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Emergency Medicine Research

Our residency program considers curiosity an important character trait of all successful emergency physicians.

We believe research is the process of asking and answering questions in a scientifically valid way. This is why we focus on questions regarding the best ways to deliver care to our patients, the most effective ways to teach and learn as healthcare providers, and how to most efficiently work in teams.

Our faculty members and residents engage in meaningful scholarly work including quality-based, educational, and clinical research. Faculty take an active part in encouraging and supporting residents in their research pursuits. 

Ongoing areas of interest include:

    • Addiction Medicine & Opioid Overdose Prevention and Treatment;
    • Development of Free Open-Access Educational Material;
    • Diagnostic Applications of Ultrasound;
    • Disparities in EMS Care Delivery;
    • Resource utilization for vulnerable patient populations;
    • Respiratory support;
    • Sepsis Prevention and Treatment; and
    • Trauma and Pre-hospital Care Performance Improvement

When the COVID-19 pandemic began, our faculty contributed to research that helped shape treatment protocols. Our research director, Dr. Jessica Whittle, authored multiple sections of the ACEP COVID-19 Field Guide and currently leads multiple research projects with students, residents, and faculty.

 

Published Research

  1. Farcas AM, Bowers KJ, et al. Disparities in Emergency Medical Services Care Delivery in the United States: A Scoping Review. Prehosp Emerg Care. 2023;27(8):1058-1071. PMID: 36369725. DOI: 10.1080/10903127.2022.2142344
  2. Sciarretta C, Greenberg J, Wyatt KD, Whittle JS. Back to basics with newer technology: Should we focus on reducing work of breathing earlier? Front Med (Lausanne). 2022 Dec 2;9:1070517. doi: 10.3389/fmed.2022.1070517. PMID: 36530918; PMCID: PMC9755340.
  3. Wyatt KD, Goel NN, Whittle JS. Recent advances in the use of high flow nasal oxygen therapies. Front Med (Lausanne). 2022 Oct 10;9:1017965. doi: 10.3389/fmed.2022.1017965. PMID: 36300187; PMCID: PMC9589055
  4. Whittle JS, Sethi J, Volakis LI, Greenberg J. Supplementation of High Velocity Nasal Insufflation with a Nonrebreather Mask for Severe Hypoxemic Respiratory Failure in Adult Patients with COVID-19. Case Rep Crit Care. 2022 May 24;2022:5004108. doi: 10.1155/2022/5004108. PMID: 35656503; PMCID: PMC9155977.
  5. Bowers KJ, Ray M, MCCallister KB. Ketamine as an adjunct to opioids for acute pain in the emergency department. Acad Emerg Med. 2017; 24(6):676-685. PMID: 28177167. DOI: 10.1111/acem.13172
  6. Dukes DW, Tift FW. A 37-year-old woman with painful unilateral vision loss. J Am Coll Emerg Physicians Open. 2022 Mar 29;3(2):e12714. doi: 10.1002/emp2.12714. PMID: 35387320; PMCID: PMC8964924.
  7. Whittle, JS. High Flow Oxygen Therapies, ACEP COVID-19 Field Guide. American College of Emergency Physicians. https://www.acep.org/corona/covid-19-field-guide/cover-page/. 2021. http://www.acep.org/corona/covid-19-field-guide/diagnosis/testing/. https://www.acep.org/corona/covid-19-field-guide/work-safety/aerosolization/. 
  8. Whittle JS, Dungan GC 2nd, Debellis RJ. Response. Chest. 2020 Oct;158(4):1789-1790. Doi: 10.1016/ j.chest.2020.06.039. PMID: 33036100; PMCID: PMC7533715.
  9. Doshi PB, Whittle JS, Dungan G 2nd, Volakis LI, Bublewicz M, Kearney J, Miller TL, Dodge D, Harsch MR, Debellis R, Chambers KA. The ventilatory effect of high velocity nasal insufflation compared to non-invasive positive-pressure ventilation in the treatment of hypercapnic respiratory failure: A subgroup analysis. Heart Lung. 2020 SepOct;49(5): 610-615. Doi: 10.1016/j.hrtlng.2020.03.008. Epub 2020 Apr 6. PMID:32273085.
  10. Leonard S, Atwood CW Jr, Walsh BK, Debellis RJ, Dungan GC, Strasser W, Whittle JS. Preliminary Findings on Control of Dispersion of Aerosols and Droplets During High-Velocity Nasal Insufflation Therapy Using a Simple Surgical Mask: Implications for the High-Flow Nasal Cannula. Chest. 2020 Sep;158(3):1046-1049. Doi: 10.1016/ j.chest.2020.03.043. Epub 020 Apr 2. PMID: 32247712; PMCID: PMC7130245.
  11. Leonard S, Strasser W, Whittle JS, Volakis LI, DeBellis RJ, Prichard R, Atwood CW Jr, Dungan GC 2nd. Reducing aerosol dispersion by High Flow Therapy in COVID-19: High Resolution Computational Fluid Dynamics Simulations of Particle Behavior During High Velocity Nasal Insufflation with a Simple Surgical Mask. J Am Coll Emerg Physicians Open. 2020 May 29;1(4):578–91. doi: 10.1002/emp2.12158. Epub ahead of print. PMID: 32838373; PMCID: PMC7283709.
