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The emergency department trigger tool: Multicenter trigger query validation Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-03-18 Richard T. Griffey, Ryan M. Schneider, Keith E. Kocher, Edmund S. H. Kwok, Ellen Salmo, Nora Malone, Carrie Smith, Catie Guarnacia, April Rick, Tamara Clavet, Phil Asaro, Rich Medlin, Alexandre A. Todorov
We previously described derivation and validation of the emergency department trigger tool (EDTT) for adverse event (AE) detection. As the first step in our multicenter study of the tool, we validated our computerized screen for triggers against manual review, establishing our use of this automated process for selecting records to review for AEs.
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Prospective validity evidence for the abbreviated emergency medicine Copenhagen Burnout Inventory Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-03-17 Earl J. Reisdorff, Mary M. Johnston, Michelle D. Lall, Dave W. Lu, Karl Y. Bilimoria, Melissa A. Barton
Prior research has provided retrospective validity evidence for an abbreviated Copenhagen Burnout Inventory (CBI) to measure burnout among emergency medicine (EM) residents. We sought to provide additional validity and reliability evidence for the two-factor, six-item abbreviated CBI.
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Hot off the press: Microaggressions in the emergency department Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-03-11 Christopher Bond, Suchisimita Datta, William K. Milne
CONFLICT OF INTEREST STATEMENT The authors declare no conflicts of interest.
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Public support for and concerns regarding pediatric dose optimization for seizures in emergency medical services: An exception from informed consent (EFIC) trial Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-03-07 Caleb E. Ward, Kathleen M. Adelgais, Maija Holsti, Kammy K. Jacobsen, Harold K. Simon, Claudia R. Morris, Victor M. Gonzalez, Gonzalo Lerner, Kimia Ghaffari, John M. VanBuren, E. Brooke Lerner, Manish I. Shah
Federal regulations allow exception from informed consent (EFIC) to study emergent conditions when obtaining prospective consent is not feasible. Little is known about public views on including children in EFIC studies. The Pediatric Dose Optimization for Seizures in EMS (PediDOSE) trial implements age-based, standardized midazolam dosing for pediatric seizures. The primary objective of this study
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The association of prehospital systemic corticosteroids with emergency department and in‐hospital outcomes for patients with asthma exacerbations Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-03-08 Sriram Ramgopal, Vishal V. Naik, Sho Komukai, Sylvia Owusu‐Ansah, Remle P. Crowe, Masashi Okubo, Christian Martin‐Gill
BackgroundTimely administration of systemic corticosteroids is a cornerstone of asthma exacerbation treatment, yet little is known regarding potential benefits of prehospital administration by emergency medical services (EMS) clinicians. We examined factors associated with prehospital corticosteroid administration with hospitalization and hospital length of stay (LOS).MethodsWe performed a retrospective
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Eligibility for anticoagulation initiation in atrial fibrillation: Agreement between emergency physician and medical record review Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-03-08 Darshana Seeburruth, X. Catherine Tong, Christopher Kirwan, Sophie Ramsden, Aqsa Kibria, Jaimie Carter, Johnny Huang, Robyn McArthur, Natasha Clayton, Kerstin de Wit
CONFLICT OF INTEREST STATEMENT This was a secondary analysis of an implementation study which was funded by a grant from Bayer HealthCare Pharmaceuticals Inc. (manufacturers of rivaroxaban).
