Francis M. Fesmire Explained

Francis M. Fesmire
Birth Date:16 November 1959
Birth Place:Atlanta, Georgia, U.S.
Death Place:Chattanooga, Tennessee, U.S.
Work Institution:University of Tennessee College of Medicine
Field:Emergency medicine
Specialism:Myocardial infarction
Education:Baylor School
Harvard College
Vanderbilt University Medical School
Prizes:Young Investigator Award (1996)
Ig Nobel Prize in Medicine (2006)
Hero of Emergency Medicine (2008)

Francis Miller Fesmire (November 16, 1959 – January 31, 2014) was an American emergency physician and a nationally recognized expert in myocardial infarction.[1] He authored numerous academic articles and assisted in the development of clinical guidelines on the standard of care in treating patients with suspected myocardial infarction by the American College of Emergency Physicians[1] [2] [3] [4] [5] and the American Heart Association/American College of Cardiology.[6] [7] [8] [9] [10] [11] [12] [13] He performed numerous research investigations in chest pain patients, reporting the usefulness of continuous 12-lead ECG monitoring,[14] [15] [16] two-hour delta cardiac marker testing,[15] [17] [18] and nuclear cardiac stress testing in the emergency department.[19] The culmination of his studies was The Erlanger Chest Pain Evaluation Protocol published in the Annals of Emergency Medicine in 2002.[20] In 2011 he published a novel Nashville Skyline[21] that received a 5 star review by ForeWord Reviews.[22] His most recent research involved the risk stratification of chest pain patients in the emergency department.[23] [24]

Background

Born in 1959 in Atlanta, Georgia, Fesmire grew up in Chattanooga, Tennessee and graduated high school Valedictorian from the Baylor School in 1978. He graduated Magna Cum Laude from Harvard College in 1981. Fesmire graduated from Vanderbilt University School of Medicine in 1985 and completed a residency in Emergency Medicine at University Hospital in Jacksonville, Florida in 1988 where he received the Outstanding Resident Award.[25] In 1992 Fesmire was elected as a Fellow of American College of Emergency Physicians.[25] He practiced as an emergency physician at Chattanooga Memorial Hospital from 1988 until 1991 and had been practicing at Erlanger Baroness Hospital from 1991 until his death in 2014.

Awards

Fesmire received the Emergency Medicine Foundation's Young Investigator Award in 1996 for his work in developing a rapid protocol for the evaluation of chest pain patients.[26] In 2006, he received the Ig Nobel Prize in Medicine for a 1988 case report detailing the use of digital rectal massage as a cure for persistent singultus (hiccups).[27] [28] In 2008, Dr Fesmire was named a Hero of Emergency Medicine by the American College of Emergency Physicians.[1]

He later on told New Scientist in an interview that he found a "treatment sure to be more popular with hiccup patients. "An orgasm results in incredible stimulation of the vagus nerve. From now on, I will be recommending sex – culminating with orgasm – as the cure-all for intractable hiccups"."[29]

Later work

At the time of his death, Fesmire lived in Chattanooga with his wife and two sons. He was medical director of Chest Pain Center of Erlanger Medical Center.[30] He was also professor and clinical research director of the Emergency Medicine Residency Program[31] of the University of Tennessee College of Medicine[30] and chairman of the Clinical Policy Committee of the American College of Emergency Physicians.[32]