  12. Tift FW, Nable JV. Online Medical Control for EMS: A Lecture and Case-Based Teaching Module. MedEdPORTAL. 2020;16:10902. Published 2020 May 15.
  13. Martin RA, Couture R, Tasker N, et al. Emergency Medical Care of Incarcerated Patients: Opportunities for Improvement and Cost Savings. PLoS One. 2020;15(4):e0232243. Published 2020 Apr 27.
  14. Martin RA, Buchheit R, Carman C, Gray JK, Mendiratta S, Whittle JS. A paramedic patient flow coordinator improves ambulance offload times in the emergency department. 2020. J Hosp Manag Health Policy 2020;4:21.
  15. Whittle JS, Pavlov I, Sacchetti AD, Atwood C, Rosenberg MS. Respiratory support for adult patients with COVID-19 [published online ahead of print, 2020 Apr 13]. J Am Coll Emerg Physicians Open. 2020;10.1002/emp2.12071.
  16. Doshi PB, Whittle JS, Dungan G 2nd, et al. The Ventilatory Effect of High-Velocity Nasal Insufflation Compared to Non-Invasive Positive-Pressure Ventilation in the Treatment of Hypercapneic Respiratory Failure: a Subgroup Analysis [published online ahead of print, 2020 Apr 6]. Heart Lung. 2020;S0147-9563(20)30095-9.
  17. Leonard S, Atwood CW Jr, Walsh BK, Whitte JS, et al. Preliminary Findings on Control of Dispersion of Aerosols and Droplets During High-Velocity Nasal Insufflation Therapy Using a Simple Surgical Mask: Implications for the High-Flow Nasal Cannula [published online ahead of print, 2020 Apr 2]. Chest. 2020;S0012-3692(20)30579-1.
  18. Haywood ST, Volakis LI, Whittle JS. Beyond NIPPV: HVNI Expands Potential Treatment Options For Acute Decompensated Heart Failure. AM J Emerg Med. 2019;38(8):1589.
  19. Haywood ST, Whittle JS, Volakis LI, et al. HVNI vs NIPPV in the Treatment of Acute Decompensated Heart Failure: Subgroup Analysis of a Multi-Center Trial in the ED. Am J Emerg Med. 2019;37(11):2084-2090.
  20. Whittle JS, Goyal P, Tarrant N, Schuur DJ, Yealy DM, Venkatesh A. Urban and Rural Emergency Department Performance on National Quality Metrics for Sepsis Care in the United States. J Rural Health. 2019 Sep;35(4):490-497.
  21. Walsh BA, Gregorie WD, Whittle JS. Deconstructing Dissections: A Case Report and Review of Blunt Cerebrovascular Injury of the Neck. Case Rep Emerg Med. 2018 Aug 9;2018:6120781.
  22. Doshi P, Whittle JS, Bublwicz M, Kearney J, Ashe T, Graham R, Salazar S, Ellis TW Jr, Maynard D, Dennis R, Tillotson A, Hill M, Granado M, Gordon N, Dunlap C, Spivey S, Miller TL. High Velocity Nasal Insufflation in the Treatment of Respiratory Failure: A Randomized Clinical Trial. Ann Emerg Med. 2018 Jul;72(1):73-83.e5.
  23. Martin RA, Reuhland B, Carlson LS, Love M, Maxwell RA, Whittle JS. Gastropericardial Fistula Presenting 27 Years After Bariatric Surgery. Clin Pract Cases Emerg Med. 2017 Oct 6;1(4)435-436.
  24. Neal M, Culbertson MC 3rd, Mendiratta S, Smith BC 3rd, Whittle JS. Boy With Muscle Spasms. Ann Emerg Med. 2017 Sep;70(3):432-440.
  25. Venkatesh AK, Slesinger T, Whittle JS, Osborn T, Aaronson E, Rothenberg C, Tarrant N, Goyal P, Yealy DM, Schuur JD.  Preliminary Performance on the New CMS Sepsis-1 National Quality Measure: Early Insights From the Emergency Quality Network (E-QUAL). Ann Emerg Med. 2017 Aug 5. pii: S0196-0644(17)30872-7.
  26. Martin RA, Wharton D, Barker C, Haivas, CH, Kaur B, Whittle JS. Elderly Woman With Altered Mental Status and Hypoxia. An Emerg Med. 2016 Dec; 68(6):778-779.
  27. David J. Barton BS, Frank W. Tift MD, Lauren E. Cournoyer BS, Julie T. Vieth MBChB & Korin B. Hudson MD. Acute Alcohol Use and Injury Patterns in Young Adult Prehospital Patients, Prehospital Emergency Care, 2016 Mar.20:2, 206-211.
  28. Smith BC 3rd, Avila J. M.mode.ify: A Free Online Tool to Generate Post Hoc M-Mode Images From Any Ultrasound Clip. J Ultrasound Med. 2016 Feb;35(2):435-9.
  29. Clinkscales JD, Fesmire FM, Hennings JR, Severance HW, Seaberg DC, Patil N. The Effect of Emergency Medicine Residents on Clinical Efficiency and Staffing Requirements. Acad Emerg Med. 2016 Jan;23(1):78-82.
  30. Avila JO, Noble VE. The irregular diaphragmatic pleural interface: a novel sonographic sign facilitating the diagnosis of pneumonia. J Ultrasound Med. 2015 Jun;34(6):1147-57.
  31. Avila JO, Smith BC, Seaberg DC. Use of echocardiography to identify appropriate placement of a central venous catheter wire in the vena cava prior to cannulation. Acad Emerg Med. 2014 Aug;21(8):E1-2. 

