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Sound Decisions: Rethinking the Role of Ultrasound-Guided Regional Analgesia in the Emergency Department Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-03-12 Michael Gottlieb MD, Arun Nagdev MD
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Harnessing the Power of Generative AI for Clinical Summaries: Perspectives From Emergency Physicians Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-03-12 Yuval Barak-Corren MD MS, Rebecca Wolf BSc, Ronen Rozenblum MPH PhD, Jessica K. Creedon MD, Susan C. Lipsett MD, Todd W. Lyons MD MPH, Kenneth A. Michelson MD MPH, Kelsey A. Miller MD EdM, Daniel Shapiro MD, Ben Y. Reis PhD, Andrew M. Fine MD MPH
The workload of clinical documentation contributes to health care costs and professional burnout. The advent of generative artificial intelligence language models presents a promising solution. The perspective of clinicians may contribute to effective and responsible implementation of such tools. This study sought to evaluate 3 uses for generative artificial intelligence for clinical documentation
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Geriatric Emergency Medication Safety Recommendations (GEMS-Rx): Modified Delphi Development of a High-Risk Prescription List for Older Emergency Department Patients Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-03-12 Rachel M. Skains MD MSPH, Jennifer L. Koehl PharmD BCPS, Amer Aldeen MD, Christopher R. Carpenter MD MSc, Cameron J. Gettel MD MHS, Elizabeth M. Goldberg MD ScM, Ula Hwang MD MPH, Keith E. Kocher MD MPH, Lauren T. Southerland MD MPH, Pawan Goyal MD, Carl T. Berdahl MD MS, Arjun K. Venkatesh MD MBA, Michelle P. Lin MD MPH
Half of emergency department (ED) patients aged 65 years and older are discharged with new prescriptions. Potentially inappropriate prescriptions contribute to adverse drug events. Our objective was to develop an evidence- and consensus-based list of high-risk prescriptions to avoid among older ED patients. We performed a modified, 3-round Delphi process that included 10 ED physician experts in geriatrics
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Midline Catheters Are the Optimal Vascular Access Device For Managing Septic Shock in the Emergency Department Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-03-08 Alexander Bracey MD, Michael H. Sherman MD MA
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Peripheral Intravenous Catheters Are Preferable for Emergency Department Patients With Septic Shock Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-03-07 Michael J. Waxman MD MPH, Elissa M. Schechter-Perkins MD MPH
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The Central Venous Catheter Cannot Be Supplanted When It Comes to Septic Shock Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-03-07 Gregory P. Wu MD, Nana Sefa MD MPH
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Development and Validation of a Natural Language Processing Model to Identify Low-Risk Pulmonary Embolism in Real Time to Facilitate Safe Outpatient Management Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-03-02 Krunal D. Amin MD, Elizabeth Hope Weissler MD, William Ratliff MBA, Alexander E. Sullivan MD, Tara A. Holder MD, Cathleen Bury MD, Samuel Francis MD, Brent Jason Theiling MD MS, Bradley Hintze BS, Michael Gao BS, Marshall Nichols MS, Suresh Balu MBA, William Schuyler Jones MD, Mark Sendak MD MPP
This study aimed to (1) develop and validate a natural language processing model to identify the presence of pulmonary embolism (PE) based on real-time radiology reports and (2) identify low-risk PE patients based on previously validated risk stratification scores using variables extracted from the electronic health record at the time of diagnosis. The combination of these approaches yielded an natural
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Reliability of a Measure of Admission Intensity for Emergency Physicians Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-03-02 Alexander T. Janke MD MHS, Jonathan J. Oskvarek MD MBA, Mark S. Zocchi PhD MPH, Angela G. Cai MD MBA, Ori Litvak MBA, Jesse M. Pines MD MBA, Arjun K. Venkatesh MD MBA
We assess the stability of a measure of emergency department (ED) admission intensity for value-based care programs designed to reduce variation in ED admission rates. Measure stability is important to accurately assess admission rates across sites and among physicians. We sampled data from 358 EDs in 41 states (January 2018 to December 2021), separate from sites where the measure was derived. The
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Topical Diclofenac Versus Oral Ibuprofen Versus Diclofenac + Ibuprofen for Emergency Department Patients With Acute Low Back Pain: A Randomized Study Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-03-02 Nauman Khankhel MD, Benjamin W. Friedman MD MS, Jesse Baer MD, Lucy Lopez RPA, Carmen Feliciano RN, Sharon Lee PharmD, Eddie Irizarry MD
Topical nonsteroidal anti-inflammatory drugs (NSAIDs) are useful for a variety of musculoskeletal injuries. It is not known whether topical NSAIDs should be used for patients presenting with acute nonradicular musculoskeletal low back pain. We conducted a randomized, placebo-controlled double-blind study in which patients 18 to 69 years of age visiting the emergency department (ED) with acute, nontraumatic
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Peripheral Nerve Blocks in the Preoperative Management of Hip Fractures: A Systematic Review and Network Meta-Analysis Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-02-22 Minoru Hayashi, Norio Yamamoto, Naoto Kuroda, Kenichi Kano, Takanori Miura, Yuji Kamimura, Akihiro Shiroshita
