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Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine

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https://www.readbyqxmd.com/read/28503848/in-response-ultrasound-assisted-lumbar-puncture-on-infants-in-the-pediatric-emergency-department
#1
Samuel H F Lam
I read with interest the recently published article on ultrasound assisted pediatric lumbar puncture (UALP) by Gorn and colleagues(1) . As an advocate of point-of-care ultrasound in the pediatric emergency department setting, I am greatly encouraged by the study results. However, I would suggest clarification on several details of the study, some of which could potentially lead to biased outcomes. This article is protected by copyright. All rights reserved.
May 15, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28500785/don-t-label-me-a-qualitative-study-of-patients-perceptions-and-experiences-of-sedation-during-behavioral-emergency-in-the-emergency-department
#2
Celene Y L Yap, Jonathan C Knott, David C M Kong, Marie Gerdtz, Kay Stewart, David McD Taylor
OBJECTIVES: Behavioral emergencies are commonly seen in emergency departments. Acutely agitated patients can be difficult to manage and sedation may be required to decrease dangerous behavior and to ensure the safety of both the patient and staff. While the experience of staff caring for this population has been reported, patients' experiences with their overall management remains unknown. We aimed to describe the perceptions and experiences of patients regarding the use of sedation during acute behavioral emergencies...
May 13, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28500753/a-0h-1h-protocol-for-safe-early-discharge-of-chest-pain-patients
#3
Arash Mokhtari, Bertil Lindahl, Alexandru Schiopu, Troels Yndigegn, Ardavan Khoshnood, Patrik Gilje, Ulf Ekelund
OBJECTIVES: Guidelines recommend a 0h/1h high-sensitivity cardiac troponin T (hs-cTnT) diagnostic strategy in acute chest pain patients. There is however little data on the performance of this strategy when combined with clinical risk stratification. We aimed to evaluate the diagnostic accuracy of an accelerated diagnostic protocol (ADP) using the 0h/1h hs-cTnT strategy together with an adapted Thrombolysis In Myocardial Infarction (TIMI) score and ECG for ruling out major adverse cardiac events (MACE) within 30 days...
May 13, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28493646/validation-of-the-no-objective-testing-rule-and-comparison-to-the-heart-pathway
#4
Jason P Stopyra, Chadwick D Miller, Brian C Hiestand, Cedric W Lefebvre, Bret A Nicks, David M Cline, Kim L Askew, Robert F Riley, Gregory B Russell, James W Hoekstra, Simon A Mahler
BACKGROUND: The No Objective Testing Rule (NOTR) is a decision aid designed to safely identify Emergency Department (ED) patients with chest pain who do not require objective testing for coronary artery disease. OBJECTIVES: To validate the NOTR in a cohort of US ED patients with acute chest pain and compare its performance to the HEART Pathway. METHODS: A secondary analysis of 282 participants enrolled in the HEART Pathway Randomized Controlled Trial was conducted...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28493642/adverse-events-with-ketamine-versus-ketofol-for-procedural-sedation-on-adults-a-double-blinded-randomized-controlled-trial
#5
Fabien Lemoel, Julie Contenti, Didier Giolito, Mathieu Boiffier, Jocelyn Rapp, Jacques Istria, Marc Fournier, Fran├žois-Xavier Ageron, Jacques Levraut
OBJECTIVES: The goal of our study was to compare the frequency and severity of recovery reactions between ketamine and ketamine-propofol 1:1 admixture ("ketofol"). METHODS: We performed a multicentric, randomized, double-blinded trial in which adult patients received emergency procedural sedations with ketamine or ketofol. Our primary outcome was the proportion of unpleasant recovery reactions. Other outcomes were frequency of interventions required by these recovery reactions, rates of respiratory or hemodynamic events, emesis, and satisfaction of patients as well as providers...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28493626/why-do-people-choose-emergency-and-urgent-care-services-a-rapid-review-utilizing-a-systematic-literature-search-and-narrative-synthesis
#6
Joanne E Coster, Janette K Turner, Daniel Bradbury, Anna Cantrell
OBJECTIVES: Rising demand for emergency and urgent care services are well documented, as are the consequences, for example, ED crowding, increased costs, pressure on services and waiting times. Multiple factors have been suggested to explain why demand is increasing, including an aging population, rising number of people with multiple chronic conditions and behavioural changes relating to how people choose to access health services. The aim of this systematic mapping review is to bring together published research from urgent and emergency care settings to identify drivers that underpin patient decisions to access urgent and emergency care...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28493614/accuracy-of-physical-exam-ankle-brachial-index-and-ultrasonography-in-the-diagnosis-of-arterial-injury-in-patients-with-penetrating-extremity-trauma-a-systematic-review-and-meta-analysis
#7
Ian S deSouza, Roshanak Benabbas, Sean McKee, Bardiya Zangbar, Ashika Jain, Lorenzo Paladino, Leon Boudourakis, Richard Sinert
BACKGROUND: Penetrating Extremity Trauma (PET) may result in arterial injury, a rare but limb- and life-threatening surgical emergency. Accurate and timely diagnosis is vital to enable potential intervention and prevent significant morbidity. OBJECTIVES: Using a systematic review/meta-analysis approach, we determined the utility of Physical Examination (exam), Ankle-Brachial Index (ABI), and Ultrasonography (US) in the diagnosis of arterial injury in ED patients who have sustained PET...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28493608/the-epidemiology-of-emergency-department-trauma-discharges-in-the-united-states
