Bio

Clinical Focus


  • Emergency Medicine

Academic Appointments


Administrative Appointments


  • EMS Medical Director, San Mateo (2008 - Present)
  • Biodesign Faculty - Assistant Director, Stanford University (2008 - Present)
  • EMRI - Assistant Director, Emergency Management and Research Institute, Andhra Pradesh, India (2007 - 2009)
  • EMS/Disaster Fellowship Director, Stanford University/Santa Clara County EMS (2006 - Present)
  • LifeFlight Medical Director, Stanford LifeFlight (2005 - Present)
  • Paramedic Training Medical Director, National University - WestMed Training Facility (2004 - Present)
  • POM Emed Procedures Associate Director, Stanford University (2003 - Present)
  • EM Clerkship Director, Stanford University (2002 - Present)

Honors & Awards


  • Outstanding Teaching Resident, Emory Medical School (2000)
  • Resident of the Year Award, Emory University/Pfizer (2001)
  • Excellence in Clinical Service Award, Stanford Emergency Department (2002)
  • Save of the Month, Stanford Emergency Department (2002)
  • Innovations in Emergency Medicine Exhibit (IEME) Award, Society for Academic Emergency Medicine (SAEM) (2003)
  • Preclinical Teaching Award, Henry J. Kaiser (2004)
  • Yearly Bedside Teaching Award, Stanford-Kaiser Emergency Medicine Residency (2004)
  • Quarterly Bedside Teaching Award, Stanford-Kaiser Emergency Medicine Residency (2005)
  • STAR Award, Stanford Emergency Department (2007)

Professional Education


  • Residency:Emory University Hospital (2001) GA
  • Medical Education:SUNY at Brooklyn School Of Medicine (1998) NY
  • Board Certification: Emergency Medicine, American Board of Emergency Medicine (2002)
  • Internship:Emory University Hospital (1999) GA
  • EM, Emory University, Emergency Medicine (2001)
  • MD, SUNY HSC-Brooklyn, Medicine (1998)
  • BS, SUNY Geneseo, Biochemistry (1994)

Research & Scholarship

Current Research and Scholarly Interests


Interested in education and different modalities to perform education. In addition, interested in different aspects of pre-hospital and disaster medicine. Currently looking into CPR education in the pre-hospital setting.

Publications

Journal Articles


  • Characteristics of Pediatric Trauma Transfers to a Level I Trauma Center: Implications for Developing a Regionalized Pediatric Trauma System in California ACADEMIC EMERGENCY MEDICINE Acosta, C. D., Delgado, M. K., Gisondi, M. A., Raghunathan, A., D'Souza, P. A., Gilbert, G., Spain, D. A., Christensen, P., Wang, N. E. 2010; 17 (12): 1364-1373

    Abstract

    since California lacks a statewide trauma system, there are no uniform interfacility pediatric trauma transfer guidelines across local emergency medical services (EMS) agencies in California. This may result in delays in obtaining optimal care for injured children.this study sought to understand patterns of pediatric trauma patient transfers to the study trauma center as a first step in assessing the quality and efficiency of pediatric transfer within the current trauma system model. Outcome measures included clinical and demographic characteristics, distances traveled, and centers bypassed. The hypothesis was that transferred patients would be more severely injured than directly admitted patients, primary catchment transfers would be few, and out-of-catchment transfers would come from hospitals in close geographic proximity to the study center.this was a retrospective observational analysis of trauma patients ? 18 years of age in the institutional trauma database (2000-2007). All patients with a trauma International Classification of Diseases, 9th revision (ICD-9) code and trauma mechanism who were identified as a trauma patient by EMS or emergency physicians were recorded in the trauma database, including those patients who were discharged home. Trauma patients brought directly to the emergency department (ED) and patients transferred from other facilities to the center were compared. A geographic information system (GIS) was used to calculate the straight-line distances from the referring hospitals to the study center and to all closer centers potentially capable of accepting interfacility pediatric trauma transfers.of 2,798 total subjects, 16.2% were transferred from other facilities within California; 69.8% of transfers were from the catchment area, with 23.0% transferred from facilities ? 10 miles from the center. This transfer pattern was positively associated with private insurance (risk ratio [RR] = 2.05; p < 0.001) and negatively associated with age 15-18 years (RR = 0.23; p = 0.01) and Injury Severity Score (ISS)?> 18 (RR = 0.26; p < 0.01). The out-of-catchment transfers accounted for 30.2% of the patients, and 75.9% of these noncatchment transfers were in closer proximity to another facility potentially capable of accepting pediatric interfacility transfers. The overall median straight-line distance from noncatchment referring hospitals to the study center was 61.2 miles (IQR = 19.0-136.4), compared to 33.6 miles (IQR = 13.9-61.5) to the closest center. Transfer patients were more severely injured than directly admitted patients (p < 0.001). Out-of-catchment transfers were older than catchment patients (p < 0.001); ISS > 18 (RR = 2.06; p < 0.001) and age 15-18 (RR = 1.28; p < 0.001) were predictive of out-of-catchment patients bypassing other pediatric-capable centers. Finally, 23.7% of pediatric trauma transfer requests to the study institution were denied due to lack of bed capacity.from the perspective an adult Level I trauma center with a certified pediatric intensive care unit (PICU), delays in definitive pediatric trauma care appear to be present secondary to initial transport to nontrauma community hospitals within close proximity of a trauma hospital, long transfer distances to accepting facilities, and lack of capacity at the study center. Given the absence of uniform trauma triage and transfer guidelines across state EMS systems, there appears to be a role for quality monitoring and improvement of the current interfacility pediatric trauma transfer system, including defined triage, transfer, and data collection protocols.

