Dr. Jim Christenson - St. Paul's and Mount St. Joseph Hospital Emergency Departments

Jim Christenson MD FRCPC
Professor and Head, Department of Emergency Medicine
University of British Columbia Faculty of Medicine
email: jim.christenson@ubc.ca

Dr. Christenson has had an interest in cardiovascular research for 25 years. With others he has developed an early discharge rule for patients with chest pain and helped to support Dr. Scheuermeyer’s exploration of best practices for patients in trial fibrillation. His primary interest is in investigating mechanisms and better treatments for patients with sudden unexpected death (cardiac arrest) and works closely with paramedics to collect prehospital information and run clinical trials. For 9 years he has been the Principal Investigator for British Columbia, one of ten North American sites, in the Resuscitation Outcomes Collaboration During that time, survival to discharge has risen from 6.6% to 14.3% (2014). In 2015, he and two other PI’s, Dr. Morrison at (University of Toronto) and Dr. Stiell (University of Ottawa) have been awarded a 5 year grant ($1.5 M) from the Institute of Cardiovascular and Respiratory Health for a Canadian Resuscitations Outcome Consortium. The Heart and Stroke foundation of Canada have provided matching funding and locally the Provincial Health Services Authority will provide funds to enhance BC data collection and reporting. The initiative will work to expand the partners in other Canadian provinces for a truly national picture of cardiac arrest care and outcomes and will provide a solid foundation for clinical trials and quality improvement and train the next generation of resuscitation scientists.

Dr. Christenson is the PI on an exciting new trial for a neuro protective agent (NA-1) for stroke given by primary care paramedics in the field. The Frontier Trial – Field Randomization of NA-1 Treatment In Early Responders is funded by Brain Canada. He is also the BC PI on a trial to evaluate the effectiveness of the early prehospital delivery of Tranexamic acid in Traumatic Brain Injury co-funded by the NIH/CIHR ROC project and the US Army.

Publications from 2011 – Present

Time on the scene and interventions are associated with improved survival in pediatric out-of-hospital cardiac arrest
Janice A. Tijssen, David K. Prince, Laurie J. Morrisond, Dianne L. Atkins, Michael A. Austin, Robert Berg, Siobhan P. Brown, Jim Christenson, Debra Egan, Preston J. Fedor, Ericka L. Fink, Garth D. Meckler, Martin H. Osmond, Kathryn A. Sims, James S. Hutchison on behalf of the Resuscitation Outcomes Consortium. Time on the scene and interventions are associated with improved survival in pediatric out-of-hospital cardiac arrest. Resuscitation Volume 94, September 2015, Pages 1–7. doi:10.1016/j.resuscitation.2015.06.012

Speed and accuracy of text-messaging emergency department electrocardiograms from a small community hospital to a provincial referral center .
Frank Xavier Scheuermeyer, Brian E Grunau, Timothy Findlay, Eric Grafstein, Jim Christenson, Eddy Lang, Brian Rowe, Kendall Ho. Speed and accuracy of text-messaging emergency department electrocardiograms from a small community hospital to a provincial referral center. Journal of Telemedicine and Telecare 05/2015; DOI:10.1177/1357633X15587626.

A Quantitative Analysis of Out-of-Hospital Pediatric and Adolescent Resuscitation Quality–A Report from the ROC Epistry–Cardiac Arrest
Robert M Sutton, Erin Case, Siobhan P Brown, Dianne L Atkins, Vinay M Nadkarni, Jonathan Kaltman, Clifton Callaway, Ahamed Idris, Graham Nichol, Jamie Hutchison, Mohamud Daya, Sheldon Cheskes, Jack Nuttall, Heather Herren, James Christenson, Dug Andrusiek, Christian Vaillancourt, James J Menegazzi, Thomas D Rea, Robert A Berg. A Quantitative Analysis of Out-of-Hospital Pediatric and Adolescent Resuscitation Quality–A Report from the ROC Epistry–Cardiac Arrest. Resuscitation 04/2015; DOI:10.1016/j.resuscitation.2015.04.010 · 3.96 Impact Factor

Targeted temperature management after out-of-hospital cardiac arrest: who, when, why, and how.
Grunau BE, Christenson J, Brooks SC. (2015). Targeted temperature management after out-of-hospital cardiac arrest: who, when, why, and how. Canadian Family Physician. 61(2): 129-134.