We conducted a systematic review and network meta-analysis to evaluate the comparative efficacy of peripheral nerve block types for preoperative pain management of hip fractures. We searched Cochrane, Central Register of Controlled Trials, MEDLINE, EMBASE, ICTRP, , and Google Scholar for randomized clinical trials. We included participants aged more than 16 years with hip fractures who received peripheral
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Are the HINTS and HINTS Plus Examinations Accurate for Identifying a Central Cause of Acute Vestibular Syndrome? Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-02-22 Kyle Smiley, Michael Jay Yoo, Brit Long
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In reply Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-02-20 Hidde ten Berg, Bram van Bakel, Lieke van de Wouw, Kim E. Jie, Anoeska Schipper, Henry Jansen, Rory D. O’Connor, Bram van Ginneken, Steef Kurstjens
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A Violently Violaceous Rash of Infancy Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-02-20 Jennie Xu, Evan Mahl
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Man With Nocturnal Cough Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-02-20 Hung-Bin Tsai, Hsin-Lu Yang, Fei-Ti Lee, Nin-Chieh Hsu
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Evidence-Based Emergency Care: Diagnostic Testing and Clinical Decision Rules (Evidence-Based Medicine) 3rd Edition Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-02-20 Jason D. Heiner
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In reply Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-02-20 Lisa Marie Saffire, Jake Valentine, Joshua Niforatos, Paul Logan Weygandt
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Finding the Foliage in Forest Plots: Vertigo Management Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-02-20 Brendan Freeman, Shorok Hassan, Anand K. Swaminathan
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In a Postpandemic Era, Is Telehealth Still a Vital Tool? Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-02-20 Monique Brouillette
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Man With Knee Pain Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-02-20 Tien-You Hsu, Yu-Chen Chiu, Sheng-En Chu, Chun-Yen Huang, Jen-Tang Sun, Chih-Jung Chang
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Newborn With Scrotal Swelling Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-02-20 Diana Savitzky, Yash Chavda
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Diagnostic Dilemma: ChatGPT Can’t Tell You What You Don’t Already Know Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-02-20 Carl Preiksaitis, Christian Rose
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Implications and Limitations of Point-of-Care Ultrasound in Diagnosing Acute Cholecystitis Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-02-20 Daniel Weingrow
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The 4 S's of Disaster Management Framework: A Case Study of the 2022 Pediatric Tripledemic Response in a Community Hospital Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-02-15 Alexandra H. Baker, Lois K. Lee, Brian E. Sard, Sarita Chung
Most children in the United States present to community hospitals for emergency department (ED) care. Those who are acutely ill and require critical care are stabilized and transferred to a tertiary pediatric hospital with intensive care capabilities. During the fall of 2022 “tripledemic,” with a marked increase in viral burden, there was a nationwide surge in pediatric ED patient volume. This caused
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Recommendations for Choosing Wisely in Pediatric Emergency Medicine: Five Opportunities to Improve Value Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-02-11 Paul C. Mullan, Kelly A. Levasseur, Lalit Bajaj, Michele Nypaver, James M. Chamberlain, Jennifer Thull-Freedman, Olivia Ostrow, Shabnam Jain
Unnecessary diagnostic tests and treatments in children cared for in emergency departments (EDs) do not benefit patients, increase costs, and may result in harm. To address this low-value care, a taskforce of pediatric emergency medicine (PEM) physicians was formed to create the first PEM Choosing Wisely recommendations. Using a systematic, iterative process, the taskforce collected suggested items
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Blunt Head Injury in the Elderly: Analysis of the NEXUS II Injury Cohort Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-02-10 William R. Mower, Thomas E. Akie, Naseem Morizadeh, Malkeet Gupta, Gregory W. Hendey, Jake L. Wilson, Lorenzo Pierre Leonid Duvergne, Phillip Ma, Pravin Krishna, Robert M. Rodriguez
Changes with aging make older patients vulnerable to blunt head trauma and alter the potential for injury and the injury patterns seen among this expanding cohort. High-quality care requires a clear understanding of the factors associated with blunt head injuries in the elderly. Our objective was to develop a detailed assessment of the injury mechanisms, presentations, injury patterns, and outcomes
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Use of Topical Anesthetics in the Management of Patients With Simple Corneal Abrasions: Consensus Guidelines from the American College of Emergency Physicians Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-02-06 Steven M. Green, Christian Tomaszewski, Jonathan H. Valente, Bruce Lo, Ken Milne
