About

Irene (Allie) Hurst, MD, MS, is an Assistant Professor of Emergency Medicine and Pediatrics at the University of Wisconsin–Madison. She is a Pediatric Emergency Medicine physician and a flight physician consultant with UW Health Med Flight. Dr. Hurst completed her pediatric residency at Ann & Robert H. Lurie Children’s Hospital of Chicago with Northwestern University, followed by a pediatric emergency medicine fellowship at Children’s Hospital of Colorado through the University of Colorado. She also completed a critical care transport fellowship with UW Health Med Flight at the University of Wisconsin Hospitals and Clinics. Prior to medical school, she earned a graduate degree in clinical research from The Dartmouth Institute. Her research interests focus on adolescent health, particularly substance use disorders and the human trafficking of children. She has a special interest in pediatric critical care retrieval and transport education and operations. Outside of her professional work, Dr. Hurst enjoys bicycle racing, cooking, and surfing Lake Michigan.

Research topics

• Computer Science
• Internal medicine
• Database
• Programming language
• Emergency medicine
• Medicine
• Operating system
• Psychiatry
• Pediatrics

Selected publications

• Using MedSMA℞T Families for Opioid Safety Education: Emergency Department Staff Perspective

  Pediatrics Open Science · 2025-02-10 · 2 citations

  articleOpen access

  OBJECTIVES Misuse of opioid medications was associated with 75% of drug-related deaths in 2020. Although emergency departments (EDs) frequently prescribe opioids, no preventive interventions have been implemented to educate adolescents and their families on safe opioid use. This study aimed to characterize ED staff’s perspectives on implementing the MedSMA℞T Families intervention in the ED to improve opioid education and safety among adolescents. METHODS ED staff played the MedSMA℞T game, completed a survey, and were asked open-ended questions regarding their experience interfacing with the technology. Transcripts were coded using NVivo to conduct content analysis. The analysis integrated the Systems Engineering Initiative for Patient Safety 3.0 model into the intervention. RESULTS A total of 23 ED staff were recruited. Staff reported that the game was more interactive and age-appropriate for adolescents compared with other educational materials in the ED. Reflecting on the care team, nurses and child life specialists were identified as appropriate roles for delivering the game to patients. Moreover, staff buy-in, training, and ED workflows were recognized as important factors within the organizational conditions allowing for game implementation. Space, loudness, and allocated resources in the ED were perceived as challenges to game implementation. Lastly, waiting room gameplay was thought to be the most efficient setting of game implementation. CONCLUSIONS MedSMA℞T Families can be efficiently implemented into ED settings. It is one of the first serious games to target opioid education and to engage and better retain the attention of younger patients and was well received by ED staff.

  PublisherOA PDFDOI

• Adolescents’ and Parents’ Perspectives on Using the MedSMARxT Families Intervention in Emergency Departments for Opioid Medication Safety Education: Mixed Methods Study

  JMIR Serious Games · 2025-04-25 · 2 citations

  articleOpen accessSenior author

  Background: The opioid crisis has significantly impacted adolescents and their families. This is attributed in part to increased opioid prescriptions in pediatric emergency departments (EDs) due to acute pain conditions and injuries. Although EDs frequently prescribe opioids, no effective preventative interventions have been implemented to educate adolescents and their families on safe opioid use. This study evaluates the MedSMA℞T Families intervention, which consists of an engaging serious game, Adventures in PharmaCity, and a personalized Family Medication Safety Plan (FMSP) with the aim of reducing opioid misuse and promoting opioid medication safety. The MedSMA℞T Families intervention was developed to educate adolescents and adults prescribed opioids on safe practices such as opioid storage and disposal. Objective: This study aimed to explore and characterize adolescents' and parents' experiences and perspectives on implementing the MedSMA℞T Families intervention in the ED to improve opioid education and safety among adolescents. Methods: A total of 93 participants, including 16 children and 77 parents, were recruited from the pediatric ED at a tertiary academic hospital to play the MedSMA℞T game in the ED. A total of 16 participants, including 8 children and 8 parents, were followed up with interviews to gather qualitative feedback. Participants engaged with the MedSMA℞T game-Adventures in PharmaCity-and the FMSP. Data were collected through gameplay observation and 75-minute semistructured interviews via Zoom. Quantitative in-game data were analyzed using descriptive analysis and qualitative data were analyzed using thematic analysis with NVivo (version 14; Lumivero). Results: Parents spent an average of 22.16 (SD 4.97) minutes playing the game, while children spent an average of 21.99 (SD 8.06) minutes. Families appreciated the game's design and noted usability challenges and suggested enhancements for clearer gameplay instructions. Participants reported increased knowledge of opioid safety, highlighted the importance of communication with health care providers, and a desire for a mobile app to assist with medication management. The FMSP was perceived as valuable for promoting awareness of safe practices and connected well to the knowledge gained from the game. Conclusions: The MedSMA℞T Families intervention was well received as a beneficial educational tool to educate adolescents and their families on safe opioid use. Additionally, it highlights a clear need for more accessible digital tools to increase opioid education. This feedback indicates a strong interest in improving educational resources to ensure safe opioid management within families.

