended-release injectable buprenorphine versus sublingual buprenorphine in emergency department patients.
- James Cao leads the site in another NIH HEAL Initiative-funded research network, EPPIC-Net, to conduct phase two clinical trials of non-opioid therapeutics for acute and chronic pain.
- Dr. Kim Aldy, a recent graduate of the UT Southwestern medical toxicology fellowship, is the program manager for the Toxicology Investigators Consortium (ToxIC). She has been instrumental in obtaining a recent $1 million contract award from the FDA for a multicenter COVID-19 pharmacovigilance project, in which UT Southwestern will be an integral part of.
“The UT Southwestern Division of Medical Toxicology provides world-class patient care to poisoned and envenomated patients. We have a panel of leading experts whose interests range from addiction medicine to forensic toxicology. Our faculty have been active in multicenter research efforts in addiction medicine and in toxicology registry studies.”
Review of Health Consequences of Electronic Cigarettes and the Outbreak of Electronic Cigarette, or Vaping, Product Use-Associated Lung Injury. Journal of Medical Toxicology 2020
Clinical Features of E-cigarette, or Vaping, Product Use-Associated Lung Injury in Teenagers. Pediatrics 2020
Trends in Snakebites Related to Texas Tropical Storms and Hurricanes, 2000-2017. Wilderness Environ Med 2020
- UTSW is a participating site for the NIH-funded SIREN network of emergency medicine acute care research institutions. This work focuses on acute time-dependent care interventions in neurologic, cardiovascular, and traumatic emergencies.
- Studies in Process:
Additional Studies in Planning or Enrollment
- BNP and troponin biomarker studies: Supported by Siemens
- TRUST: D-Dimer biomarker study supported by Stago
- Sickle Cell: NIH-funded study with Dr. Ava Pierce as site investigator
- ACCESS: Post-cardiac arrest immediate vs. later catheterization supported by NIH
- Dallas Ft. Worth Cardiac Arrest Database Study: Supported by AHA and University of Washington
- HeartSine AED Study: Bioimpedance amplitude and chest compression depth supported by HeartSine/Stryker
- Multi-center Ventilation in Cardiac arrest study: Additional data analysis planned from the Resuscitation Outcomes Consortium project with a recent R21 grant submitted to NIH
- TBIT: Traumatic brain injury study of novel biomarker panel to identify minor brain injury.
- Short-stay unit study: Treatment of mild congestive heart failure in ED-based short stay unit as alternative to admission. Funding from AHRQ.
- INSPIRE Registry: For adults 18+ who have experienced COVID-19 symptoms and been tested recently. Funded by the CDC. More information here.
Research Staff and Resources
The Department currently supports two research coordinators as well as two people in research administration to assist with pre- and post-award management, IRB submission and maintenance, and other regulatory work. There are additional research personnel in the Department dedicated to cardiac arrest and resuscitation research.
Director, Department of Emergency Medicine Research