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Prospective evaluation of single‐dose aminoglycosides for treatment of complicated cystitis in the emergency department Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-03-07 Jordan E. Jenrette, Kyle Coronato, Matthew A. Miller, Kyle C. Molina, Alexander Quinones, Gabrielle Jacknin
BackgroundAntimicrobial resistance among Enterobacterales continues to be a growing problem, particularly in those with urinary infections. Previous studies have demonstrated safety and efficacy with the use of single‐dose aminoglycosides in uncomplicated cystitis. However, data in complicated infections are limited. Single‐dose aminoglycosides may provide a convenient alternative for those with or
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Predicting posthospitalization falls in Brazilian older adults: External validation of the Carpenter instrument Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-03-07 Pedro K. Curiati, Marcela dos S. Arruda, Christopher R. Carpenter, Christian V. Morinaga, Hugo M. A. Melo, Thiago J. Avelino‐Silva, Marlon R. Aliberti
ObjectivesThis study sought to explore and externally validate the Carpenter instrument's efficacy in predicting postdischarge fall risk among older adults admitted to the emergency department (ED) for reasons other than falls or related injuries.MethodsA prospective cohort study was conducted on 779 patients aged ≥ 65 years from a tertiary hospital in São Paulo, Brazil, who were monitored for up to
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Hot off the press: I ain't missing you—Spinal epidural abscess Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-03-01 Kirsty Challen, Lauren M. Westafer, W. Ken Milne
CONFLICT OF INTEREST STATEMENT The authors declare no conflicts of interest.
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Epidemiology of brief resolved unexplained events and impact of clinical practice guidelines in general and pediatric emergency departments Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-03-01 Nassr Nama, Amy M. DeLaroche, Mark I. Neuman, Manoj K. Mittal, Bruce E. Herman, Daniela Hochreiter, Ron L. Kaplan, Allayne Stephans, Joel S. Tieder
ObjectivesThe aim of this study was to describe the incidence of brief resolved unexplained events (BRUEs) and compare the impact of a national clinical practice guideline (CPG) on admission and diagnostic testing practices between general and pediatric emergency departments (EDs).MethodsUsing the Nationwide Emergency Department Sample for 2012–2019, we conducted a cross‐sectional study of children
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Peripheral nervous system and neuromuscular disorders in the emergency department: A review Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-02-29 Ajith Sivadasan, Miguel A. Cortel‐LeBlanc, Achelle Cortel‐LeBlanc, Hans Katzberg
IntroductionAcute presentations and emergencies in neuromuscular disorders (NMDs) often challenge clinical acumen. The objective of this review is to refine the reader's approach to history taking, clinical localization and early diagnosis, as well as emergency management of neuromuscular emergencies.MethodsAn extensive literature search was performed to identify relevant studies. We prioritized meta‐analysis
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Conflict in emergency medicine: A systematic review Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-02-28 Timothy Edward Tjan, Lee Yung Wong, Andrew Rixon
BackgroundThe emergency department (ED) is a demanding and time‐pressured environment where doctors must navigate numerous team interactions. Conflicts between health care professionals frequently arise in these settings. We aim to synthesize the individual‐, team‐, and systemic‐level factors that contribute to conflict between clinicians within the ED and explore strategies and opportunities for future
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Blood biomarkers for the differentiation between central and peripheral vertigo in the emergency department: a systematic review and meta‐analysis Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-02-26 Vincent W. Klokman, Fiona N. Koningstein, Job W. W. Dors, Marieke S. Sanders, Sam W. Koning, Dominique P. V. de Kleijn, Kim E. Jie
Background/introductionIn patients with acute vestibular syndrome (AVS), differentiating between stroke and nonstroke causes is challenging in the emergency department (ED). Correct diagnosis of vertigo etiology is essential for early optimum treatment and disposition.ObjectivesThe aim of this systematic review and meta‐analysis was to summarize the published evidence on the potential of blood biomarkers
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Troponin thresholds for myocardial infarction risk stratification Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-02-24 John W. Pickering
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Evaluating the performance of the HEART score in a Tanzanian emergency department Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-02-24 Braylee Grisel, Olanrewaju Adisa, Francis M. Sakita, Tumsifu G. Tarimo, Godfrey L. Kweka, Jerome J. Mlangi, Amedeus V. Maro, Marilyn Yamamoto, Lauren Coaxum, David Arthur, Alexander T. Limkakeng, Julian T. Hertz
ObjectiveThe HEART score successfully risk stratifies emergency department (ED) patients with chest pain in high‐income settings. However, this tool has not been validated in low‐income countries.MethodsThis is a secondary analysis of a prospective observational study that was conducted in a Tanzanian ED from January 2019 through January 2023. Adult patients with chest pain were consecutively enrolled
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Finding success in failure Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-02-24 Huma Farid
CONFLICT OF INTEREST STATEMENT The author has no conflicts of interest to disclose.