    View details for DOI 10.1111/j.1553-2712.2010.00926.x

    View details for Web of Science ID 000284848100018

    View details for PubMedID 21122022

  • Drive-Through Medicine: A Novel Proposal for Rapid Evaluation of Patients During an Influenza Pandemic ANNALS OF EMERGENCY MEDICINE Weiss, E. A., Ngo, J., Gilbert, G. H., Quinn, J. V. 2010; 55 (3): 268-273

    Abstract

    During a pandemic, emergency departments (EDs) may be overwhelmed by an increase in patient visits and will foster an environment in which cross-infection can occur. We developed and tested a novel drive-through model to rapidly evaluate patients while they remain in or adjacent to their vehicles. The patient's automobile would provide a social distancing strategy to mitigate the person-to-person spread of infectious diseases.We conducted a full-scale exercise to test the feasibility of a drive-through influenza clinic and measure throughput times of simulated patients and carbon monoxide levels of staff. We also assessed the disposition decisions of the physicians who participated in the exercise. Charts of 38 patients with influenza-like illness who were treated in the Stanford Hospital ED during the initial H1N1 outbreak in April 2009 were used to create 38 patient scenarios for the drive-through influenza clinic.The total median length of stay was 26 minutes. During the exercise, physicians were able to identify those patients who were admitted and discharged during the real ED visit with 100% accuracy (95% confidence interval 91% to 100%). There were no significant increases of carboxyhemoglobin in participants tested.The drive-through model is a feasible alternative to a traditional walk-in ED or clinic and is associated with rapid throughput times. It provides a social distancing strategy, using the patient's vehicle as an isolation compartment to mitigate person-to-person spread of infectious diseases.

    View details for DOI 10.1016/j.annemergmed.2009.11.025

    View details for Web of Science ID 000275882400008

    View details for PubMedID 20079956

  • Evaluating the efficacy of simulators and multimedia for refreshing ACLS skills in India RESUSCITATION Delasobera, B. E., Goodwin, T. L., Strehlow, M., Gilbert, G., D'Souza, P., Alok, A., Raje, P., Mahadevan, S. V. 2010; 81 (2): 217-223

    Abstract

    Data on the efficacy of the simulation and multimedia teaching modalities is limited, particularly in developing nations. This study evaluates the effectiveness of simulator and multimedia educational tools in India.Advanced Cardiac Life Support (ACLS) certified paramedic students in India were randomized to either Simulation, Multimedia, or Reading for a 3-h ACLS refresher course. Simulation students received a lecture and 10 simulator cases. The Multimedia group viewed the American Heart Association (AHA) ACLS video and played a computer game. The Reading group independently read with an instructor present. Students were tested prior to (pre-test), immediately after (post-test), and 3 weeks after (short-term retention test), their intervention. During each testing stage subjects completed a cognitive, multiple-choice test and two cardiac arrest scenarios. Changes in exam performance were analyzed for significance. A survey was conducted asking students' perceptions of their assigned modality.One hundred and seventeen students were randomized to Simulation (n=39), Multimedia (n=38), and Reading (n=40). Simulation demonstrated greater improvement managing cardiac arrest scenarios compared to both Multimedia and Reading on the post-test (9% versus 5% and 2%, respectively, p<0.05) and Reading on the short-term retention test (6% versus -1%, p<0.05). Multimedia showed significant improvement on cognitive, short-term retention testing compared to Simulation and Reading (5% versus 0% and 0%, respectively, p<0.05). On the survey, 95% of Simulation and 84% of Multimedia indicated they enjoyed their modality.Simulation and multimedia educational tools were effective and may provide significant additive benefit compared to reading alone. Indian students enjoyed learning via these modalities.

    View details for DOI 10.1016/j.resuscitation.2009.10.013

    View details for Web of Science ID 000274982500014

    View details for PubMedID 19926385

  • Digital necrosis necessitating amputation after tube gauze dressing application in the ED AMERICAN JOURNAL OF EMERGENCY MEDICINE Norris, R. L., Gilbert, G. H. 2006; 24 (5): 618-621

    View details for DOI 10.1016/j.ajem.2005.12.009

    View details for Web of Science ID 000240448700016

    View details for PubMedID 16938605

  • Emergency department orientation utilizing web-based streaming video ACADEMIC EMERGENCY MEDICINE Mahadevan, S. V., Gisondi, M. A., Sovndal, S. S., Gilbert, G. H. 2004; 11 (8): 848-852

    Abstract

    To assure a smooth transition to their new work environment, rotating students and housestaff require detailed orientations to the physical layout and operations of the emergency department. Although such orientations are useful for new staff members, they represent a significant time commitment for the faculty members charged with this task. To address this issue, the authors developed a series of short instructional videos that provide a comprehensive and consistent method of emergency department orientation. The videos are viewed through Web-based streaming technology that allows learners to complete the orientation process from any computer with Internet access before their first shift. This report describes the stepwise process used to produce these videos and discusses the potential benefits of converting to an Internet-based orientation system.

    View details for DOI 10.1197/j.aem.2003.10.032

    View details for Web of Science ID 000223090900006

    View details for PubMedID 15289191

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