STUDY OBJECTIVES To determine the rate of violent patient encounters continued across longitudinal health care settings and to assess for rates of violence among individual care settings. METHODS We conducted an observational cohort study from December 1, 2022, to November 30, 2023, within a large, quaternary academic center's emergency department (ED), hospital, and affiliated emergency medical services

STUDY OBJECTIVE Low back pain is a common complaint in the emergency department (ED), often attributed to myofascial pain syndrome. Prior studies demonstrate trigger point injection efficacy in the ED in various body distributions, but only one has specifically assessed myofascial low back pain, and none have evaluated functional outcomes. The purpose of this study was to compare the efficacy of trigger

STUDY OBJECTIVE To determine the diagnostic accuracy of point-of-care ultrasound (POCUS) performed by pediatric emergency physicians for the diagnosis of hip effusion. METHODS This multicenter, prospective study was conducted in 5 pediatric emergency departments (PEDs) in the United States and Australia from October 2019 to October 2023. Children aged 18 years and younger who presented to the PED with

STUDY OBJECTIVES We wished to assess the frequency of critical and high-risk adverse events when ketamine is administered for emergency department (ED) procedural sedation in children and to identify clinical predictors of such adverse events. METHODS We studied 20 years of sedation encounters from the Pediatric Sedation Research Consortium registry. We descriptively report the frequencies of critical

STUDY OBJECTIVE Tension-type headache is the most common primary headache worldwide, significantly reducing individuals' quality of life. Although nonsteroidal anti-inflammatory drugs are commonly used for the pharmacologic treatment of tension-type headache, complementary and alternative treatment methods are gaining increasing importance. In this context, virtual reality technology stands out as

STUDY OBJECTIVE Achieving first-pass success during endotracheal intubation has been identified as an area for emergency medical services improvement efforts. Evidence on the effect of out-of-hospital drug-assisted airway management, including rapid sequence intubation, sedation-only intubation, and paralytic-only intubation on first-pass success, is limited. Our objective was to determine the association

STUDY OBJECTIVE Screening for suicide risk at medical encounters is an essential step in suicide prevention. Electronic devices have been used for screening in emergency departments (EDs) for sensitive health topics, including mental health. This study explored adolescent and caregiver perspectives of privacy, autonomy, and honesty when completing suicide screening on an electronic device in the ED

STUDY OBJECTIVE Sensitivity for stroke detection in emergency medical communication centers (EMCCs) varies widely. Few studies offer detailed insights into the out-of-hospital pathways of patients with stroke. This study explored the ability of EMCCs to detect strokes in medical emergency calls using an alternative method for estimating stroke sensitivity in EMCCs, thereby laying the foundation for

STUDY OBJECTIVE This study aimed to assess gender representation among speakers invited to give presentations at the 2022 and 2023 annual meetings of the American College of Emergency Physicians (ACEP), Society for Academic Emergency Medicine (SAEM), and the American Academy of Emergency Medicine (AAEM) and identify trends in the representation of women physician speakers. METHODS A retrospective analysis

STUDY OBJECTIVE The Emergency Medical Treatment and Labor Act (EMTALA) of 1986 requires Medicare-participating hospitals to provide medical examination screenings to patients in emergency situations, regardless of their ability to pay, and prohibits the transfer of patients under these circumstances, unless essential or requested. This study examines spatial clustering of EMTALA violations between

STUDY OBJECTIVE Emergency department (ED) staffing shortages have increased reliance on locum tenens physicians (locums). We compared productivity, quality, utilization, and clinical practice measures between permanent staff, employed travelers, and locums during their first 100 shifts at a site. METHODS We performed a retrospective cohort study comparing outcomes between the 3 physician types with

STUDY OBJECTIVE To assess whether Emergency Procedures App (EPApp) use among emergency physicians improves knowledge and skill in performing corneal foreign body removal compared with usual practice. METHODS This single-blinded, multicenter, randomized trial involved emergency physicians assessing their knowledge and performance in corneal foreign body removal. Participants were randomized into 2 groups

STUDY OBJECTIVE Injury is a leading cause of hospitalization in people experiencing homelessness, yet post-injury care use is unknown. We sought to understand care use patterns in the 12 months after injury in people experiencing homelessness versus housed low-income Medicaid beneficiaries. METHODS We conducted a retrospective cohort study examining injured Medicaid beneficiaries in San Francisco from

STUDY OBJECTIVE Sepsis bundles are effective in reducing mortality for sepsis, the leading cause of admissions to intensive care units. However, little is known about factors that hinder and facilitate the delivery of sepsis bundles in emergency departments. Guided by the Exploration, Preparation, Implementation, and Sustainment (EPIS) Framework, the objective of the present study was to characterize

Hospital-at-home is an evidence-based model for delivering care in patient homes in lieu of a traditional hospital admission. Recent policy changes and technological advancement have spurred growth in hospital-at-home programs across the United States. The role of emergency medicine in hospital-at-home programs has not been clearly defined. We argue that emergency medicine should contribute to the