  PublisherDOI

• Evaluating the Implementation of a “COVID-19 Test” Chief Concern in the Emergency Department

  Western Journal of Emergency Medicine · 2025-05-02

  articleOpen access

  BACKGROUND: During the COVID-19 pandemic, rapid, at-home testing for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) was inconsistently available. Consequently, for some patients, emergency departments (ED) became the preferred site to access COVID-19 testing. To improve operational efficiency, our ED implemented a "COVID-19 Test" chief concern (CC). Our primary objective in this analysis was to broadly assess the utilization of the new "COVID-19 Test" CC and associated clinical care. METHODS: We conducted a retrospective analysis of ED encounters from an academic ED and an affiliated, community-based ED of all patients after the establishment of a CC of "COVID-19 Test" from October 11, 2021-July 31, 2022. The data were extracted from the electronic health record. We calculated descriptive demographic statistics and ran a univariate and multivariate logistic regression with additional diagnostic or therapeutic interventions (binary) as the outcome variable to generate odds ratios (OR) and 95% confidence intervals (CI). RESULTS: A total of 320 patients were assigned a "COVID-19 Test" CC by a triage nurse. This was 0.5% of all ED encounters in this time frame. Of those, 45% were found to be SARS-CoV-2 positive. Admission or repeat ED visit at 72 hours occurred in 5.3% of patients. Nearly half (46.9%) of patients assigned a "COVID-19 Test" CC underwent additional ED interventions. Patients on Medicaid and those who self-identified as Black or Hispanic/Latino were disproportionately represented in the "COVID-19 Test" CC group as compared to the overall ED population. In multivariate analysis, an Emergency Severity Index of 1, 2 or 3 was associated with significantly higher odds of receiving additional interventions compared to ESI of 4 or 5 (adjusted OR: 46.85; 95% CI 13.28-165.26; P <0.001). CONCLUSION: Patients assigned a chief concern of "COVID-19 Test" had a high COVID-19 positivity rate, often underwent additional ED interventions, and were at low risk of return ED visits or admission. Minoritized and low-income patients were disproportionately represented in the "COVID-19 Test" CC group, highlighting potential disparities in access to at-home COVID-19 testing and implementation of this CC.

  PublisherOA PDFDOI

• Reduced left‐without‐being‐seen rates and impact on disparities after guest services ambassadors implementation

  Academic Emergency Medicine · 2025-02-05 · 1 citations

  articleOpen access

  BACKGROUND: The rate of patients who leave without being seen (LWBS) from an emergency department (ED) is a common measurement of quality, operational efficiency, and patient satisfaction. We hypothesized that adding a nonclinical staff role, guest service ambassadors (GSA), to the ED waiting room would decrease LWBS rates and reduce existing differences by race, ethnicity, sex, and primary language for ED patients. METHODS: We conducted an observational cohort study at a quaternary care academic ED in the Midwestern United States with approximately 60,000 annual visits between April and December 2022. GSAs were trained to guide patients and visitors through the check-in process and help manage the waiting room. LWBS rates were compared between pre- and postimplementation periods using logistic regression. Using two-sample proportion tests, subgroup analyses were performed to assess differences according to race, ethnicity, sex, and primary language. RESULTS: = 17.357, p < 0.001) with an adjusted odds ratio (OR) of 0.65 (95% confidence interval [CI] 0.49-0.85). There was a greater reduction in LWBS for Black, Indigenous, and people of color (BIPOC) patients compared to White patients (BIPOC ARR 1.8%, 95% CI 0.39%-3.14%; White ARR 1.2%, 95% CI 0.48%-1.94%). There was a reduction in LBWS rates for both males and females (female ARR 1.7%, 95% CI 0.80%-2.63%; male ARR 1.0%, 95% CI 0.06%-1.90%). The reduction in LWBS for patients speaking a language other than English and requiring interpreter services did not meet statistical significance (ARR 1.4%, 95% CI -1.04% to 3.85%). CONCLUSIONS: Although some disparities remain, our study suggests that GSAs may provide an effective strategy to reduce the overall LWBS rate and reduce disparities across diverse demographic groups including BIPOC and female patients.

