EM Research

Research is integral to a successful residency in emergency medicine. The University of Tennessee Chattanooga College of Medicine has a long history of quality emergency medicine research in chest pain patients, stroke patients, and trauma patients. 

Under the leadership of Francis Fesmire, MD, Research Director, and Harry Severance, MD, our goal is to foster emergency medicine research for residents, medical students, faculty, and community partners.  Plans are underway by the University to establish a Medical Research Center in collaboration with the University of Tennessee Health Science Center, the University of Tennessee at Chattanooga, Oak Ridge National Laboratory, and local health insurance companies.  The goal of this center is to provide support for each of the college’s residency programs.  

Our mission is to facilitate the advancement of knowledge in emergency medicine. We are in the process of hiring an emergency medicine research coordinator who will be responsible for such tasks as enrolling patients, initiating study drugs, processing research samples, and overseeing a team of clinical study assistances.  As emergency medicine often overlaps with other specialties, we are actively encouraging research collaboration with the residency programs in Family Practice, Internal Medicine, Obstetrics & Gynecology, Orthopaedics, Pediatrics, Plastic Surgery, and Surgery.  We believe our commitment to excellence in research will enhance our reputation as well as provide residents an environment in which they will thrive academically.

Latest publication:

Bledsoe BE, Nowicki K, Creel JH Jr, Carrison D, Severance HW, Use of pulse co-oximetry as a screening and monitoring tool in mass carbon monoxide poisoning. Prehosp Emerg Care. 2010;14(1):131-3. [http://www.ncbi.nlm.nih.gov/pubmed/19947878]

Select Publications by Dr. Fesmire:

Fesmire FM, Brady WJ, Hahn S, et al.  Clinical Policy: Indications for Reperfusion Therapy in Emergency Department Patients with Suspected Acute Myocardial Infarction.  Ann Emerg Med  2006; 48:358-383. 

Fesmire  FM, Decker WW, Diercks DB, et al.  Clinical Policy: Critical issues in the evaluation and management of adult patients with non-ST-segment elevation acute coronary syndromes.  Ann Emerg Med 2006; 48:270-301.

Fesmire FM.  Improving Care in Patients with Acute Coronary Syndromes: The Erlanger Quality Improvement Initiative.  Crit Pathways in Cardiol 2004;3:158-164. 

Fesmire FM, Christenson, Fody EP, Feintuch. Delta CK-MB outperforms myoglobin at 2 hours during the ED identification and exclusion of troponin positive non-ST segment elevation acute coronary syndromes.  Ann Emerg Med 2004; 44:12-19.

Fesmire FM, Hughes AD, Fody EP, Stout PK, et al: The Erlanger Protocol: A one year experience with serial 12-lead ECG monitoring, 2-hour delta serum marker measurements, and selective nuclear stress test to identify and exclude acute coronary syndromes.  Ann Emerg Med 2002; 40: 584-594. 

Fesmire FM, Peterson ED Roe MT, Wojcik JF: Early utilization of IIb/IIIa inhibitors in the emergency department treatment of acute coronary syndromes: A local quality improvement initiative.  Am J Emerg Med 2003;21:302-308.

Fesmire FM, Hughes AD, Stout PK, et al: Selective dual nuclear scanning in low risk patients with chest pain to reliably identify and exclude acute coronary syndromes.  Ann Emerg Med 2001;38:207-215.

Fesmire FM, Eriksson SV, Stout PK, et al: Utilization of Baseline ST-Vector Magnitude to Identify Electrocardiographic Injury in Patients with Suspected Acute Myocardial Infarction.  Am J Emerg Med 2002; 20:535-540.

Fesmire FM, Percy RF, Bardonner JB, Wharton DR, Calhoun FB: Usefulness of Automated Serial ECG Monitoring During the ED Evaluation of Chest Pain Patients.  Ann Emerg Med 1998; 31:3-11.

Fesmire FM: A rapid rule out protocol for identification and exclusion of acute myocardial infarction: Continuous 12-lead ECG monitoring in conjunction with the 2-hour delta CK-MB.  Am J Emerg Med 2000;18:698-702.

Fesmire FM, Percy RF, Bardonner JB, Wharton DR, Calhoun FB:  Serial CK-MB Testing During the Emergency Department Evaluation of Chest Pain: Utility of a 2 hour Delta CK-MB of +1.6 ng/ml.   Am Heart J 1998:136:237-244.

Select Publications by Dr. Severance:

Severance HW, Morris KG, Wagner GS: Criteria for early discharge after acute myocardial infarction; validation in a community hospital. Archives of Internal Medicine, 1982;142:39-41.