Out-of-hospital cardiac arrest survival improving over time: Results from the Resuscitation Outcomes Consortium (ROC)
Daya MR, Schmicker RH, Zive DM, Rea TD, Nichol G, Buick JE, Brooks S, Christenson J, MacPhee R, Craig A, Rittenberger JC, Davis DP, May S, Wigginton J, Wang H; for the Resuscitation Outcomes Consortium Investigators. Out-of-hospital cardiac arrest survival improving over time: Results from the Resuscitation Outcomes Consortium (ROC). Resuscitation. 2015 Feb 9. DOI: 10.1016/j.resuscitation.2015.02.003. [Epub ahead of print]

Chest compression rates and survival following out-of-hospital cardiac arrest
Idris AH, Guffey D, Pepe PP, Brown SP, Brooks SC, Callaway CW, Christenson J, Davis DP, Daya MR, Gray R, Kudenchuk PJ, Larsen J, Lin S, Menegazzi JJ, Sheehan K, Sopko G, Stiell I, Nichol G, Aufderheide TP; for The Resuscitation Outcomes Consortium Investigators. Chest compression rates and survival following out-of-hospital cardiac arrest. Crit Care Med. 2015 Jan 6. [Epub ahead of print]

A network to improve emergency patient care by facilitating practitioners to effectively support practitioners
Christenson, J. A network to improve emergency patient care by facilitating practitioners to effectively support practitioners. Healthcare Management Forum. 2014 Autumn; 27(3):132-135.

What Is the optimal chest compression depth during out-of-hospital cardiac arrest resuscitation of adult patients?
Stiell IG, Brown SP, Nichol G, Cheskes S, Vaillancourt C, Callaway CW, Morrison LJ, Christenson J, Aufderheide TP, Davis DP, Free C, Hostler D, Stouffer JA, Idris AH; Resuscitation Outcomes Consortium Investigators. What Is the Optimal Chest Compression Depth During Out-of-Hospital Cardiac Arrest Resuscitation of Adult Patients? Circulation. 2014 Nov 25;130(22):1962-70. DOI: 10.1161/CIRCULATIONAHA.114.008671. Epub 2014 Sep 24.

Association between survival and early versus later rhythm analysis in out-of-hospital cardiac arrest: do agency-level factors influence outcomes
Rea T, Prince D, Morrison L, Callaway C, Aufderheide T, Daya M, Stiell I, Christenson J, Powell J, Warden C, van Ottingham L, Kudenchuk P, Weisfeldt M. Association between survival and early versus later rhythm analysis in out-of-hospital cardiac arrest: do agency-level factors influence outcomes? Ann Emerg Med. 2014 Jul;64(1):1-8. DOI: 10.1016/j.annemergmed.2014.01.014. Epub 2014 Feb 13.

Emergency department patients with atrial fibrillation or flutter and an acute underlying medical illness may not benefit from attempts to control rate or rhythm
Scheuermeyer FX, Pourvali R, Rowe BH, Grafstein E, Heslop C, MacPhee J, McGrath L, Ward J, Heilbron B, Christenson J. Emergency Department Patients With Atrial Fibrillation or Flutter and an Acute Underlying Medical Illness May Not Benefit From Attempts to Control Rate or Rhythm. Ann Emerg Med. 2014;1-11. Epub 2014 Nov 6.

Early coronary angiography and induced hypothermia are associated with survival and functional recovery after out-of-hospital cardiac arrest
Callaway CW, Schmicker RH, Brown SP, Albrich JM, Andrusiek DL, Aufderheide TP, Christenson J, Daya MR, Falconer D, Husa RD, Idris AH, Ornato JP, Rac VE, Rea TD, Rittenberger JC, Sears G, Stiell IG; ROC Investigators. Early coronary angiography and induced hypothermia are associated with survival and functional recovery after out-of-hospital cardiac arrest. Resuscitation. 2014 May;85(5):657-63. doi: 10.1016/j.resuscitation.2013.12.028. Epub 2014 Jan 8.

