Clinical Focus

  • Emergency Medicine
  • Point-of-Care Ultrasound
  • Innovations in Care Delivery

Academic Appointments

Professional Education

  • Fellowship: Medical University of South Carolina (2018) SC United States of America
  • Medical Education: Tufts University School of Medicine (2014) MA
  • Board Certification: American Board of Emergency Medicine, Emergency Medicine (2018)
  • Residency: Maine Medical Center (2017) ME

All Publications

  • The Role of Large Language Models in Transforming Emergency Medicine: Scoping Review. JMIR medical informatics Preiksaitis, C., Ashenburg, N., Bunney, G., Chu, A., Kabeer, R., Riley, F., Ribeira, R., Rose, C. 2024; 12: e53787


    Artificial intelligence (AI), more specifically large language models (LLMs), holds significant potential in revolutionizing emergency care delivery by optimizing clinical workflows and enhancing the quality of decision-making. Although enthusiasm for integrating LLMs into emergency medicine (EM) is growing, the existing literature is characterized by a disparate collection of individual studies, conceptual analyses, and preliminary implementations. Given these complexities and gaps in understanding, a cohesive framework is needed to comprehend the existing body of knowledge on the application of LLMs in EM.Given the absence of a comprehensive framework for exploring the roles of LLMs in EM, this scoping review aims to systematically map the existing literature on LLMs' potential applications within EM and identify directions for future research. Addressing this gap will allow for informed advancements in the field.Using PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) criteria, we searched Ovid MEDLINE, Embase, Web of Science, and Google Scholar for papers published between January 2018 and August 2023 that discussed LLMs' use in EM. We excluded other forms of AI. A total of 1994 unique titles and abstracts were screened, and each full-text paper was independently reviewed by 2 authors. Data were abstracted independently, and 5 authors performed a collaborative quantitative and qualitative synthesis of the data.A total of 43 papers were included. Studies were predominantly from 2022 to 2023 and conducted in the United States and China. We uncovered four major themes: (1) clinical decision-making and support was highlighted as a pivotal area, with LLMs playing a substantial role in enhancing patient care, notably through their application in real-time triage, allowing early recognition of patient urgency; (2) efficiency, workflow, and information management demonstrated the capacity of LLMs to significantly boost operational efficiency, particularly through the automation of patient record synthesis, which could reduce administrative burden and enhance patient-centric care; (3) risks, ethics, and transparency were identified as areas of concern, especially regarding the reliability of LLMs' outputs, and specific studies highlighted the challenges of ensuring unbiased decision-making amidst potentially flawed training data sets, stressing the importance of thorough validation and ethical oversight; and (4) education and communication possibilities included LLMs' capacity to enrich medical training, such as through using simulated patient interactions that enhance communication skills.LLMs have the potential to fundamentally transform EM, enhancing clinical decision-making, optimizing workflows, and improving patient outcomes. This review sets the stage for future advancements by identifying key research areas: prospective validation of LLM applications, establishing standards for responsible use, understanding provider and patient perceptions, and improving physicians' AI literacy. Effective integration of LLMs into EM will require collaborative efforts and thorough evaluation to ensure these technologies can be safely and effectively applied.

    View details for DOI 10.2196/53787

    View details for PubMedID 38728687

  • Eight weeks pregnant woman with heavy vaginal bleeding. Journal of the American College of Emergency Physicians open Moody, G. G., Batchelor, T. J., Ashenburg, N. 2024; 5 (1): e13113

    View details for DOI 10.1002/emp2.13113

    View details for PubMedID 38333104

    View details for PubMedCentralID PMC10850606

  • Improved First Dose Conversion of Supraventricular Tachycardia Using Weight-Based Adenosine. Cureus Deck, C. M., Dang, B., Ashenburg, N., Rice, B. 2023; 15 (3): e35995