The management of corneal abrasions has largely excluded dispensing topical local anesthetics for home use due to concern for corneal toxicity. We have reviewed and critically appraised the available literature evidence regarding the use of topical anesthetics in patients with simple corneal abrasions. Using sequential Delphi review, we have developed these clinical guidelines. Herein are evidentiary
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A Longitudinal Survey on Canadian Emergency Physician Burnout Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-02-06 Kerstin de Wit, Anna Tran, Natasha Clayton, Darshana Seeburruth, Rodrick K. Lim, Patrick M. Archambault, Teresa M. Chan, Louise C.F. Rang, Sara Gray, Kerri Ritchie, Caroline Gérin-Lajoie, Mathew Mercuri
Since Canada eased pandemic restrictions, emergency departments have experienced record levels of patient attendance, wait times, bed blocking, and crowding. The aim of this study was to report Canadian emergency physician burnout rates compared with the same physicians in 2020 and to describe how emergency medicine work has affected emergency physician well-being. This longitudinal study on Canadian
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Implementation of Extracorporeal CPR Programs for Out-of-Hospital Cardiac Arrest: Another Tale of Two County Hospitals Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-02-06 Anna Condella, Nicholas S. Simpson, Kyle S. Bilodeau, Barclay Stewart, Samuel Mandell, Mark Taylor, Beth Heather, Eileen Bulger, Nicholas J. Johnson, Matthew E. Prekker
Extracorporeal cardiopulmonary resuscitation (ECPR) is a form of intensive life support that has seen increasing use globally to improve outcomes for patients who experience out-of-hospital cardiac arrest (OHCA). Hospitals with advanced critical care capabilities may be interested in launching an ECPR program to offer this support to the patients they serve; however, to do so, they must first consider
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Changes in Clinical Management Following 14-Day Ambulatory ECG Monitoring Following Emergency Department Evaluation for Unexplained Syncope Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-23 Andrew B. Moore, Colin Gershon, Christa Fiske, Benjamin Sun, Babek Nazer, Bory Kea
Abstract not available
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Racial and Socioeconomic Disparities Evident in Inappropriate Antibiotic Prescribing in the Emergency Department Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-23 Eili Klein, Mustapha Saheed, Nathan Irvin, Kamna S. Balhara, Oluwakemi Badaki-Makun, Suprena Poleon, Gabor Kelen, Sara E. Cosgrove, Jeremiah Hinson
Study objective Inappropriate antibiotic prescribing for acute respiratory tract infections is a common source of low-value care in the emergency department (ED). Racial and socioeconomic disparities have been noted in episodes of low-value care, particularly in children. We evaluated whether prescribing rates for acute respiratory tract infections when antibiotics would be inappropriate by guidelines
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The Clinical Emergency Data Registry: Structure, Use, and Limitations for Research Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-23 Michelle P. Lin, Dhruv Sharma, Arjun Venkatesh, Stephen K. Epstein, Alexander Janke, Nicholas Genes, Abhi Mehrotra, James Augustine, Bill Malcolm, Pawan Goyal, Richard T. Griffey
The Clinical Emergency Data Registry (CEDR) is a qualified clinical data registry that collects data from participating emergency departments (EDs) in the United States for quality measurement, improvement, and reporting purposes. This article aims to provide an overview of the data collection and validation process, describe the existing data structure and elements, and explain the potential opportunities
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After Two Rough Match Days, Emergency Medicine Looks to a Changing Future Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-18 Crystal Phend
Abstract not available
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A Balancing Act: Navigating Fear, Bias, Safety, and Equity in Managing Agitated Patients Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-18 Nathan Irvin
Abstract not available
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Young Man With Abdominal Pain and Fever Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-18 Wei Wang, Wen-Hui Zhai, Ying Zhang, Li Tao, Yue Cao
Abstract not available
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Woman in Cardiac Arrest Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-18 Ming-Jen Tsai, Hsueh-Chao Weng, Kai-Yuan Cheng
Abstract not available
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Man With Dyspnea Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-18 Zachary Boivin, David Cannata, Trent She
Abstract not available
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Elderly Man With Fall Incident Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-18 Chia-Hao Hsu, Nin-Chieh Hsu
Abstract not available
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Man With Abdominal Pain Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-18 Eric Chang, Duncan Carlton, Tucker Brady, William Goldenberg
Abstract not available
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Everyone Gets Their Time on the Gurney Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-18 Katren Tyler
Abstract not available
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Is a Full Heart a Happy Heart?: February 2024 Annals of Emergency Medicine Journal Club Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-18 Ryan P. Radecki