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Clinically significant differences in self‐reported pain scores in children with headaches Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-02-24 Daniel S. Tsze, Christian Thiele, Gerrit Hirschfeld, Peter S. Dayan
ObjectivesChanges in pain scores that represent clinically significant differences in children with headaches are necessary for study design and interpretation of findings reported in studies. We aimed to determine changes in pain scores associated with a minimum clinically significant difference (MCSD), ideal clinically significant difference (ICSD), and patient‐perceived adequate analgesia (PPAA)
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“I don't want to be the squeaky wheel”: Addressing bias as a leader in emergency medicine Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-02-23 Ambuj Suri, David Yang, Wendy W. Sun, Mariame Fofana, Emily S. Binstadt, Paul Logan Weygandt, Joel L. Moll, Tania D. Strout, Katrina Gipson, Marquita S. Norman, Ryan E. Tsuchida, Al'ai Alvarez, Kamna S. Balhara
BackgroundImplicit bias poses a barrier to inclusivity in the health care workforce and is detrimental to patient care. While previous studies have investigated knowledge and training gaps related to implicit bias, emergency medicine (EM) leaders’ self‐awareness and perspectives on bias have not been studied. Using art to prompt reflections on implicit bias, this qualitative study explores (1) the
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Acute care utilization for ambulatory care–sensitive conditions among publicly insured children Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-02-22 Daniel J. Shapiro, Matt Hall, Sriram Ramgopal, Elizabeth R. Alpern, Pradip P. Chaudhari, Mohamed Eltorki, Oluwakemi Badaki‐Makun, Kelly R. Bergmann, Michelle L. Macy, Carolyn C. Foster, Mark I. Neuman
BackgroundAlthough characteristics of preventable hospitalizations for ambulatory care–sensitive conditions (ACSCs) have been described, less is known about patterns of emergency and other acute care utilization for ACSCs among children who are not hospitalized. We sought to describe patterns of utilization for ACSCs according to the initial site of care and to determine characteristics associated
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Utility of electroencephalography in toxin-induced seizures Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-02-22 Alexander M. Sidlak, Brent Dibble, Brian Schultz
Toxin-induced seizures differ from seizures occurring in epilepsy and have a high rate of complications. Electroencephalography (EEG) is routinely obtained when there is concern for nonconvulsive status epilepticus (NCSE). The purpose of this study was to characterize the typical findings after toxin-induced seizures, assess the rate of epileptiform discharges and NCSE, and identify any changes in
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Response to “troponin thresholds for MI risk stratification” by Dr. Pickering Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-02-21 Michael W. Supples, Anna C. Snavely, Nicklaus P. Ashburn, Brandon R. Allen, Simon A. Mahler
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Biomarkers for acute dizziness: Nowhere near ready for prime time Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-02-21 Jonathan A. Edlow, Evie Marcolini
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Implementation and analysis of a multifaceted intervention for alcohol use disorder from a single academic urban emergency department Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-02-21 Eva Duvalyan, Israel Falade, Winnie Fan, Meghan Foe, Audrey Mvemba, Jay W. Zussman, Curtis Geier, Kathy T. LeSaint, Sally Graglia
BackgroundFrom 2006 to 2014, alcohol‐related visits to the emergency department (ED) increased by 76% in the United States, highlighting the need for improved ED‐driven interventions addressing alcohol use disorder (AUD). Naltrexone is an FDA‐approved medication for AUD shown to decrease craving and self‐administration of alcohol. While oral naltrexone and extended‐release naltrexone have been long
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SPEED of sound: The role of ultrasound in aortic dissection Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-02-20 Michael Gottlieb
CONFLICT OF INTEREST STATEMENT The authors declare no conflicts of interest.