    Introduction Paroxysmal supraventricular tachycardia (PSVT) is an often-recurring tachyarrhythmia that frequently results in emergency department visits and is commonly treated using intravenous adenosine. Given the anecdotal variable success of adenosine, the question arose of which patient factors may affect its success. This retrospective cohort analysis seeks to test the hypothesis that adult patients who receive adenosine at doses of ≥0.1mg/kg will have greater rates of successful conversion upon receipt of the first dose of adenosine. Methods This retrospective cohort analysis examines the charts from patients with known paroxysmal supraventricular tachycardia from November 1, 2015, through March 31, 2020, who were treated with intravenous adenosine. The primary outcome was the first-dose success of adenosine when stratified by patient weight (greater than 0.1mg/kg or less than 0.1mg/kg). Baseline characteristics and adverse effects were also collected. Results Seventy-six patients were included in the analysis. Patients who received adenosine at doses greater than or equal to 0.1mg/kg were more likely to convert to sinus rhythm than those who received doses less than 0.1mg/kg (p=0.006). No difference in adverse effects was noted between the groups (p=0.75). Conclusion This retrospective cohort analysis found that patients who received adenosine at doses greater than or equal to 0.1mg/kg for the treatment of PSVT were more likely to convert to sinus rhythm than those who received lower doses, with no difference in adverse effects. This hypothesis-generating finding provides the basis for a subsequent randomized, controlled trial to investigate the effectiveness and safety of weight-based adenosine.

    View details for DOI 10.7759/cureus.35995

    View details for PubMedID 37041920

    View details for PubMedCentralID PMC10083097

  • 19-Year-Old with Sudden Onset Left Testicular Pain. Clinical practice and cases in emergency medicine Small, E., Ashenburg, N., Schertzer, K. 2022; 6 (4): 327-329


    A previously healthy 19-year-old man presented to the emergency department with severe, sudden onset of left testicular pain. Physical exam revealed a left high-riding, horizontally oriented testicle without cremasteric reflex. Point-of-care ultrasound was used to confirm the diagnosis of testicular torsion, as well as to guide manual detorsion, verifying return of blood flow after reduction.Testicular torsion is a urologic emergency in which testicular viability is time dependent. Point-of-care ultrasound can be an important and helpful tool to not only confirm suspicion but help guide adequacy of blood flow return after manual detorsion in conjunction with comprehensive ultrasound.

    View details for DOI 10.5811/cpcem.2022.7.56747

    View details for PubMedID 36427024

  • Converting an ED Fast Track to an ED Virtual Visit Track NEJM Catalyst Innovations in Care Delivery Ashenburg, N., Ribeira, R., Lindquist, B., Matheson, L., Shen, S., Yiadom, M. 2022; 3 (11)

    View details for DOI 10.1056/CAT.22.0130

  • A Distance-Learning Approach to Point-of-Care Ultrasound Training (ADAPT): A Multi-Institutional Educational Response During the COVID-19 Pandemic. Academic medicine : journal of the Association of American Medical Colleges Nix, K., Liu, E. L., Oh, L., Duanmu, Y., Fong, T., Ashenburg, N., Liu, R. B. 2021