Severance HW, Bassett FH: Rupture of the Plantaris - Does it exist? Journal of Bone and Joint Surgery , 1982;64-A,#9:1187-88.

Crimm A, Severance HW, Coffey K, McKinnis R, Wagner GS, Califf RM: Prognostic significance of isolated sinus tachycardia during first three days of acute myocardial infarction. American Journal of Medicine, Vol. 76, pp. 983-988, June 1984.

Wilson BH, Severance HW, Raney MP, Pressley JC, McKinnis RA, Hindman MC, Smith M, Wagner GS: Out-of-hospital management of cardiac arrest by basic emergency medical technicians. American Journal of Cardiology, 1984; 53:68-70.

Pressley JC, Raney MP, Wilson BH, Severance HW, Wagner GS: Assessment of Out-of-hospital Resuscitation. American Journal of Emergency Medicine, 1984;2(3):215-216.

Pressley JC, Wilson BH, Severance HW, Raney MP, McKinnis RA, Smith MW, Hindman MC, Wagner GS: Basic Emergency Medical Care of Patients with Acute Myocardial Infarction: Initial Prehospital Characteristics and In-Hospital Complications. Journal of American College of Cardiology, 1984; 4(3):487-492.

Severance HW: A Christmas Story; (Near Drowning), Case Studies in Emergency Medicine , 1986, Vol 2, no. 10, p 13.

Severance HW: Vomiting and Abdominal Pain, Case Studies in Emergency Medicine , 1986, Vol 2, no. 12, pp 4-6.

Severance HW: Viral Syndrome, Case Studies in Emergency Medicine, 1987, Vol. 4(1) pp.11-14.

Severance HW, Holt T, Patrone N, et.al.: Profound Muscle Weakness and Hypokalemia Secondary to Clay Ingestion, A Report and Review of the Literature. Southern Medical Journal, 1988;81(2): 272 - 274.

Holley J, Severance HW, An Upper Respiratory Infection and a Rash, Case Studies in Emergency Medicine, 1988; Vol 4, no. 9, pp 1-5.

Pressley JC, Severance HW, Raney MP, McKinnis RA, Smith MW, Hindman MC, Wilson BH, Wagner GS: A Comparison of Paramedic vs Basic Emergency Medical Care of Patients at High and Low Risk During Acute Myocardial Infarction. Journal of American College of Cardiology, 1988; Vol. 12, no. 6, 1555-61.

Severance HW, Kolb JC, Carlton FB, Jorden RC: Acute Carbon Monoxide Poisoning, Emergency Management and Hyperbaric Oxygen Therapy, Journal of Mississippi State Medical Association, 1989:Vol. 30, No. 10, pp. 321-325.

Severance HW, Kolb JC, Carlton FB, Jorden RC: Acute Carbon Monoxide Poisoning, Emergency Management and Hyperbaric Oxygen Therapy, [abstract] Journal of Hyperbaric Medicine, 1989;Vol 4, #3, p. 153.

Ward GLH, Jorden RC, Severance HW, Management of Pyelonephritis in an Observation Unit. [abstract] Ann Emerg Med, 1989:18;443-444.

Pollack CV, Severance HW: Sialolithiasis: Case Studies and Review, Journal of Emergency Medicine , 1990, 8:5;561-65.

Severance HW: Acute, Otitis Media in Adults; Appropriate Diagnosis Coding and Methods of Diagnosis in E.M. Populations, [abstract] Southern Medical Journal, 1990, 83:9; p. 2S-20.

Severance HW: Assault Rifles; Definitions, Evolutionary History and Medical Consequences, Journal of the Mississippi State Medical Association, 1990, vol 31, #12, pp 403-407.

Severance HW: Acute Otitis Media in Adults, in Harwood-Nuss AL, Linden CH, Luten RC, Sternbach G, Wolfson AB. eds: The Clinical Practice of Emergency Medicine, 1st Edition. Philadelphia, J.B. Lippincott 1991: (31); 93-97.

Severance HW: Acute Otitis Externa, in Harwood-Nuss AL, Linden CH, Luten RC, Sternbach G, Wolfson AB. eds: The Clinical Practice of Emergency Medicine, 1st Edition. Philadelphia. J.B. Lippincott. 1991: (32); 97-100.

Severance HW, Graff L, Observation Committee Completes Fall Meeting; Accent on Review of Issues for Research and Investigation. [letter] Academic Emergency Med. 1991:3:2;4-5.

Ward GLH, Jorden RC, Severance HW: Treatment of Pyelonephritis In An Observation Unit, Ann Em Med. 1991:20:3;258-61.