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Reporting of sex and gender demographics among research studies Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-02-17 Michael Gottlieb, Rachel Chang, Miranda Viars, Alexandra Mannix
CONFLICT OF INTEREST STATEMENT The authors declare no conflicts of interest.
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Patient-reported outcome measure use among older adults after emergency department care: A systematic review Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-02-17 Cameron J. Gettel, James Galske, Anna R. Sather, Ali K. Haidous, Ula Hwang, Alexandria L. Brackett, Arjun K. Venkatesh, Kristin L. Rising, Elizabeth M. Goldberg, James D. van Oppen, Simon P. Conroy, Christopher R. Carpenter
Patient-reported outcome measures (PROMs) are gaining favor in clinical and research settings given their ability to capture a patient's symptom burden, functional status, and quality of life. Our objective in this systematic review was to summarize studies including PROMs assessed among older adults (age ≥ 65 years) after seeking emergency care.
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A qualitative assessment of emergency physicians’ experiences with robust emergency department buprenorphine bridge programs Acad. Emerg. Med. (IF 4.4) Pub Date : 2024-02-15 Jessica Marie Heil, Jonathan M. Lassiter, Matthew S. Salzman, Andrew Herring, Jason Hoppe, Michael Lynch, Scott G. Weiner, Brian Roberts, Rachel Haroz
Emergency departments (EDs) are a critical point of entry into treatment for patients struggling with opioid use disorder (OUD). When initiated in the ED, buprenorphine is associated with increased addiction treatment engagement at 30 days when initiated. Despite this association, it has had slow adoption. The barriers to ED buprenorphine utilization are well documented; however, the benefits of prescribing
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Hot off the press: Subcutaneous insulin for mild to moderate diabetic ketoacidosis Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-12-22 Suchismita Datta, Christopher Bond, William Ken Milne
CONFLICT OF INTEREST STATEMENT The authors declare no conflicts of interest.
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Addressing the rising trend of high-risk pulmonary embolism mortality: Clinical and research priorities Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-12-21 Scott D. Casey, William B. Stubblefield, Dieuwke Luijten, Frederikus A. Klok, Lauren M. Westafer, David R. Vinson, Christopher Kabrhel
Deaths from high-risk pulmonary embolism (PE) appear to have increased in the US over the last decade. Modifiable risks contributing to this worrisome trend present opportunities for physicians, researchers, and healthcare policymakers to improve care.
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Provider-to-provider telehealth for sepsis patients in a cohort of rural emergency departments Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-12-19 Nicholas M. Mohr, Tracy Young, J. Priyanka Vakkalanka, Knute D. Carter, Dan M. Shane, Fred Ullrich, Allison R. Schuette, Luke J. Mack, Katie DeJong, Amanda Bell, Mark Pals, Carlos A. Camargo, Kori S. Zachrison, Krislyn M. Boggs, Adam Skibbe, Marcia M. Ward
Telehealth has been proposed as one strategy to improve the quality of time-sensitive sepsis care in rural emergency departments (EDs). The purpose of this study was to measure the association between telehealth-supplemented ED (tele-ED) care, healthcare costs, and clinical outcomes among patients with sepsis in rural EDs.
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Malignant spinal cord compression: Atypical presentation, false localizing signs, time course, and implications for the emergency physician Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-12-19 Anastasios Georgiou, Adam Farmer, Loukas Georgiou, Brian Walker
Malignant spinal cord compression (MSCC) is often diagnosed after irreversible severe motor weakness occurs. The incidence of MSCC varies from 1% to 10% depending on the underlying histology with lung cancer being the most common.1 Most patients with MSCC have advanced cancer but approximately 20% of patients present with MSCC as the initial manifestation of their malignancy.2 Unfortunately, MSCC is
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The use of radiopaque markers is medical dogma Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-12-19 Khurram Sarfaraz, Joe Nemeth, Maryam Bahreini
Paperclips or radiopaque markers (ROM) in cases of penetrating trauma has become embedded in medical practice based on expert opinion and has become dogma as standard practice for physicians to mark the injury site for imaging procedures in penetrating trauma. In this article, we question the justification of this practice beyond accurate injury site documentation and the risks of extrapolating clinical
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Emergency department usage of sugammadex in a large regional health system Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-12-19 Paul S. Jansson, Marc P. T. Pimentel, Raghu R. Seethala
CONFLICT OF INTEREST STATEMENT The authors declare no conflicts of interest.
