Nathaniel Lee Coggins

All Publications

• From Addiction to Acute Pain Relief: A Narrative Review on Buprenorphine's Expanding Role in Emergency Department Pain Management. The Journal of emergency medicine Lee, J. B., Ognian, I., Park, J., Coggins, N., DeJulio, P., Ashenburg, N., Ahern, T. 2025; 79: 371-384

  Abstract

  Buprenorphine, a partial µ-opioid receptor agonist, has gained attention for its potential role in pain management across various clinical settings, including emergency departments (ED), perioperative care, and palliative care. Its unique pharmacological profile may offer advantages over traditional opioids, particularly in mitigating opioid-related complications.This narrative review aims to synthesize current literature on the efficacy, safety, and clinical applications of buprenorphine for pain management, highlighting its use in acute pain contexts. The review also seeks to provide practical dosing and implementation recommendations informed by multidisciplinary expert opinion and existing evidence.Buprenorphine presents several advantages which include its ceiling effect on respiratory depression, lower potential for misuse and addiction, and longer duration of sustained analgesia. The review discusses the diverse formulations of buprenorphine, including sublingual, transdermal, and intravenous options, and their respective roles in acute pain management. It addresses the limitations of current research, including the heterogeneity of study designs and the need for further ED based studies to establish robust clinical guidelines. Additionally, it examines barriers to buprenorphine's broader adoption, such as insurance coverage, stigma, and administrative challenges.Buprenorphine represents a promising alternative to full opioid agonists for pain management, particularly in acute settings. Future research is essential to validate its efficacy and optimize its integration into acute care settings such as emergency departments.

  View details for DOI 10.1016/j.jemermed.2025.08.038

  View details for PubMedID 41175543

• Hypertensive Disorders of Pregnancy. Emergency medicine clinics of North America Coggins, N., Lai, S. 2023; 41 (2): 269-280

  Abstract

  Hypertensive disorders in pregnancy are a leading cause of global maternal and fetal morbidity. The four hypertensive disorders of pregnancy include chronic hypertension, gestational hypertension, preeclampsia-eclampsia, and chronic hypertension with superimposed preeclampsia. A careful history, review of systems, physical examination, and laboratory analysis can help differentiate these disorders and quantify the severity of the disease, which holds important implications for disease management. This article reviews the different types of disorders of hypertension in pregnancy and how to diagnose and manage these patients, with special attention paid to any recent changes made to this management algorithm.

  View details for DOI 10.1016/j.emc.2023.01.002

  View details for PubMedID 37024163

• Adaptive leadership curriculum for Indian paramedic trainees. International journal of emergency medicine Mantha, A., Coggins, N. L., Mahadevan, A., Strehlow, R. N., Strehlow, M. C., Mahadevan, S. V. 2016; 9 (1): 9-?

  Abstract

  Paramedic trainees in developing countries face complex and chaotic clinical environments that demand effective leadership, communication, and teamwork. Providers must rely on non-technical skills (NTS) to manage bystanders and attendees, collaborate with other emergency professionals, and safely and appropriately treat patients. The authors designed a NTS curriculum for paramedic trainees focused on adaptive leadership, teamwork, and communication skills critical to the Indian prehospital environment.Forty paramedic trainees in the first academic year of the 2-year Advanced Post-Graduate Degree in Emergency Care (EMT-paramedic equivalent) program at the GVK-Emergency Management and Research Institute campus in Hyderabad, India, participated in the 6-day leadership course. Trainees completed self-assessments and delivered two brief video-recorded presentations before and after completion of the curriculum.Independent blinded observers scored the pre- and post-intervention presentations delivered by 10 randomly selected paramedic trainees. The third-party judges reported significant improvement in both confidence (25 %, p < 0.01) and body language of paramedic trainees (13 %, p < 0.04). Self-reported competency surveys indicated significant increases in leadership (2.6 vs. 4.6, p < 0.001, d = 1.8), public speaking (2.9 vs. 4.6, p < 0.001, d = 1.4), self-reflection (2.7 vs. 4.6, p < 0.001, d = 1.6), and self-confidence (3.0 vs. 4.8, p < 0.001, d = 1.5).Participants in a 1-week leadership curriculum for prehospital providers demonstrated significant improvement in self-reported NTS commonly required of paramedics in the field. The authors recommend integrating focused NTS development curriculum into Indian paramedic education and further evaluation of the long term impacts of this adaptive leadership training.

  View details for DOI 10.1186/s12245-016-0103-x

  View details for PubMedID 26897379

  View details for PubMedCentralID PMC4761349