  PublisherOA PDFDOI

• Adolescents’ and Parents’ Perspectives on Utilizing the MedSMA℞T Families intervention in Emergency Departments for Opioid Medication Safety Education: Mixed Methods Study (Preprint)

  2024-11-14

  preprintOpen accessSenior author

  <sec> <title>BACKGROUND</title> The opioid crisis has significantly impacted adolescents and families. This is attributed in part to increased opioid prescriptions in pediatric Emergency Departments (EDs) due to acute pain and injuries. Although EDs frequently prescribe opioids, no preventative interventions have been implemented to educate adolescents and their families on safe opioid use. This study evaluates the MedSMA℞T Families intervention, which consists of a serious game and a personalized Family Medication Safety Plan (FMSP) with the aim to reduce opioid misuse. The MedSMA℞T Families intervention was developed to educate adolescents and adults prescribed opioids on safe practices such as opioid storage and disposal. </sec> <sec> <title>OBJECTIVE</title> This study aimed to characterize adolescents’ and parents’ perspectives on implementing the MedSMA℞T Families intervention in the ED to improve opioid education and safety among adolescents. </sec> <sec> <title>METHODS</title> A total of 93 participants, including 16 children and 77 parents, were recruited from the Pediatric ED at a tertiary academic hospital to play the MedSMA℞T game in the ED. A total of 16 participants, including 8 children and 8 parents, were followed up with interviews. Participants engaged with a serious game – Adventures in PharmaCity – and an FMSP. Data were collected through gameplay observation and 75-minute semi-structured interviews via Zoom. In-game data was analyzed using descriptive analysis and qualitative data was analyzed using thematic analysis with NVivo 14. </sec> <sec> <title>RESULTS</title> Parents spent an average of 21 minutes playing the game, while children spent an average of 22 minutes. Families appreciated game design and noted usability challenges and suggested enhancements for more gameplay instructions. Participants reported increased knowledge of opioid safety, highlighted the importance of communication with healthcare providers, and suggested a mobile app for medication management. The FMSP was perceived as valuable for promoting awareness of safe practices and connected well to the knowledge gained from the game. </sec> <sec> <title>CONCLUSIONS</title> The MedSMA℞T Families intervention was well received as a beneficial educational tool to educate adolescents and their families on safe opioid use. Additionally, it highlights the need for more accessible digital tools. This feedback indicates a strong interest in improving educational resources to ensure safe opioid management. </sec>