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Gender and emergency physicians’ experiences of leading decision making about restraint use: A qualitative study Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-12-14 Anita Chary, Beatrice Torres, Elise Brickhouse, Datonye Charles, Ynhi Thomas, Michelle Suh
CONFLICT OF INTEREST STATEMENT The authors declare no conflicts of interest.
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Examining trends in emergency medicine journals' publications about racism Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-12-14 Caitlin R. Ryus, David Yang, Alexandria Brackett, Lindsay Barnett, Dowin Boatright
In recent years, the academic medicine community has produced numerous statements and calls to action condemning racism. Though health equity work examining health disparities has expanded, few studies specifically name racism as an operational construct. As emergency departments serve a high proportion of patients with social and economic disadvantage rooted in structural racism, it is critically
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Mortality in adolescents and young adults following a first presentation to the emergency department for alcohol Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-12-14 Lyndsay D. Harrison, Asnake Y. Dumicho, Anan Bader Eddeen, Peter Tanuseputro, Claire E. Kendall, Jess G. Fiedorowicz, Tea Rosic, Shannon M. Fernando, Candace D. McNaughton, Kim Corace, Paul Kurdyak, Weiwei Beckerleg, Colleen Webber, William Gardner, Manish Sood, Daniel Thomas Myran
We conducted a population-based, retrospective cohort study of first-time emergency department (ED) visits in adolescents and young adults (AYA) due to alcohol and compared mortality to AYA with nonalcohol ED visits between 2009 and 2015 using standardized all-cause mortality ratios (age, sex, income, and rurality). We described the cause of death for AYA and examined the association between clinical
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Odds ratios versus risk ratios in intensive care research: Using frailty in intensive care as a case study Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-12-07 Bernhard Wernly, Michael Beil, Bertrand Guidet, Hans Flaatten, Christian Jung
With the global population aging, there is an increasing demand for intensive care among elderly patients. Frailty has emerged as a pivotal consideration in their management.1 Logistic regression, commonly used in studies, produces odds ratios (OR) to analyze associations, such as the one between frailty and mortality. OR measures the odds of an event occurring given an exposure compared to its absence
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Dexmedetomidine in the emergency department: A prospective observational cohort study Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-12-07 Kevin Baumgartner, Matt Joseph, Emilie Lothet, Brian M. Fuller
Dexmedetomidine (DEX) is a centrally acting sympatholytic sedative. Abundant evidence from the intensive care unit and other settings demonstrates that the use of DEX is associated with improved sedation-related outcomes. There is a paucity of data on the use and efficacy of DEX in the emergency department (ED).
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Overcoming stagnant flow: A scoping review of vertical movement in the emergency department Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-12-07 Bobbi-Jo Lowie, Courtney Hicks, Cheyenne Falat, Stacey Chaney Hydorn, T. Andrew Windsor, Angela Smedley, Yunting Fu, J. David Gatz
Improving emergency department (ED) patient flow has plagued many hospitals worldwide. “Vertical” flow improves throughput by maximizing use of chairs and waiting areas instead of beds. This process, however, is inconsistently described in the literature. The objective of this study was to collate existing evidence of successful vertical care programs.
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Extracorporeal cardiopulmonary resuscitation for refractory out-of-hospital cardiac arrest Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-12-05 Brit Long, Michael Gottlieb
CONFLICT OF INTEREST STATEMENT The authors declare no conflicts of interest.
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Agreement of electronic health record–documented race and ethnicity with parental report Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-12-04 Monika Goyal, Elizabeth R. Alpern, Michael Webb, David C. Brousseau, James M. Chamberlain, Joseph J. Zorc, Theresa Frey, Alexandria Wiersma, Bradley J. Barney, Amy L. Drendel,
CONFLICT OF INTEREST STATEMENT The authors have no conflicts of interest to report.