Severance HW, Dillard D, Griswold JA, Investigation of Adjunctive HBO Therapy For Rhinocerebral Mucormycosis Utilizing Animal Models of an Immunocompromised State. [abstract]. Jour. Hyperbaric Med. 1991:6:1;56-7.

Severance HW, Graff L, Issues Needing Research in Observation Medicine. Academic Emergency Medicine, 1991:3(2);4-5.

Pollack CV, Sanders DY, Severance HW. Emergency Department Analgesia without Narcotics for Adults with Acute Sickle Cell Pain Crisis: Case Reports and Review of Crisis Management. J. Emerg. Med. 1991:9(6)445-52.

Graff LG, Dunbar L, Gibler WB, Goldfrank L, Leikin J, Schultz C, Severance H, Watkins R, Yealy DM, Zun LS. Observation Medicine Curriculum, Ann. Emerg. Med., 1992:21:8;963-6.

Sanders DV, Severance HW, Pollack CV. Sickle cell Vaso-occlusive Pain Crisis in Adults: Alternative Strategies for Management in the Emergency Department. Southern Med.Jour. 1992:85(8);808-11.

Severance HW, Continuity of Care for the Emergency Department Observation Unit Patient, (Chap. 5) in Graff LG, ed: Textbook of Observation Medicine, Andover Medical Publishers, Butterworth-Heinemann, Stoneham MA, 1993, pp 65-83.

Severance HW, Acute Otitis Media in Adults, in Harwood-Nuss A, Luten RC (eds): Handbook of Emergency Medicine, 1995, Lippincott, Philadelphia, 45-48.

Severance HW, Acute Otitis Externa in Adults, in: Harwwod Nuss A, Luten RC (eds): Handbook of Emergency Medicine, 1995, Lippincott, Philadelphia, 48-50.

Brillman J, Mathers-Dunbar L, Graff L, Joseph T, Leikin JB, Schultz C, Severance HW, Werne C, Management of Observation Units, Annals of Emergency Medicine, 1995:25;823 -30.

Graff L, Joseph T, Andelmam R, Bahr R, DeHart D, Espinosa J, Gibler B, Hoekstra J, Mathers-Dunbar L, Ornato JP, Page J, Severance H. American College of Emergency Physicians Information Papaer: Chest Pain Units in Emergency Departments - A report from the short-term observation services section. American Journal of Cardiology, 1995:76;1036-39.

Severance HW, Ballistics: a brief Review. Duke Trauma Center Newsletter. 1996;5:1-3.

Severance HW, Acute Otitis Media in Adults, in Harwood-Nuss Al, Linden CH, Luten RC, Shepard S, Wolfson AB, (eds) The Clinical Practice of Emergency Medicine, 2nd Edition, Philadelphia, 1996, Lippencott - Raven, Philadelphia, 109-112.

Severance HW, Acute Otitis Externa, in Harwood-Nuss Al, Linden CH, Luten RC, Shepard S, Wolfson AB, (eds) The Clinical Practice of Emergency Medicine, 2nd Edition, Philadelphia, 1996, Lippencott - Raven, Philadelphia, 112-116.

Severance HW, Ballistic Wounding: An Overview and Case Studies. Sterling Clinical Bulletin 1997;3(1):1-8.

Dallara J, Severance HW, Davis B, Schulz G, Differences between Chest Pain Observation Service Patients and Admitted “Rule-out Myocardial Infarction” Patients. Acad. Emerg. Med. 1997;4:693-8.

Graff LG, Dallara J, Ross MA, Joseph AJ, Itzocovitz J, Andelman RP, Emerman C, Turbiner S, Espinosa JA, Severance HW, Impact on the care of the emergency department chest pain patient from the chest pain evaluation registry (cheper) study. American Journal of Cardiology, 1997;80:563-8.

Severance HW, Breeden PC, Documenting Patient Care in the Observation Unit, in: Graff LG. (Editor) Observation Units, Implementation and Management Strategies. 1998, ACEP Press, Dallas, TX, pp 37-45.

Severance HW, Enrolling Patients in Clinical Trials: Improving Performance, Care and Return, in Gibler WB, (editor), Presentations in Focus; Reports and Expert Commentary, 1998;11-12.

Severance HW, Blast-Related Injuries: Special Considerations for Mass-Casualties Management. TraumaVue, 1999;7:1-3.

Severance HW, Ballistic Wounding, Application of Ballistic Principles to Emergency Department Management, Critical Decisions in Emergency Medicine, 1999;13:7-18.