  PublisherOA PDFDOI

• Expanding Neck Mass in an 8-year-old Girl

  Pediatrics in Review · 2022-05-01

  articleSenior author

  An 8-year-old girl presents to the emergency department (ED) of a large, tertiary care children’s hospital in central Wisconsin during the late summer. Three weeks earlier she was playing at a lake near her home in southeastern Wisconsin and sustained a bug bite to her left lateral neck. She presented to a local clinic, where she was diagnosed as having a local reaction to a bee sting and was treated with hot and cold compresses, diphenhydramine, and cetirizine. During the next 10 days the area continued to swell, and a rash began to form around the site, as well as some bloody discharge. She returned to the local clinic, where she was started on cephalexin for presumed abscess, and a culture of the bloody discharge was obtained. She took only a few doses of the antibiotic due to stomach upset. Three days later, when the skin changes persisted and swelling worsened, her parents brought her to a local ED (Fig 1). Ultrasonography of the area demonstrated what appeared to be a fluid pocket, so incision and drainage was attempted. When lidocaine was injected to numb the area, an insect emerged (Fig 2). It was removed with forceps and disposed of, and the patient was sent home with instructions to continue use of heat and cold packs as needed. The insect was not identified at this time.The patient presents to the tertiary care center 3 days later due to continued swelling of the same area on the left side of her neck. Due to swelling and concern for cellulitis or abscess formation, her primary care physician had prescribed amoxicillin-clavulanate the afternoon before presentation. Her parents were concerned about further stomach upset and did not give her the morning dose. She complains of mild itching and pain at the site of insect removal but has no fever, rash, or other symptoms of illness. She denies recent travel outside the United States. The family has 2 pet dogs at home and no exposure to cats or sick contacts. She is otherwise healthy, with no known allergies and no contributory family history, and daily polyethylene glycol for constipation is her only home medication. Physical examination findings are normal except for an erythematous, swollen area in the left anterolateral neck, approximately 1 × 2 cm, which is well-circumscribed and fluctuant (Fig 3). Two small wounds are visible from the recent incision and drainage. Bedside ultrasonography is performed and demonstrates a 1.6 × 0.6 × 1-cm complex multiloculated cystic focus with minimal hyperemia surrounding, consistent with a developing phlegmon versus postoperative changes from the recent procedure. Pediatric ear, nose, and throat physicians are consulted due to the wound’s proximity to major neck vessels (internal and external jugular veins, carotid artery) and thyroid gland, and dilute fluid is drained from the area. A pediatric infectious disease specialist is also consulted for further evaluation. Review of the photographs confirmed the diagnosis.The differential diagnoses included congenital branchial cleft cyst, cellulitis, abscess, retained foreign body, and recurrence of the original infestation. The original neck swelling was identified with a high level of certainty by the pediatric infectious disease specialist as cutaneous myiasis due to botfly infestation.Pediatric neck masses can generally be categorized as congenital, inflammatory/reactive, or neoplastic in origin. (1) Rarely on the differential diagnosis for a pediatric neck mass is myiasis, or a cutaneous infestation by larvae; the human botfly can cause a cutaneous furuncular myiasis. (2) For people living in North America, it is primarily contracted through travel to Latin America. Case reports have included infestations contracted in Guatemala, (3) Belize, (4) Costa Rica, (5) and Bolivia. (6) However, there are a few existing reports of a human botfly infestation that has been contracted in North America. (7)(8)(9) Most cases of botfly infestation originating in North America are due to Cuterebra species, with 1 reported case of Dermatobia hominis infestation in Winnipeg, Canada. (7) Cuterebra infestations remain rare in North America as well, with fewer than 80 reported in the literature, most of which have been reported from the northeast or pacific northwest. We outline the case of a human botfly infestation contracted in Wisconsin, as well as common characteristics associated with this infestation and treatment interventions.The human botfly, Dermatobia hominis, infests the human body after a female botfly attaches her eggs to a blood-feeding insect such as a mosquito. (2) The blood-feeding insect serves as the intermediate vector, eventually delivering the botfly eggs to hosts. The botfly eggs sense a temperature change once they are deposited on the host's skin, causing them to hatch into larvae and burrow into the host. Those with botfly infestations will often give a history of an insect bite before the development of furuncular myiasis. A local inflammatory reaction almost always develops around the larvae, and patients commonly report pruritus, erythema, swelling, pain, and discharge. Secondary bacterial infections can occur, although they are rare. The botfly maggot produces bacteriostatic secretions during development, which are believed to hinder bacterial growth in the area, although this has not been definitively demonstrated. (10)The larvae maintain a connection to the outside world via a respiratory spiracle. The spiracle can often be seen as a dark speck in the center of the furuncle (Fig 3). The larvae have hooklets that hold them in place in the skin, making removal difficult. (2)(11) If these hooklets remain in the skin during removal of the larvae, which is more common during forced, direct removal via forceps, then the patient can develop a subsequent inflammatory reaction or infection.Ultrasonography can be useful in the management of a Dermatobia hominis infestation. It can identify the presence of larvae before removal, as well as confirm complete removal of the insect after treatment. On ultrasonography, a botfly larva may appear as a hyperechoic mass, with a surrounding hypoechoic halo representing its surrounding cavity. (12) In addition, ultrasonography can identify the extent of a local inflammatory reaction, an associated abscess, and regional vasculature. In this patient, ultrasonography showed no residual larvae, although the fluid collection identified was investigated with incision and drainage.The preferred treatment for botfly infestation involves covering the larvae’s respiratory spiracle with an occlusive dressing. (11) The occlusion is often with a petroleum ointment, fingernail polish, or fat. The botfly is, therefore, forced to emerge from the lesion to respirate. If it fails to emerge, it will asphyxiate and die within approximately 24 hours. In that case, the dead larva is extracted through a sterile surgical technique. In some reports, lidocaine injections have been recommended as a way to remove the fly and avoid surgical incision and exploration. (13) In our case, a lidocaine injection incidentally identified the larvae and provided a therapeutic response.Currently, many human botfly infestations are improperly diagnosed because the condition is rare. Instead, patients are often misdiagnosed as having cellulitis, folliculitis, an abscess, a foreign body, a cyst, or atopic dermatitis. (7) Patients with a botfly infestation will commonly return to their primary care physician or local ED after failed treatment with an antibiotic for presumed cellulitis, as in our patient.The culture from the previous ED visit demonstrated growth of Acinetobacter iwoffii, a normal skin flora bacterium, (14) which may have led to poor wound healing at the infestation site. A 7-day course of doxycycline was started, as recommended by the pediatric infectious disease specialist, and the patient was instructed to follow up in the clinic. Although the cultured organism may have been a contaminant, antibiotic treatment was felt to be appropriate given the increased swelling and lack of wound healing. At the telemedicine follow-up visit, the patient’s condition was improving. Antibiotic treatment was changed to trimethoprim-sulfamethoxazole after susceptibilities from the culture returned, and the patient had no recurrent symptoms.