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The sonographic protocol for the emergent evaluation of aortic dissections (SPEED protocol): A multicenter, prospective, observational study Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-11-27 Ryan C. Gibbons, Dylan Smith, Rivka Feig, Molly Mulflur, Thomas G. Costantino
An aortic dissection (AoD) is a potentially life-threatening emergency with mortality rates exceeding 50%. While computed tomography angiography remains the diagnostic standard, patients may be too unstable to leave the emergency department. Investigators developed a point-of-care ultrasound (POCUS) protocol combining transthoracic echocardiography (TTE) and the abdominal aorta. The study objective
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Predilection to pursue pulmonary embolism in young females. Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-11-10 Murtaza Akhter
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Response to: Predilection to pursue pulmonary embolism in young females. Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-11-10 Angela F Jarman,Bryn E Mumma,Richard White,Craig Newgard,Brandon C Maughan
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Characteristics of pediatric behavioral health emergencies in the prehospital setting Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-11-10 Julia H. Wnorowska, Vishal Naik, Sriram Ramgopal, Kenshata Watkins, Jennifer A. Hoffmann
Approximately 10% of emergency medical services (EMS) encounters in the United States are behavioral health related, but pediatric behavioral health EMS encounters have not been well characterized. We sought to describe demographic, clinical, and EMS system characteristics of pediatric behavioral health EMS encounters across the United States and to evaluate factors associated with sedative medication
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Establishing outcome-driven vital signs ranges for children in the prehospital setting Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-11-09 Sriram Ramgopal, Christopher M. Horvat, Michelle L. Macy, Rebecca E. Cash, Robert J. Sepanski, Christian Martin-Gill
Vital signs are frequently used in pediatric prehospital assessments and guide protocol utilization. Common pediatric vital sign classification criteria identify >80% of children in the prehospital setting as having abnormal vital signs, though few receive lifesaving interventions (LSIs). We sought to identify data-driven thresholds for abnormal vital signs by evaluating their association with prehospital
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Patterns of emergency department visits prior to dementia or cognitive impairment diagnosis: An opportunity for dementia detection? Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-11-07 Justine Seidenfeld, Tessa Runels, Joseph L. Goulet, Matthew Augustine, Cynthia A. Brandt, Susan N. Hastings, William W. Hung, Luna Ragsdale, Jennifer L. Sullivan, Carolyn W. Zhu, Ula Hwang
CONFLICT OF INTEREST STATEMENT The authors declare no conflicts of interest.
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Performance of the 0/2-hour high-sensitivity cardiac troponin T diagnostic protocol in a multisite United States cohort Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-11-04 Michael W. Supples, Anna C. Snavely, Nicklaus P. Ashburn, Brandon R. Allen, Robert H. Christenson, Richard Nowak, R. Gentry Wilkerson, Bryn E. Mumma, Troy Madsen, Jason P. Stopyra, Simon A. Mahler
The diagnostic performance of the high-sensitivity troponin T (hs-cTnT) 0/2-h algorithm is unclear among U.S. emergency department (ED) patients with acute chest pain.
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Phenobarbital treatment of alcohol withdrawal in the emergency department: A systematic review and meta-analysis Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-11-03 Carmen M. Lee, David G. Dillon, Peggy M. Tahir, Charles E. Murphy
Despite frequent treatment of alcohol withdrawal syndrome (AWS) in the emergency department (ED), evidence for phenobarbital (PB) as an ED alternative therapy is mixed. We conducted a systematic review and meta-analysis comparing safety and efficacy of PB to benzodiazepines (BZDs) for treatment of AWS in the ED.