STUDY OBJECTIVES Brain biomarkers have been used to predict intracranial injury in both adults and children following mild traumatic brain injury (mTBI). Several biomarkers have been evaluated, including S100B, NfL, Tau, glial fibrillary acidic protein (GFAP), and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1). The combined measurement of GFAP and UCH-L1 has recently been recommended by scientific

STUDY OBJECTIVE Children with upper respiratory infections (URIs) have an increased risk of respiratory adverse events when undergoing operative anesthesia and in general populations of children receiving procedural sedation. It is unclear if children with URI undergoing emergency department (ED) sedation share the same increased risk. We aimed to determine if the presence of a URI in children undergoing

STUDY OBJECTIVE As a safety net for adolescents, the emergency department (ED) is considered an opportune setting for suicide screening and response (ie, safety assessments, brief interventions, and referrals). This study explored adolescent and caregiver perspectives on the ED's response when nonacute suicide risk was identified during universal screening. METHODS This was a qualitative study of adolescents

Suicide remains one of the leading causes of death among youth, as the incidence of suicidal ideation and attempts continue to rise. Mental health-related concerns now account for nearly 1 in 7 presentations to the emergency department (ED) among youth-approximately 7.5 million visits annually. For many children in the United States, the ED serves as their first or only point of medical contact, placing

STUDY OBJECTIVE Mismatches in the supply and demand for hospital care are important causes of emergency department (ED) crowding. The extent to which short-stay hospitalizations contribute to overall hospital capacity constraints has not been well described. METHODS Retrospective cross-sectional analysis of hospitalizations at 4 US EDs (January 2018 to June 2024). Total occupancy hours were calculated

STUDY OBJECTIVE This study sought to explore the clinical and process factors that, alone or in combination, influence the accuracy of stroke diagnosis in the emergency department (ED) by applying a novel design of experiments methodology. METHODS We used design of experiments, a branch of applied statistics, to create a screening experiment comprised of patient simulation scenarios in which purposeful

To enable emergency physicians to make well-informed triage and treatment decisions, accurate tools to evaluate the severity of diquat poisoning are needed. This study establishes severity indices for diquat poisoning (SIDPs) in assessing the risk of death for patients with acute diquat poisoning for triage purposes and 28-day mortality.

STUDY OBJECTIVE To compare the effectiveness of high-sensitivity cardiac troponin (hs-cTn) point-of-care testing to central laboratory hs-cTn measurements when investigating patients presenting to the emergency department (ED) with symptoms of acute coronary syndrome. METHODS The WESTCOR point-of-care study was a single-center prospective randomized controlled trial where we randomized patients presenting

The evaluation for suspected acute coronary syndrome is a common and high-risk presentation in emergency departments (EDs). After exclusion of acute myocardial infarction (MI), patients often undergo early (within 72 hours) noninvasive cardiac testing. We evaluated the association between early noninvasive testing and death/acute MI in ED patients suspected of acute coronary syndrome.

STUDY OBJECTIVE It is unclear which opioid-naïve emergency department (ED) patients prescribed an opioid progress to opioid use disorder. We tested the hypothesis that opioid-induced euphoria and persistent pain 2 weeks after an ED visit would be associated with persistent prescribed opioid use among opioid-naïve ED patients who presented to the ED with pain and were discharged with an opioid prescription

The COVID-19 pandemic posed exposure risk for health care personnel, potentially affecting the care for patients with cardiac arrest. We compare emergency department (ED) cardiac arrest management in patients who were suspected and not suspected of COVID-19 early in the pandemic in 2020.

STUDY OBJECTIVE Violence in health care settings is a growing threat to patients and clinicians. This study's objective was to describe the demographic distribution of the Dynamic Appraisal of Situational Aggression (DASA) score at emergency department (ED) triage, identifying patterns in score variability across different patient groups and exploring associations with demographic factors. METHODS

Blind placement of a transvenous pacemaker is a core emergency medicine resuscitative procedure. The commonly used balloon-tipped pacing wire is designed to allow the flow of blood returning to the heart to carry the pacer wire through the tricuspid valve and into the right ventricle. Presented here is a case of misdirection of such a pacemaker into the left pericardiophrenic vein.

STUDY OBJECTIVES We sought to identify physician and environmental factors (eg, crowding) associated with emergency physician productivity, measured as patients per hour. We also assessed whether physician productivity is associated with higher emergency department (ED) return rates. METHODS We used data from 184 EDs in 24 states staffed by a national ED group from January 2021 to December 2022. Clinical

In 2022, Choosing Wisely released recommendations to decrease the frequency of low-value testing in pediatric emergency medicine. The extent to which low-value testing occurs in US emergency departments (EDs) may vary by ED experience. We compared the frequency of low-value testing with ED volume.