    PROBLEM: The COVID-19 pandemic significantly disrupted point-of-care ultrasound (POCUS) education. Medical schools and residency programs placed restrictions on bedside teaching and clinical scanning as part of risk mitigation. In response, POCUS faculty nationwide from 15 institutions collaborated on an alternative model of ultrasound education, A Distance-learning Approach to POCUS Training (ADAPT).APPROACH: ADAPT was repeated monthly from April 1 through June 30, 2020. It accommodated 70 learners, who included 1- to 4-week rotators and asynchronous learners. The curriculum included assigned pre-work and learning objectives covering 20 core POCUS topics. A rotating group of 30 faculty and fellows delivered daily virtual teaching sessions that included gamification to increase learner engagement and hands-on instruction through teleguidance. After participation, faculty and learners completed anonymous surveys.OUTCOMES: Educators reported a significant decrease in preparatory time (6.2 vs. 3.1 hours per week, P < .001) dedicated to ultrasound education after implementing ADAPT. The majority of 29 learners who completed surveys felt "somewhat confident" or "very confident" in their ability to acquire (n = 25, 86.2%) and interpret (n = 27, 93.1%) ultrasound images after the intervention; the majority of 22 educators completing surveys rated the program "somewhat effective" or "very effective" at contributing to learner's ability to acquire (n = 13, 59.1%) and interpret (n = 20, 90.9%) images. Most learners (n = 28, 96.6%) and all educators (n = 22, 100%) were "satisfied" or "very satisfied" with ADAPT as a whole, and the large majority of educators were "very likely" (n = 18, 81.8%) to recommend continued use of this program.NEXT STEPS: A virtual curriculum that pools the efforts of multiple institutions nationwide was implemented rapidly and effectively while satisfying educational expectations of both learners and faculty. This collaborative framework can be replicated and may be generalizable to other educational objectives.

    View details for DOI 10.1097/ACM.0000000000004399

    View details for PubMedID 34524135

  • Using a Simulated Model and Mastery Learning Approach to Teach the Ultrasound-guided Serratus Anterior Plane Block to Emergency Medicine Residents: A Pilot Study. AEM education and training Rider, A. C., Miller, D. T., Ashenburg, N., Duanmu, Y., Lobo, V., Schertzer, K., Sebok-Syer, S. S. 2021; 5 (3): e10525


    Background: The serratus anterior plane block (SAPB) is a safe, single-injection alternative for pain control in patients with rib fractures. This pilot study aims to teach the ultrasound-guided SAPB to emergency medicine (EM) residents using a mastery learning approach.Methods: A 19-item checklist was created and mastery was determined to be 17 of 19 items correct. This pass score was established using a Mastery Angoff standard-setting exercise with a group of EM experts. Learners participated in baseline testing on a simulated model and performance was assessed by two raters. Learners then watched an instructional video and participated in an individualized teaching session. Learners underwent deliberate practice followed by posttesting until mastery was achieved. Score differences in baseline testing and posttesting were analyzed using a paired t-test. Pre- and posttesting surveys were also completed by participants.Results: Twenty-eight PGY-1 to -4 residents volunteered to participate in the study. The range of reported SAPBs seen previously was 0 to 5. The mean (±SD) number of items correct on the checklist for initial testing was 8.5 of 19 (±2.7), while the mean (±SD) final score was 18 of 19 (±0.6; p<0.001). All participants met mastery standards after the curriculum intervention. Median self-reported procedural confidence was 2 out of 5 on a 5-point Likert scale before the session and 5 out of 5 after the session (Z=-4.681, p<0.001).Conclusions: Using a mastery learning approach and simulated model, we were able to successfully train EM residents to perform the SAPB at a level of mastery and increase their overall confidence in executing this procedure.

    View details for DOI 10.1002/aet2.10525

    View details for PubMedID 34041432

  • Nephrolithiasis diagnoised by point of care ultrasound Visual Journal of Emergency Medicine Edgar, L., Ashenburg, N. 2020; 21 (October)
  • Intra-Articular Catheter Placement: A Novel Approach for Simulating Ankle Effusions in Cadaver Models. The western journal of emergency medicine Ross, G. A., Ashenburg, N. G., Wynn, W. D., McCarthy, J. J., Clendening, A. M., Presley, B. C., Kubalak, S. W., Barnes, R. M. 2019; 20 (1): 92-93

    View details for DOI 10.5811/westjem.2018.9.39810

    View details for PubMedID 30643607

    View details for PubMedCentralID PMC6324721

  • Walking on eggshells: Point of Care Ultrasound for Patellar Fractures Visual Journal of Emergency Medicine Winstead-derlega, C., Makhijani, P., Ashenburg, N. 2019; 15