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Initial treatment of uninsured patients with ST-elevation myocardial infarction by facility percutaneous coronary intervention capabilities Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-11-03 Sara Lin, Andrew Shermeyer, Sayeh Nikpay, Renee Y. Hsia, Michael J. Ward
Timely reperfusion is necessary to reduce morbidity and mortality in patients with ST-elevation myocardial infarction (STEMI). Initial care by facilities with percutaneous coronary intervention (PCI) capabilities reduces time to reperfusion. We sought to examine whether insurance status was associated with initial care at emergency departments (EDs) with PCI capabilities among adult patients with STEMI
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Hypertension in the emergency department: A missed opportunity to screen for primary aldosteronism? Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-10-28 Rachel D. Graven, Ignatius Lee, Jing Ren, Jun Yang, Diana Egerton-Warburton
Primary aldosteronism (PA) is a common but underdiagnosed secondary cause of hypertension. Emergency departments (EDs) often assess patients with severe hypertension or its sequelae, some of whom have underlying PA. We aimed to determine the proportion of patients presenting to the ED with hypertension who meet the Endocrine Society criteria for PA testing and the proportion who were screened.
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#StopTheStigmaEM: Building a social media–based movement to support emergency medicine mental health Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-10-27 Amanda J. Deutsch, Al’ai Alvarez, Stephanie Balint, Ryan D. Pappal, Stacey Roseen, Wendy W. Sun, Jonathan Warren, Kelsey Stanton, Anish K. Agarwal
Mental health strain in health care is a critical problem affecting students, residents, and faculty. More than one-third of medical students experience depression or anxiety,1 while nearly half of residents experience depression.2 Within health care, there exists a persistent reluctance to connect with mental health care, with less than a third of physicians seeking help.3 Stigma and fear of professional
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Real-time artificial intelligence predicts adverse outcomes in acute pancreatitis in the emergency department: Comparison with clinical decision rule Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-10-26 Ching-Hung Chang, Chia-Jung Chen, Yu-Shan Ma, Yu-Ting Shen, Mei-I Sung, Chien-Chin Hsu, Hung-Jung Lin, Zhih-Cherng Chen, Chien-Cheng Huang, Chung-Feng Liu
Artificial intelligence (AI) prediction is increasingly used for decision making in health care, but its application for adverse outcomes in emergency department (ED) patients with acute pancreatitis (AP) is not well understood. This study aimed to clarify this aspect.
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Hot off the press: SGEM#416: She's always a woman—Query PE Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-10-26 Corey Heitz, Kirsty Challen, William K. Milne
CONFLICT OF INTEREST STATEMENT The authors declare no conflicts of interest.
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Gender moderates the association between posttraumatic stress disorder and mutual intimate partner violence in an emergency department sample Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-10-25 Raul Caetano, Carol Cunradi, William R. Ponicki, Harrison J. Alter
Patients in emergency departments (EDs) constitute a diverse population with multiple health-related risk factors, many of which are associated with intimate partner violence (IPV). This paper examines the interaction effect of depression, posttraumatic stress disorder (PTSD), impulsivity, drug use, adverse childhood experiences (ACEs), at-risk drinking, and having a hazardous drinker partner with
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Risk factors for recurrent emergency care utilization for flares in inflammatory bowel disease Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-10-24 Benjamin G. Hassid, Julia Wei, Dana Sax, Fernando S. Velayos
Patients with inflammatory bowel disease (IBD) need frequent emergency care due to flares of their disease. However, understanding which patients are most vulnerable to repeat emergency care due to recurrent flares of their disease remains poor.
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Correlation of vital sign centiles with in-hospital outcomes among adults encountered by emergency medical services Acad. Emerg. Med. (IF 4.4) Pub Date : 2023-10-16 Sriram Ramgopal, Robert J. Sepanski, Remle P. Crowe, Masashi Okubo, Clifton W. Callaway, Christian Martin-Gill
Vital signs are a critical component of the prehospital assessment. Prior work has suggested that vital signs may vary in their distribution by age. These differences in vital signs may have implications on in-hospital outcomes or be utilized within prediction models. We sought to (1) identify empirically derived (unadjusted) cut points for vital signs for adult patients encountered by emergency medical