#8
Charles J DiMaggio, Jacob B Avraham, David C Lee, Spiros G Frangos, Stephen P Wall
OBJECTIVE: Injury related morbidity and mortality is an important emergency medicine and public health challenge in the United States (US). Here we describe the epidemiology of traumatic injury presenting to US emergency departments, define changes in types and causes of injury among the elderly and the young, characterize the role of trauma centers and teaching hospitals in providing emergency trauma care, and estimate the overall economic burden of treating such injuries. METHODS: We conducted a secondary retrospective, repeated cross-sectional study of the Nationwide Emergency Department Data Sample (NEDS), the largest all-payer emergency department survey database in the US...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28493598/bystander-cpr-is-clustered-and-associated-with-neighborhood-socioeconomic-characteristics-a-geospatial-analysis-of-kent-county-michigan
#9
Amy Uber, Richard C Sadler, Todd Chassee, Joshua C Reynolds
OBJECTIVES: Geographic clustering of bystander CPR is associated with demographic and socioeconomic features of the community where out-of-hospital cardiac arrest (OHCA) occurred, though this association remains largely untested in rural areas. With a significant rural component and relative racial homogeneity, Kent County, Michigan provides a unique setting to externally validate or identify new community features associated with bystander CPR. Using a large, countywide dataset, we tested for geographic clustering of bystander CPR, and its associations with community socioeconomic features...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28493596/overcoming-the-tower-of-babel-in-medical-science-by-finding-the-equator-research-reporting-guidelines
#10
Christopher R Carpenter, Zachary F Meisel
You are hosting a journal club on chest pain management in the emergency department (ED) for colleagues and trainees in your department. Interested in understanding the history of cardiac biomarkers to evaluate ED patients with chest pain, you search PubMed using the combination of terms "cardiac biomarker", "chest pain", and "emergency department". Your search nets no studies prior to 2002 which you doubt is accurate, so you take the old-fashioned approach and start flipping through the oldest issues of emergency medicine journals at your local medical school library...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28493551/utilization-of-a-sobering-center-for-acute-alcohol-intoxication
#11
Shannon Smith-Bernardin, Adam Carrico, Wendy Max, Susan Chapman
OBJECTIVE: To describe the population utilizing a sobering center for public alcohol intoxication, and compare between single-visit users, repeat users, and high users. METHODS: We conducted a secondary analysis of 1,271 adults cared for in the Sobering Center from July 2014 to June 2015. We divided the population into three groups: single-use (1 visit), repeat users (2-5 visits) and high (6+) users, and evaluated demographics, lifetime health diagnoses utilizing the Elixhauser Comorbidity Index, rates of public service utilization including ambulance and emergency department, and related costs...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28475282/risk-of-intracranial-hemorrhage-in-ground-level-fall-with-antiplatelet-or-anticoagulant-agents
#12
Michael Ganetsky, Gregory Lopez, Tara Coreanu, Victor Novack, Steven Horng, Nathan I Shapiro, Kenneth A Bauer
OBJECTIVES: Anticoagulant and antiplatelet medications are known to increase the risk and severity of traumatic intracranial hemorrhage (tICH), even with minor head trauma. Most studies on bleeding propensity with head trauma are retrospective, based on trauma registries, or include heterogeneous mechanisms of injury. The goal of this study was to determine the rate of tICH from only a common low-acuity mechanism of injury, that of a ground level fall, in patients taking one or more of the following antiplatelet or anticoagulant medications: aspirin, warfarin, prasugrel, ticagrelor, dabigatran, rivaroxaban, apixaban or enoxaparin...
May 5, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28474823/global-emergency-medicine-a-review-of-the-literature-from-2016
#13
Torben K Becker, Bhakti Hansoti, Susan Bartels, Alison Schroth Hayward, Braden J Hexom, Kevin M Lunney, Regan H Marsh, Maxwell Osei-Ampofo, Indi Trehan, Julia Chang, Adam C Levine
OBJECTIVES: The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a global audience of academics and clinical practitioners. METHODS: This year 13,890 articles written in four languages were identified by our search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM...
May 5, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28472554/efficacy-of-intravenous-cobinamide-versus-hydroxocobalamin-or-saline-for-treatment-of-severe-hydrogen-sulfide-toxicity-in-a-swine-sus-scrofa-model
#14
Vikhyat S Bebarta, Normalynn Garrett, Matthew Brenner, Sari Mahon, Joseph K Maddry, Susan Boudreau, Maria Castaneda, Gerard Boss
BACKGROUND: Hydrogen sulfide (H2S) is a potentially deadly gas that naturally occurs in petroleum and natural gas. The Occupational Health and Safety Administration cites H2S as a leading cause of workplace gas inhalation deaths. Mass casualties of H2S toxicity may be caused by exposure from industrial accidents or release from oil field sites. H2S is also an attractive terrorism tool because of its high toxicity and ease with which it can be produced. Several potential antidotes have been proposed for hydrogen sulfide poisoning but none have been completely successful...