Notes and References

  1. Web site: Tennessee Heroes of Emergency Medicine . American College of Emergency Physicians . September 26, 2010 . January 15, 2010 . https://web.archive.org/web/20100115212142/http://www.acep.org/aboutus.aspx?LinkIdentifier=id&id=38810&fid=2692&Mo=No . dead .
  2. American College of Emergency Physicians . Clinical policy for the initial approach to adults presenting with a chief complaint of chest pain, with no history of trauma . Annals of Emergency Medicine . 25 . 2 . 274–299 . February 1995. 7832368 . 10.1016/S0196-0644(95)70342-X.
  3. American College of Emergency Physicians . Clinical policy: Critical issues in the evaluation and management of patients with acute myocardial infarction or unstable angina . Annals of Emergency Medicine . 35 . 5 . 521–525 . May 2000. 10783419 . 10.1067/mem.2000.106387.
  4. Fesmire FM, Brady WJ, Hahn S, Decker WW, Diercks DB, Ghaemmaghami CA, Nazarian D, Jagoda AS . Clinical Policy: Indications for Reperfusion Therapy in Emergency Department Patients with Suspected Acute Myocardial Infarction . Annals of Emergency Medicine . 48 . 4 . 358–383 . October 2006. 16997672 . 10.1016/j.annemergmed.2006.07.006. free .
  5. Fesmire FM, Decker WW, Diercks DB, Ghaemmaghami CA, Nazarian D, Brady WJ, Hahn S, Jagoda AS . Clinical Policy: Critical issues in the evaluation and management of adult patients with non-ST-segment elevation acute coronary syndromes . Annals of Emergency Medicine . 48 . 4 . 358–383 . October 2006. 16934648 . 10.1016/j.annemergmed.2006.07.005.
  6. Krumholz HM, Anderson JL, Brooks NH, Fesmire FM, Lambrew CT, Landrum MB, Weaver WD, Whyte J, Bonow RO, Bennett SJ, Burke G, Eagle KA, Linderbaum J, Masoudi FA, Normand SL, Piña IL, Radford MJ, Rumsfeld JS, Ritchie JL, Spertus JA . ACC/AHA clinical performance measures for adults with ST-elevation and non-ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures (Writing Committee to Develop Performance Measures on ST-Elevation and Non-ST-Elevation Myocardial Infarction) . Circulation . 113 . 5 . 732–761 . January 2006. 16391153 . 10.1161/CIRCULATIONAHA.106.172860. free .
  7. Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE, Chavey WE, Fesmire FM, Hochman JS, Levin TN, Lincoff AM, Peterson ED, Theroux P, Wenger NK, Wright RS, Smith SC, Jacobs AK, Halperin JL, Hunt SA, Krumholz HM, Kushner FG, Lytle BW, Nishimura R, Ornato JP, Page RL, Riegel B . ACC/AHA 2007 guidelines for the management of patients with unstable angina/non ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non ST-Elevation Myocardial Infarction) . Circulation . 116 . 7 . e148–e304 . August 2007. 17679616 . 10.1161/CIRCULATIONAHA.107.181940. free .
  8. Krumholz HM, Anderson JL, Bachelder BL, Fesmire FM, Fihn SD, Foody JM, Ho PM, Kosiborod MN, Masoudi FA, Nallamothu BK . ACC/AHA 2008 performance measures for adults with ST-elevation and non-ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures (Writing Committee to develop performance measures for ST-elevation and non-ST-elevation myocardial infarction) . Circulation . 118 . 24 . 2596–2648 . December 2008. 19001027 . 10.1161/CIRCULATIONAHA.108.191099. free .
  9. Wright RS, Anderson JL, Adams CD, Bridges CR, ((Casey DE Jr)), Ettinger SM, Fesmire FM, Ganiats TG, Jneid H, Lincoff AM, Peterson ED, Phillippides GJ, Theroux P, Wenger NK, Zidar JP . 2011 ACCF/AHA focused update of the guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction (updating the 2007 guideline). A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in collaboration with the American College of Emergency Physicians, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons . J Am Coll Cardiol . 57 . 19 . 1920–1959 . May 2011. 21450428 . 10.1016/j.jacc.2011.02.009. free .
  10. Jneid H . Anderson JL . Wright RS . Adams CD . Bridges CR . Casey DE Jr . Ettinger SM . Fesmire FM . Ganiats TG . Lincoff AM . Peterson ED . Philippides GL . Theroux P . Wenger NK . Zidar JP . 2012 ACCF/AHA focused update of the guideline for the management of patients with unstable angina/non–ST-elevation myocardial infarction (updating the 2007 guideline and replacing the 2011 focused update): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines . J Am Coll Cardiol . 60 . 7 . 645–681 . August 2012. 22809746 . 10.1016/j.jacc.2012.06.004.
  11. Newby LK, Jesse RL, Babb J, Christenson RH, De Fer TM, Diamond GA, Fesmire FM, Gersh BJ, Geraci S, Larsen G, Kaul S, McKay C, Philippides G, Weintraub WS . ACCF 2012 Clinical Expert Consensus Document on Practical Clinical Consideration in the Interpretation of Troponin Elevations. A Report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents . J Am Coll Cardiol . 60 . 23 . 2427–2463 . December 2012. 23154053 . 10.1016/j.jacc.2012.08.969. free .