Apples to apples or apples to oranges? International variation in reporting of process and outcome of care for out-of-hospital cardiac arrest
Nishiyama C, Brown SP, May S, Iwami T, Koster RW, Beesems SG, Kuisma M5, Salo A, Jacobs I, Finn J, Sterz F, Nürnberger A, Smith K, Morrison L, Olasveengen TM, Callaway CW, Shin SD, Gräsner JT, Daya M, Ma MH, Herlitz J, Strömsöe A, Aufderheide TP, Masterson S, Wang H, Christenson J, Stiell I, Davis D, Huszti E, Nichol G. Apples to apples or apples to oranges? International variation in reporting of process and outcome of care for out-of-hospital cardiac arrest. Resuscitation. 2014 Jul 8. pii: S0300-9572(14)00641-8. doi: 10.1016/j.resuscitation.2014.06.031. [Epub ahead of print]

Addressing emergency department overcrowding through a systems approach using big data research
Kamal N, Barnard DK, Christenson J, Innes G, Aikman P, Grafstein E, Marsden J. Addressing Emergency Department Overcrowding Through a Systems Approach Using Big Data Research. J Health Med Informat. 2014, 5:1.

Targeted temperature management after out-of-hospital cardiac arrest: who, when, why, and how
Grunau BE, Christenson J, Brooks SC. Targeted Temperature Management After Out-Of-Hospital Cardiac Arrest: Who, When, Why, and How. Canadian Family Physician. Forthcoming 2014.

The impact of peri-shock pause on survival from out-of-hospital shockable cardiac arrest during the Resuscitation Outcomes Consortium PRIMED trial
Cheskes S, Schmicker RH, Verbeek PR, Salcido DD, Brown SP, Brooks S, Menegazzi JJ, Vaillancourt C, Powell J, May S, Berg RA, Sell R, Idris A, Kampp M, Schmidt T, Christenson J; Resuscitation Outcomes Consortium (ROC) investigators. The impact of peri-shock pause on survival from out-of-hospital shockable cardiac arrest during the Resuscitation Outcomes Consortium PRIMED trial. Resuscitation. 2014 Mar;85(3):336-42.

Cardiopulmonary resuscitation quality: improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association
Meaney PA, Bobrow BJ, Mancini ME, Christenson J, de Caen AR, Bhanji F, Abella BS, Kleinman ME, Edelson DP, Berg RA, Aufderheide TP, Menon V, Leary M; Quality Summit Investigators; the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation. CPR Quality: Improving Cardiac Resuscitation Outcomes Both Inside and Outside the Hospital: A Consensus Statement. Circulation. 2013 July;128:417-435. Epub 2013 June 25. DOI: 10.1161/CIR.0b013e31829d8654

Transfusion of red blood cells in patients with a prehospital Glasgow Coma Scale score of 8 or less and no evidence of shock is associated with worse outcomes
Joel Elterman, Karen Brasel, Siobhan Brown, Eileen Bulger, Jim Christenson, Jeffrey D Kerby, Delores Kannas, Steven Lin, Joseph P Minei, Sandro Rizoli, Samuel Tisherman, Martin A Schreiber. Transfusion of red blood cells in patients with a prehospital Glasgow Coma Scale score of 8 or less and no evidence of shock is associated with worse outcomes. The journal of trauma and acute care surgery 07/2013; 75(1):8-14. DOI:10.1097/TA.0b013e318298492e

Missed Opportunities for Appropriate Anticoagulation Among Emergency Department Patients With Uncomplicated Atrial Fibrillation or Flutter
Frank X Scheuermeyer, Grant Innes, Reza Pourvali, Chris Dewitt, Eric Grafstein, Claire Heslop, Jan Macphee, John Ward, Brett Heilbron, Lorraine McGrath, Jim Christenson. Missed Opportunities for Appropriate Anticoagulation Among Emergency Department Patients With Uncomplicated Atrial Fibrillation or Flutter. Annals of emergency medicine 05/2013; 62(6). DOI:10.1016/j.annemergmed.2013.04.004 · 4.33 Impact Factor