May 4, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28472533/a-systematic-review-of-the-impact-of-physician-implicit-racial-bias-on-clinical-decision-making
#15
Erin Dehon, Nicole Weiss, Jonathan Jones, Whitney Faulconer, Elizabeth Hinton, Sarah Sterling
OBJECTIVES: Disparities in diagnosis and treatment of racial minorities exist in the emergency department (ED). A better understanding of how physician implicit (unconscious) bias contributes to these disparities may help identify ways to eliminate such racial disparities. The objective of this systematic review was to examine and summarize the evidence on the association between physician implicit racial bias and clinical decision making. METHODS: Based on PRISMA guidelines, a structured electronic literature search of PubMed, CINAHL, Scopus, and PsycINFO databases was conducted...
May 4, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28471532/association-between-maternal-comorbidities-and-emergency-department-use-among-a-national-sample-of-commercially-insured-pregnant-women
#16
Shayna D Cunningham, Urania Magriples, Jordan L Thomas, Katy B Kozhimannil, Carolina Herrera, Eric Barrette, Fatma M Shebl, Jeannette R Ickovics
OBJECTIVES: Evidence suggests that, despite routine engagement with the health system, pregnant women commonly seek emergency care. The objectives of this study were to examine the association between maternal comorbidities and emergency department use among a national sample of commercially-insured pregnant women. METHODS: We conducted a retrospective cohort study using multi-payer medical claims data maintained by the Health Care Cost Institute for women ages 18-44 years with a live singleton birth in 2011 (N=157,786)...
May 4, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28470786/practice-variation-and-effects-of-e-mail-only-performance-feedback-on-resource-use-in-the-emergency-department
#17
Melissa M Tavarez, Brandon Ayers, Jong H Jeong, Carmen M Coombs, Ann Thompson, Robert Hickey
OBJECTIVES: Higher resource utilization in the management of pediatric patients with undifferentiated vomiting and/or diarrhea does not correlate consistently with improved outcomes or quality of care. Performance feedback has been shown to change physician practice behavior and may be a mechanism to minimize practice variation. We aimed to evaluate the effects of electronic mail (e-mail) only, provider-level performance feedback on the ordering and admission practice variation of pediatric emergency physicians for patients presenting with undifferentiated vomiting and/or diarrhea...
May 4, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28464459/accuracy-of-point-of-care-ultrasonography-for-diagnosing-acute-appendicitis-a-systematic-review-and-meta-analysis
#18
Matthew J Fields, Joshua Davis, Carl Alsup, Amanda Bates, Arthur Au, Srikar Adhikari, Isaac Farrell
INTRODUCTION: The use of ultrasonography to diagnose appendicitis has become increasingly common over recent years and is well-established. More recently, point of care ultrasonography (POCUS) has also been studied for the diagnosis of appendicitis, which may also prove a valuable diagnostic tool. The purpose of this study is through systematic review and meta-analysis to identify the test characteristics of POCUS, specifically ultrasonography performed by a non-radiologist physician, in accurately diagnosing acute appendicitis in patients of any age...
May 2, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28453186/emergency-physicians-are-able-to-detect-right-ventricular-dilation-with-good-agreement-compared-to-cardiology
#19
Matt A Rutz, Julie M Clary, Jeffrey A Kline, Frances M Russell
OBJECTIVE: Focused cardiac ultrasound (FOCUS) is a useful tool in evaluating patients presenting to the emergency department (ED) with acute dyspnea. Prior work has shown that right ventricular (RV) dilation is associated with repeat hospitalizations and shorter life expectancy. Traditionally, RV assessment has been evaluated by cardiologist-interpreted comprehensive echocardiography. The primary goal of this study was to determine the interrater reliability between emergency physicians (EPs) and a cardiologist for determining RV dilation on FOCUS performed on ED patients with acute dyspnea...
April 28, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28449293/a-novel-approach-to-study-medical-decision-making-in-the-clinical-setting-the-own-point-of-view-perspective
#20
Thierry Pelaccia, Jacques Tardif, Emmanuel Triby, Bernard Charlin
BACKGROUND: Making diagnostic and therapeutic decisions is a critical activity among physicians. It relies on the ability of physicians to use cognitive processes and specific knowledge in the context of a clinical reasoning. This ability is a core competency in physicians, especially in the field of emergency medicine where the rate of diagnostic errors is high. Studies that explore medical decision-making in an authentic setting are increasing significantly. They are based on the use of qualitative methods which are applied at two separate times: 1) a video recording of the subject's actual activity in an authentic setting and 2) an interview with the subject, supported by the video recording...
April 27, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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