Abstract not available
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Recognizing Patients With High-Intermediate Risk Acute Pulmonary Embolism Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-18 Anup Katyal, Zed Seedat, John Ponzillo
Abstract not available
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In reply Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-18 Lauren M. Westafer, Brit Long, Michael Gottlieb
Abstract not available
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Evaluation of Insurance Type as a Proxy for Socioeconomic Status in the Pediatric Emergency Department: A Pilot Study Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-18 Michael C. Monuteaux, Michelle Du, Mark I. Neuman
Study objective To determine whether insurance status can function as a sufficient proxy for socioeconomic status in emergency medicine research by examining the concordance between insurance status and direct socioeconomic status measures in a sample of pediatric patients. Methods We conducted a cross-sectional pilot study of patients aged 5 to 17 years in the emergency department of a quaternary
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Mental Practice: Applying Successful Strategies in Sports to the Practice of Emergency Medicine Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-18 John E. Schneider, Maxwell Blodgett, Spenser Lang, Chris Merritt, Sally A. Santen
Emergency physicians are expected to learn and maintain a large and varied set of competencies for clinical practice. These include high acuity, low occurrence procedures that may not be encountered frequently in the clinical environment and are difficult to practice with high fidelity and frequency in a simulated environment. Mental practice is a form of a cognitive walk-through that has been shown
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A Dedicated Outpatient Pharmacy Improves Access to Discharge Medications in a Pediatric Emergency Department: A Quality Improvement Study Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-18 Jason Hyunjoon Choi, Michelle Caruso Barrett, Nicholas Michel, Kamali Bouvay, Hamilton Schwartz, Adam Alexander Vukovic
Study objective Following discharge from a pediatric emergency department (ED) or urgent care, many families do not pick up their prescribed medications. The aim of this quality improvement study was to increase the percentage of patients discharged home with medications in-hand from 6% to 30% within 6 months. Methods Due to the planned construction of a new ED, urgent care, and dedicated pharmacy
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Challenges in the Design of Pediatric Out-of-Hospital Cardiac Arrest Trials Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-04 Marianne Gausche-Hill, Benjamin T. Kerrey
Abstract not available
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A Clinical Decision Rule for Isolated Subdural Hematomas: Divine Inspiration, Slippery Slope, or Meaningless Machinations? Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-03 Daniel P. Davis
Abstract not available
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Association Between Emergency Medical Service Agency Intubation Rate and Intubation Success Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-03 Jordan Thomas, Remle Crowe, Kevin Schulz, Henry E. Wang, Marcia C. De Oliveira Otto, Bejamin Karfunkle, Eric Boerwinkle, Ryan Huebinger
Study Objective Airway management is a crucial part of out-of-hospital care. It is not known if the rate of overall agency intubation attempts is associated with intubation success. We sought to evaluate the association between agency intubation attempt rate and intubation success using a national out-of-hospital database. Methods We conducted a retrospective secondary analysis of the ESO Data Collaborative
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Barriers and Facilitators to Harm Reduction for Opioid Use Disorder: A Qualitative Study of People With Lived Experience Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-03 Lauren M. Westafer DO MS, Samantha A. Beck BS, Caty Simon, Benjamin Potee BA, William E. Soares MD MS, Elizabeth M. Schoenfeld MD MS
Although an increasing number of emergency departments (ED) offer opioid agonist treatment, naloxone, and other harm reduction measures, little is known about patient perspectives on harm reduction practices delivered in the ED. The objective of this study was to identify patient-focused barriers and facilitators to harm reduction strategies in the ED. We conducted semistructured interviews with a
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Measured Twice: Time for the Expansion of Social Care Interventions and Patient-Centered Outcomes Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-03 Danielle Cullen MD MPH MSHP, Margaret E. Samuels-Kalow MD MPhil MSHP
Abstract not available
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Evaluating the Reliability of a Remote Acuity Prediction Tool in a Canadian Academic Emergency Department Ann. Emerg. Med. (IF 6.2) Pub Date : 2024-01-03 Laila Nasser MD, Shelley L. McLeod PhD MSc, Justin N. Hall MD MSc
There is increasing interest in harnessing artificial intelligence to virtually triage patients seeking care. The objective was to examine the reliability of a virtual machine learning algorithm to remotely predict acuity scores for patients seeking emergency department (ED) care by applying the algorithm to retrospective ED data. This was a retrospective review of adult patients conducted at an academic