Safety and efficiency of calcium channel blockers versus beta-blockers for rate control in patients with atrial fibrillation and no acute underlying medical illness
Scheuermeyer F, Grafstein E, Stenstrom R, Christenson J, Heslop C, Heilbron B, McGrath L, Innes G. Safety and efficiency of calcium channel blockers versus beta-blockers for rate control in patients with atrial fibrillation and no acute underlying medical illness. Acad Emerg Med. 2013 March;20(3):222-230. Epub 2013 Mar 20. DOI: 10.1111/acem.12091

Re: Validation of the Vancouver chest pain rule
Christenson J, Scheuermeyer, FX. Re: Validation of the Vancouver Chest Pain Rule. Acad Emerg Med [Letter to the editor]. 2013;20(1):112. Epub 2013 Jan. DOI: 10.1111/acem.12060

Development and validation of a prediction rule for early discharge of low-risk emergency department patients with potential ischemic chest pain
Scheuermeyer FX, Wong H, Yu E, Boychuk B, Innes G, Grafstein E, Gin K, Christenson J. Development and validation of a prediction rule for early discharge of low-risk emergency department patients with potential ischemic chest pain. CJEM. 2013;(15)0:1-14. DOI: 10.2310/8000.2013.130938

Does GIS derived transport time prediction reflect actual transport times in OHCA patients?
Cudnik M, Yao J, Andrusiek D, Pennington S, Christenson J, Murray A. Does GIS derived transport time prediction reflect actual transport times in OHCA patients? Acad Emerg Med. Epub 2012 May.

Endotracheal intubation versus supraglottic airway insertion in out-of-hospital cardiac arrest
Wang HE, Szydlo D, Stouffer JA, Lin S, Carlson JN, Vaillancourt C, Sears G, Verbeek RP, Fowler R, Idris AH, Koenig K, Christenson J, Minokadeh A, Brandt J, Rea T; ROC Investigators. Endotracheal intubation versus supraglottic airway insertion in out-of-hospital cardiac arrest. Resuscitation. 2012 Sep;83(9):1061-6. Epub 2012 Jun 1.

Thirty-day and 1-year outcomes of emergency department patients with atrial fibrillation and no acute underlying medical cause
Scheuermeyer FX, Grafstein E, Stenstrom R, Innes G, Heslop C, MacPhee J, Pourvali R, Heilbron B, McGrath L, Christenson J. Thirty-day and 1-year outcomes of emergency department patients with atrial fibrillation and no acute underlying medical cause. Ann Emerg Med. 2012;60(6):755-765.
Safety and efficiency of a chest pain diagnostic algorithm with selective outpatient stress testing for emergency department patients with potential ischemic chest pain
Scheuermeyer FX, Innes G, Grafstein E, Kiess M, Boychuk B, Yu E, Kalla D, Christenson J. Safety and efficiency of a chest pain diagnostic algorithm with selective outpatient stress testing for emergency department patients with potential ischemic chest pain. Ann Emerg Med. 2012 Apr;59(4):256-264.e3. Epub 2012 Jan 4. DOI: 10.1016/j.annemergmed.2011.10.016.

What is the role of chest compression depth during out-of-hospital cardiac arrest resuscitation?
Stiell IG, Brown SP, Christenson J, Cheskes S, Nichol G, Powell J, Bigham B, Morrison LJ, Larsen J, Hess E, Vaillancourt C, Davis DP, Callaway CW; Resuscitation Outcomes Consortium (ROC) Investigators. What is the role of chest compression depth during out-of-hospital cardiac arrest resuscitation? Crit Care Med. 2012 Apr;40(4):1192-8. DOI: 10.1097/CCM.0b013e31823bc8bb.

Independent predictors of 28-day survival in patients with severe traumatic brain injury
Joel Elterman, Karen Brasel, Siobhan Brown, Eileen Bulger, Jim Christenson, Jeffrey Kerby, Steve Lin, Joseph Minei, Sandro Rizoli, Martin Schreiber. Independent predictors of 28-day survival in patients with severe traumatic brain injury. Journal of the American College of Surgeons 09/2011; 213(3):S75. DOI:10.1016/j.jamcollsurg.2011.06.175 · 4.45 Impact Factor

CAEP position statement on bystander cardiopulmonary resuscitation
Vaillancourt C, Epstein N, Cheskes S, Maloney J, Stiell IG, Christenson J, Affleck A, Travers AH, Osmond MH, Forgie P, Slenys J. CAEP position statement on bystander cardiopulmonary resuscitation. CJEM. 2011 Sep;13(5):339-346.