  32.  

Grant Awards

Principal Investigator: Isabel Obrien, MD, MPH

Co-Investigators: Hong Qin, PhD (University of Tennessee at Chattanooga)

Awareded $5,000 for one-year (2023); UT College of Medicine-Chattanooga and UT-Chattanooga Biomedical Research Initiation Collaborative (BRIC) grant
Assessing Healthcare Outcomes and Utilization Among the Unhoused in the Local Community. 
Funded jointly by the University of Tennessee Health Science Center and University of Tennessee at Chattanooga.

 

Principal Investigator: Jessica Whittle, MD, PhD

Co-Investigators: Rebecca Martin, MD, PhD and Jenny Holcombe, PhD

Awarded $25,000 for one-year (2019); also obtained additional donations of naloxone (approximate value: $75,000)
Implementing an Emergency Medical Service-directed Overdose Education and Naloxone Leave Behind Program in the Local Community. 
Funded jointly by the University of Tennessee Health Science Center and University of Tennessee at Chattanooga.

 

Abstract/Research Presentations

  • KJ Bowers. "Pediatric Trauma: Little Patients Equal Big Stress." NAEMS/NAEMSP Joint Continuing Education Seminar (online). June 2024.
  • KJ Bowers. "Your Patients' Problems Are Not Always Clinical: SDOH in the Pre-hospital Setting." National Association of EMS Physicians Annual Meeting. Austin, TX. January 2024.
  • KJ Bowers. "Winning Formulas for Prehospital Stroke Assessment and Treatment." NAEMT/NAEMSP Joint Continuing Education Seminar (online). May 2023.
  • KJ Bowers. "Why Are You Calling Me If It's Not Broken? A Guide to Not Getting Yelled At By Ortho in the Middle of the Night." Coastal Emergency Medicine Conference. Charleston, SC. June 2022.
  • KJ Bowers. "Brugada Pattern Unmasked by COVID-19: a Pediatric Case Report." Southeastern Pediatric Research Conference. Atlanta, GA (online). June 2021.
  • R. Martin, D. Duk, J. Holcombe, R. Buchheit, S. Mendiratta, JS Whittle. "Exploring Barriers to Implementing an Emergency Medical Services Naloxone Leave Behind Program." Society For Academic Emergency Annual Meeting. Denver, CO. May 14-18, 2020.
  • R. Martin, D. Duk, J. Holcombe, R. Buchheit, S. Mendiratta, JS Whittle. "Exploring Barriers to Implementing an Emergency Medical Services Naloxone Leave Behind Program." Society For Academic Emergency Medicine Southeast Regional Meeting. Greenville, SC. February 24, 2020.
  • Haywood, ST, J. Whittle, M. Bublewicz, J. Kearney, T. Ashe, T. Miller, P. Doshi, “High velocity nasal Insufflation vs. non-invasive positive pressure ventilation in heart failure: a subgroup analysis.” Society for Academic Emergency Medicine Annual Meeting, Indianapolis, IN. May 16-19, 2018.
  • Pietzsch, JB, B.P. Geisler, J. Whittle, J. Kearney, T. Ashe, A. Garner, M. Bublewicz, P. Doshi, “Resource utilization and costs of high velocity nasal insufflation compared to non-invasive positive pressure ventilation for respiratory failure.” International Society for Pharmacoeconomics and Outcomes Research 22nd Annual International Meeting, Boston, MA. May 20-24, 2017.
  • Doshi, P., JS Whittle, M. Bublewicz, J. Kearney, T. Ashe, T.L. Miller. “High Velocity Nasal Insufflation Compared to Non-Invasive Positive Pressure Ventilation in the Treatment of Respiratory Failure In The Emergency Department: A Randomized Clinical Trial.” Society for Academic Emergency Medicine Annual Meeting, Orlando, FL. May 16-19, 2017.