  PublisherDOI

• Human Trafficking

  Pediatric Emergency Care · 2022-03-31 · 8 citations

  reviewSenior author

  ABSTRACT: Human trafficking, which includes sexual exploitation and forced labor, affects youth throughout the world. Victims are subject to coercion, exploitation, and repeated trauma. Given the secretive nature of this abuse, it can be difficult to identify victims. Past experience shows that most victims interact with the healthcare system at some time while they are in the control of a trafficker, providing an opportunity for healthcare providers to identify, support, and intervene. In this CME review article, we describe human trafficking, its estimated prevalence, and the identification, evaluation, and management of patients who are victims of human trafficking. Finally, we provide additional resources for practitioners and patients.

  PublisherDOI

• NGFS Climate Scenario Database: Technical Documentation V2.2

  2021 · 28 citations

  Senior authorCorresponding
  • Computer Science
  • Computer Science
  • Database

  This document provides technical information on the two datasets behind the NGFS scenarios. It is intended to answer technical questions for those who want to perform analyses on the datasets themselves. It is an update of the Technical Documentation published in June 2020 alongside the first set of NGFS Scenarios. It is therefore aligned with the second set of NGFS Scenarios, released in June 2021.

  OA PDF

• Confidential Screening for Sex Trafficking Among Minors in a Pediatric Emergency Department

  PEDIATRICS · 2021 · 22 citations

  1st authorCorresponding
  • Medicine
  • Pediatrics
  • Emergency medicine

  OBJECTIVES: Child sex trafficking is a global health problem, with a prevalence of 4% to 11% among high-risk adolescents. The objective of this study was to confidentially administer a validated screening tool in a pediatric emergency department by using an electronic tablet to identify minors at risk for sex trafficking. Our hypothesis was that this modality of administration would adequately identify high-risk patients. METHODS: English- and Spanish-speaking patients from the ages of 12 to 17 years presenting to a large urban pediatric emergency department with high-risk chief complaints were enrolled in a prospective cohort over 13 months. Subjects completed a previously validated 6-item screening tool on an electronic tablet. The screening tool's sensitivity, specificity, and positive and negative predictive values were calculated. Multivariable logistic regression was performed to identify additional risk factors. RESULTS: A total of 212 subjects were enrolled (72.6% female; median age: 15 years; interquartile range 13-16), of which 26 patients were subjected to child sex trafficking (prevalence: 12.3%). The sensitivity and specificity of the electronic screening tool were 84.6% (95% confidence interval [CI] 70.8%-98.5%) and 53.2% (95% CI 46.1%-60.4%), respectively. The positive predictive value and negative predictive value were 20.2% (95% CI 12.7%-27.7%) and 96.1% (95% CI 92.4%-99.9%), respectively. A previous suicide attempt and history of child abuse increased the odds of trafficking independent of those who screened positive but did not improve sensitivity of the tool. CONCLUSIONS: A confidentially administered, previously validated, electronic screening tool was used to accurately identify sex trafficking among minors, suggesting that this modality of screening may be useful in busy clinical environments.

  PublisherOA PDFDOI

• Metabolic Emergency in Flight

  Air Medical Journal · 2021-11-18

  article1st authorCorresponding
  PublisherDOI

Frequent coauthors

• Kathleen Adelgais

  University of Colorado System

  12 shared

• Denise Abdoo

  University of Colorado Anschutz Medical Campus

  12 shared

• Lilliam Ambroggio

  University of Colorado Denver

  8 shared

• George Sam Wang

  8 shared

• Laurie Seidel Halmo

  8 shared

• Scott B. Harpin

  6 shared

• Patrick Ng

  The University of Texas Health Science Center at San Antonio

  6 shared

• Jessica Starr

  Auburn University

  4 shared

Awards & honors

• Rising Star in Clinical Practice Physician Excellence Award,…
• UW Health Physician Leadership Development Program Graduate…
• BerbeeWalsh Department of Emergency Medicine Faculty Award f…
• BerbeeWalsh Department of Emergency Medicine Faculty Award f…