The impact of increased chest compression fraction on return of spontaneous circulation for out-of-hospital cardiac arrest patients not in ventricular fibrillation
Vaillancourt C, Everson-Stewart S, Christenson J, Andrusiek D, Powell J, Nichol G, Cheskes S, Aufderheide TP, Berg R, Stiell IG; Resuscitation Outcomes Consortium Investigators. The impact of increased chest compression fraction on return of spontaneous circulation for out-of-hospital cardiac arrest patients not in ventricular fibrillation. Resuscitation. 2011 Dec;82(12):1501-7. Epub 2011 Jul 18. DOI: 10.1016/j.resuscitation.2011.07.011

A trial of an impedance threshold device in out-of-hospital cardiac arrest
Aufderheide TP, Nichol G, Rea TD, Brown SP, Leroux BG, Pepe PE, Kudenchuk PJ, Christenson J, Daya MR, Dorian P, Callaway CW, Idris AH, Andrusiek D, Stephens SW, Hostler D, Davis DP, Dunford JV, Pirrallo RG, Stiell IG, Clement CM, Craig A, Van Ottingham L, Schmidt TA, Wang HE, Weisfeldt ML, Ornato JP, Sopko G; Resuscitation Outcomes Consortium (ROC) Investigators. A Trial of an Impedance Threshold Device in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2011 Sep 1;365(9):798-806. DOI: 10.1056/NEJMoa1010821

Early versus later rhythm analysis in patients with out-of-hospital cardiac arrest
Stiell IG, Nichol G, Leroux BG, Rea TD, Ornato JP, Powell J, Christenson J, Callaway CW, Kudenchuk PJ, Aufderheide TP, Idris AH, Daya MR, Wang HE, Morrison LJ, Davis D, Andrusiek D, Stephens S, Cheskes S, Schmicker RH, Fowler R, Vaillancourt C, Hostler D, Zive D, Pirrallo RG, Vilke GM, Sopko G, Weisfeldt M; ROC Investigators. Early versus later rhythm analysis in patients with out-of-hospital cardiac arrest. N Engl J Med. 2011 Sep 1;365(9):787-97. DOI: 10.1056/NEJMoa1010076.

Perishock pause: an independent predictor of survival from out-of-hospital shockable cardiac arrest
Cheskes S, Schmicker RH, Christenson J, Salcido DD, Rea T, Powell J, Edelson DP, Sell R, May S, Menegazzi JJ, Van Ottingham L, Olsufka M, Pennington S, Simonini J, Berg RA, Stiell I, Idris A, Bigham B, Morrison L; Resuscitation Outcomes Consortium (ROC) Investigators. Perishock pause: an independent predictor of survival from out-of-hospital shockable cardiac arrest. Circulation. 2011 Jul 5;124(1):58-66. Epub 2011 Jun 20. DOI: 10.1161/CIRCULATIONAHA.110.010736.

Grants from 2011 – Present

2015

Canadian Resuscitation Outcomes Consortium: Toward a National Resuscitation Clinical Research Network.

Institute for Cardiovascular and Respiratory Health and Heart and Stroke Foundation of Canada

Co-Principal Investigators: J Christenson (BC), I Stiell (Ottawa), L Morrison (Toronto).

Total Grant $300,000 per year for 5 years (begins October 2015).

BC Portion: $150,000 per year for 5 years.

British Columbia Prehospital Resuscitation Registry to support CanROC and BCEHS

Principal Investigator: J Christenson

$150,000 per year for 5 years (begins October 2015).

A Multicenter, Randomized, Double-Blind, Placebo-Controlled Study to Determine the Efficacy and Safety of Intravenous NA-1 Initiated by Paramedics in the Field for Acute Cerebral Ischemia Within Three Hours of Symptom Onset

Brain Canada

Co-Investigators and Co-PIs BC: Jim Christenson, William Dick

Total BC Portion: $659,500 over 3 years

BC Portion for 2015: $308,291

Resuscitation Outcomes Consortium