  • Elseroad, S., M. Dumas, DC Seaberg, J.S. Whittle, S. Mendiratta, J. Holcombe, C. Glisson. “Analysis of Patients Frequently Visiting the Emergency Department and Attempts at Navigation.” Society for Academic Emergency Medicine Annual Meeting, New Orleans, LA. May 11-14, 2016.

 

Clinical Trials

Co-Principal Investigator
FREEDOM trial for COVID: RCT comparison of oral anti-coagulation to high or low dose enoxaparin. Study based at Mount Sinai Hospital, NY. 2021-present.

Co-Investigator
Disparities in Emergency Medical Services Care Delivery: A Scoping Review. Study conducted by National Association of EMS Physicians' Diversity, Equity, and Inclusion Committee. 2021-2022.

National Principal Investigator
HYPERACT trial: RCT High flow therapy compared to non-invasive positive pressure ventilation in the treatment of acute hypercapnic respiratory failure in the emergency department. Study based at Erlanger Hospital, TN. 2020-present.

Co-Principal Investigator
VENT-AVOID trial of extracorporeal carbon dioxide removal in patients with acute or chronic hypercapnic respiratory failure. Study based at Erlanger Hospital, TN. 2019

Principal Investigator
Vapotherm RCT High flow therapy compared to non-invasive positive pressure ventilation in the treatment of acute hypercapnic respiratory failure in the emergency department. Study based at Memorial Herman Hospital, TX. 2014-2016.

 

Invited Lecures/Grand Rounds

"Post-COVID Conversations." Global Partners Annual Meeting. Greenville, SC. June 29, 2021.

"Respiratory Support for Adult Patients with COVID-19." Albert Einstein Hospital, webinar live virtual lecture. Sao Paolo, Brazil. May 8, 2020.

"High Flow Therapy for Patients with COVID-19." EmRAP Podcast. April 3, 2020.

"Mask-Free Non-invasive Ventilation in the Emergency Department." Israel National Conference of Emergency Physicians. Tel Aviv, Israel. March 26, 2019.

"Sepsis Sound-off." ACEP Frontline Podcast with host Ryan Stanton. March 11, 2019.

 

http://www.acep.org/DART/
ACEP Expert Panel on Sepsis Member, 2020
ACEP liaison to IDSA for Workgroup on Antibiotic Selection in Sepsis, 2017
Jessica Whittle, MD, PhD, FACEP

Ultrasound of the Week
Ben Smith, MD, FACEP

 

About our Director of Research:

Dr. Jessica S. Whittle is a Fellow of the American College of Emergency Physicians. She currently serves on the ACEP Clinical Policies sub-committee and previously served on the ACEP Sepsis Technical Expert Panel and as the national ACEP liaison to the Infectious Disease Society of America.

Her research interests include sepsis, critical care, and patient access issues. She holds several patents and trademarks for medical devices and products.

The University of Tennessee Health Science Center granted Dr. Whittle early promotion to professor of emergency medicine in 2021. She is currently co-chair of the Instituational Review Board at UTHSC College of Medicine Chattanooga.

Jessica Whittle

BS (Biology Education), Appalachian State University
MD, University of Alabama Birmingham
PhD (Immunology and Molecular Pathogenesis), Emory University
Jul 10, 2024