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Francis M. Fesmire

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American emergency physician (1969–2014)

Francis M. Fesmire
Born(1959-11-16)November 16, 1959
Atlanta, Georgia, U.S.
DiedJanuary 31, 2014(2014-01-31) (aged 54)
Chattanooga, Tennessee, U.S.
EducationBaylor School
Harvard College
Vanderbilt University Medical School
Medical career
FieldEmergency medicine
InstitutionsUniversity of Tennessee College of Medicine
Sub-specialtiesMyocardial infarction
AwardsYoung 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. 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 and the American Heart Association/American College of Cardiology. He performed numerous research investigations in chest pain patients, reporting the usefulness of continuous 12-lead ECG monitoring, two-hour delta cardiac marker testing, and nuclear cardiac stress testing in the emergency department. The culmination of his studies was The Erlanger Chest Pain Evaluation Protocol published in the Annals of Emergency Medicine in 2002. In 2011 he published a novel Nashville Skyline that received a 5 star review by ForeWord Reviews. His most recent research involved the risk stratification of chest pain patients in the emergency department.

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. In 1992 Fesmire was elected as a Fellow of American College of Emergency Physicians. 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. 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). In 2008, Dr Fesmire was named a Hero of Emergency Medicine by the American College of Emergency Physicians.

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"."

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. He was also professor and clinical research director of the Emergency Medicine Residency Program of the University of Tennessee College of Medicine and chairman of the Clinical Policy Committee of the American College of Emergency Physicians.

References

  1. ^ "Tennessee Heroes of Emergency Medicine". American College of Emergency Physicians. Archived from the original on January 15, 2010. Retrieved September 26, 2010.
  2. American College of Emergency Physicians (February 1995). "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. doi:10.1016/S0196-0644(95)70342-X. PMID 7832368.
  3. American College of Emergency Physicians (May 2000). "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. doi:10.1067/mem.2000.106387. PMID 10783419.
  4. Fesmire FM, Brady WJ, Hahn S, Decker WW, Diercks DB, Ghaemmaghami CA, Nazarian D, Jagoda AS (October 2006). "Clinical Policy: Indications for Reperfusion Therapy in Emergency Department Patients with Suspected Acute Myocardial Infarction". Annals of Emergency Medicine. 48 (4): 358–383. doi:10.1016/j.annemergmed.2006.07.006. PMID 16997672.
  5. Fesmire FM, Decker WW, Diercks DB, Ghaemmaghami CA, Nazarian D, Brady WJ, Hahn S, Jagoda AS (October 2006). "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. doi:10.1016/j.annemergmed.2006.07.005. PMID 16934648.
  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 (January 2006). "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. doi:10.1161/CIRCULATIONAHA.106.172860. PMID 16391153.
  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 (August 2007). "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. doi:10.1161/CIRCULATIONAHA.107.181940. PMID 17679616.
  8. Krumholz HM, Anderson JL, Bachelder BL, Fesmire FM, Fihn SD, Foody JM, Ho PM, Kosiborod MN, Masoudi FA, Nallamothu BK (December 2008). "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. doi:10.1161/CIRCULATIONAHA.108.191099. PMID 19001027.
  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 (May 2011). "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. doi:10.1016/j.jacc.2011.02.009. PMID 21450428.
  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 (August 2012). "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. doi:10.1016/j.jacc.2012.06.004. PMID 22809746.
  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 (December 2012). "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. doi:10.1016/j.jacc.2012.08.969. PMID 23154053.
  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 (January 2013). "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. doi:10.1161/CIR.0b013e3182742cf6. PMID 23247304.
  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 (March 2013). "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. doi:10.1161/CIR.0B013E3182831A11. PMC 5681220. PMID 23357718.
  14. Fesmire FM, Percy RF, Bardonner JB, Wharton DR, Calhoun FB (January 1998). "Usefulness of Automated Serial ECG Monitoring During the ED Evaluation of Chest Pain Patients". Annals of Emergency Medicine. 31 (1): 3–11. doi:10.1016/S0196-0644(98)70274-4. PMID 9437335.
  15. ^ Fesmire FM (October 2000). "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. doi:10.1053/ajem.2000.16302. PMID 11043626.
  16. Fesmire FM (November 2000). "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. doi:10.1053/ajem.2000.18036. PMID 11103727.
  17. Fesmire FM, Percy RF, Bardonner JB, Wharton DR, Calhoun FB (August 1998). "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. doi:10.1053/hj.1998.v136.89571. PMID 9704684.
  18. Fesmire FM, Fesmire CE (February 2000). "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. doi:10.1016/S0736-4679(01)00456-5. PMID 11858918.
  19. Fesmire FM, Hughes AD, Stout PK, Wojcik JF, Wharton DR (September 2001). "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. doi:10.1067/mem.2001.116594. PMID 11524638.
  20. Fesmire FM, Hughes AD, Fody EP, Jackson AP, Fesmire CE, Gilbert MA, Stout PK, Wojcik JF, Wharton DR, Creel JH (December 2002). "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. doi:10.1067/mem.2002.129506. PMID 12447334.
  21. Fesmire, Francis (2011). Nashville Skyline (1st ed.). Lulu.com. ISBN 978-0-5576-9779-3.
  22. "ForeWord Review Nashville Skyline". ForeWord Review. March 25, 2011. Retrieved August 16, 2012.
  23. Fesmire FM, Martin EJ, Cao Y, Heath GW (November 2012). "Improving risk stratification in chest pain patients: The Erlanger HEARTS3 score". Am J Emerg Med J Am. 30 (9): 1829–1837. doi:10.1016/j.ajem.2012.03.017. PMID 22626816.
  24. "Probability of ACS". Yu Cao. Archived from the original on July 7, 2014. Retrieved July 4, 2014.
  25. ^ "Faculty-Emergency Medicine CV" (PDF). University of Tennessee Chattanooga College of Medicine. Archived from the original (PDF) on September 21, 2018. Retrieved September 28, 2010.
  26. ^ "Francis Fesmire, MD named hero of emergency medicine". Chattanoogan.com. Archived from the original on May 22, 2011. Retrieved September 26, 2010.
  27. Fesmire FM (August 1988). "Termination of intractable hiccups with digital rectal massage". Annals of Emergency Medicine. 17 (8): 872. doi:10.1016/S0196-0644(88)80594-8. PMID 3395000.
  28. "Winners of the Ig Nobel Prize". Improbable Research. August 2006. Retrieved September 26, 2010.
  29. "Ig Nobel prizes hail digital rectal massage". NewScientist. Retrieved February 15, 2019.
  30. ^ "Faculty-Emergency Medicine". University of Tennessee Chattanooga College of Medicine. Retrieved September 26, 2010.
  31. "Emergency Medicine Residency Program Committee". utcomchatt.org. Retrieved August 16, 2012.
  32. "Clinical Policies Committee". ACEP.org. Archived from the original on March 4, 2016. Retrieved August 16, 2012.
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