  12. O'Gara PT, Kushner FG, Ascheim DD, Casey DE, Chung MK, de Lemos JA, Ettinger SM, Fang JC, Fesmire FM, Franklin BA, Granger CB, Krumholz HM, Linderbaum JA, Morrow DA, Newby LK, Ornato JP, Ou N, Radford MJ, Tamis-Holland JE, Tommaso CL, Tracy CM, Woo YJ, Zhao DX, Anderson JL, Jacobs AK, Halperin JL, Albert NM, Brindis RG, Creager MA, DeMets D, Guyton RA, Hochman JS, Kovacs RJ, Kushner FG, Ohman EM, Stevenson WG, Yancy CW . 2013 ACCF/AHA guideline for management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines . Circulation . 127 . 4 . 3362–3425 . January 2013 . 23247304. 10.1161/CIR.0b013e3182742cf6. free .
  13. Cannon CP, Brindis RG, Chaitman BR, Cohen DJ, ((Cross JT Jr)), ((Drozda JP Jr)), Fesmire FM, Fintel DJ, Fonarow GC, Fox KA, Gray DT, Harrington RA, Hicks KA, Hollander JE, Krumholz H, Labarthe DR, Long JB, Mascette AM, Meyer C, Peterson ED, Radford MJ, Roe MT, Richmann JB, Selker HP, Shahian DM, Shaw RE, Sprenger S, Swor R, Underberg JA, Van de Werf F, Weiner BH, Weintraub WS . 2013 ACCF/AHA Key Data Elements and Definitions for Measuring the Clinical Management and Outcomes of Patients With Acute Coronary Syndromes and Coronary Artery Disease: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Acute Coronary Syndromes and Coronary Artery Disease Clinical Data Standards) . Circulation . 127 . 9 . 1052–1089 . March 2013 . 23357718 . 10.1161/CIR.0B013E3182831A11. 5681220 .
  14. Fesmire FM, Percy RF, Bardonner JB, Wharton DR, Calhoun FB . Usefulness of Automated Serial ECG Monitoring During the ED Evaluation of Chest Pain Patients . Annals of Emergency Medicine . 31 . 1 . 3–11 . January 1998 . 9437335 . 10.1016/S0196-0644(98)70274-4.
  15. 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 ΔCK-MB . American Journal of Emergency Medicine . 18 . 6 . 698–702 . October 2000 . 11043626 . 10.1053/ajem.2000.16302.
  16. Fesmire FM . Which chest pain patients potentially benefit from continuous 12-lead ST-segment monitoring with automated serial ECG . American Journal of Emergency Medicine . 18 . 7 . 773–778 . November 2000 . 11103727 . 10.1053/ajem.2000.18036.
  17. 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 . American Heart Journal . 136 . 2 . 237–244 . August 1998 . 9704684 . 10.1053/hj.1998.v136.89571.
  18. Fesmire FM, Fesmire CE . Improved identification of acute coronary syndromes with second generation cardiac troponin I assay: Utility of 2-hour delta cTnI > + 0.02 ng/ml . Journal of Emergency Medicine . 22 . 2 . 147–152 . February 2000 . 11858918. 10.1016/S0736-4679(01)00456-5 .
  19. Fesmire FM, Hughes AD, Stout PK, Wojcik JF, Wharton DR . Selective dual nuclear scanning in low risk patients with chest pain to reliably identify and exclude acute coronary syndromes . Annals of Emergency Medicine . 38 . 3 . 207–215 . September 2001 . 11524638 . 10.1067/mem.2001.116594.
  20. Fesmire FM, Hughes AD, Fody EP, Jackson AP, Fesmire CE, Gilbert MA, Stout PK, Wojcik JF, Wharton DR, Creel JH . The Erlanger chest pain evaluation protocol: a one-year experience with serial 12-lead ECG monitoring, two-hour delta serum marker measurements, and selective nuclear stress testing to identify and exclude acute coronary syndromes . Annals of Emergency Medicine . 40 . 6 . 207–215 . December 2002 . 12447334 . 10.1067/mem.2002.129506 .
  21. Book: Fesmire, Francis . Nashville Skyline. 2011 . Lulu.com. 1st. 978-0-5576-9779-3.
  22. Web site: ForeWord Review Nashville Skyline. ForeWord Review. August 16, 2012.
  23. Fesmire FM, Martin EJ, Cao Y, Heath GW . Improving risk stratification in chest pain patients: The Erlanger HEARTS3 score . Am J Emerg Med J Am. 30. 9 . 1829–1837. November 2012. 22626816. 10.1016/j.ajem.2012.03.017.
  24. Web site: Probability of ACS. Yu Cao. July 4, 2014. dead. https://archive.today/20140707053138/http://54.221.245.91/hearts3/. July 7, 2014.
  25. Web site: Faculty-Emergency Medicine CV . University of Tennessee Chattanooga College of Medicine . September 28, 2010 . September 21, 2018 . https://web.archive.org/web/20180921204434/http://utcomchatt.org/docs/Fesmire_CV_83110_903.pdf . dead .
  26. Web site: Francis Fesmire, MD named hero of emergency medicine . Chattanoogan.com . September 26, 2010 . https://web.archive.org/web/20110522154120/http://www.chattanoogan.com/articles/article_129248.asp . May 22, 2011 . dead .
  27. Fesmire FM . Termination of intractable hiccups with digital rectal massage . Annals of Emergency Medicine . 17 . 8. 872 . August 1988. 3395000 . 10.1016/S0196-0644(88)80594-8.
  28. Web site: Winners of the Ig Nobel Prize . August 2006 . Improbable Research . September 26, 2010.
  29. Web site: Ig Nobel prizes hail digital rectal massage . February 15, 2019 . NewScientist.
  30. Web site: Faculty-Emergency Medicine . University of Tennessee Chattanooga College of Medicine . September 26, 2010.
  31. Web site: Emergency Medicine Residency Program Committee. utcomchatt.org. August 16, 2012.
  32. Web site: Clinical Policies Committee. ACEP.org. August 16, 2012. March 4, 2016. https://web.archive.org/web/20160304025615/http://www.acep.org/content.aspx?LinkIdentifier=id&id=23044&fid=1590&Mo=No&acepTitle=Clinical%20Policies%20Committee. dead.

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