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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/30637897/inclusion-of-sex-and-gender-in-emergency-medicine-research-a-2018-update
#1
Basmah Safdar, Kimberly E Ona Ayala, Syed Shayan Ali, Benjamin J Seifer, Michelle Hong, Marna Rayl Greenberg, Esther K Choo, Alyson J McGregor
OBJECTIVES: To a) evaluate the inclusion of sex and gender in publications by emergency medicine (EM) researchers following the 2014 federal mandate and an Academic EM Consensus Conference on sex- and gender-based research and b) assess trends compared with 2011 status report that showed 29% studies used sex and gender in the study design and 2% reported it as a primary outcome. METHODS: Using MEDLINE, the term "emergency" was used to identify all English-language studies of adult humans published between 2014-2017 as EM affiliated (i...
January 14, 2019: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/30637887/tiny-cargo-big-deal-pilot-trial-of-an-emergency-department-based-intervention-to-promote-child-passenger-safety-best-practices
#2
Michelle L Macy, Deepika Kandasamy, Ken Resnicow, Rebecca M Cunningham
BACKGROUND: Despite demonstrated effectiveness of child restraint systems (CRSs), use remains suboptimal. In this randomized pilot trial, we sought to determine the feasibility, acceptability, and potential efficacy of "Tiny Cargo, Big Deal" an ED-based intervention to promote guideline concordant size-appropriate CRS use. METHODS: Parents of children <11 years old were recruited in two EDs and randomized in a 2x2 factorial design to four conditions: 1) generic information sheet, 2) tailored brochure mailed after the ED visit, 3) a single motivational interviewing-based counseling session in the ED, 4) full intervention (counseling session plus tailored brochure)...
January 14, 2019: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/30636377/gender-differences-in-faculty-rank-among-academic-emergency-physicians-in-the-united-states
#3
Christopher L Bennett, Ali S Raja, Neena Kapoor, Dara Kass, Daniel Blumenthal, Nate Gross, Angela M Mills
BACKGROUND: The purpose of this study was to complete a comprehensive analysis of gender differences in faculty rank among United States (U.S.) emergency physicians that reflected all academic emergency physicians. METHODS: We assembled a comprehensive list of academic emergency medicine physicians with U.S. medical school faculty appointments from Doximity. com linked to detailed information on physician gender, age, years since residency completion, scientific authorship, National Institutes of Health (NIH) research funding, and participation in clinical trials...
January 13, 2019: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/30636353/the-birth-of-a-return-to-work-policy-for-new-resident-parents-in-emergency-medicine
#4
Alexandra June Gordon, Stefanie Sebok-Syer, Ann M Dohn, Rebecca Smith-Coggins, N Ewen Wang, Sarah R Williams, Michael A Gisondi
OBJECTIVE: With the rising number of female physicians, there will be more children than ever born in residency and the current system is inadequate to handle this increase in new resident parents. Residency is stressful and rigorous in isolation, let alone when pregnant or with a new child. Policies that ease these stressful transitions are generally either insufficient or do not exist. Therefore, we created a comprehensive Return to Work Policy for resident parents and piloted its implementation...
January 13, 2019: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/30636351/point-of-care-ocular-ultrasound-for-the-diagnosis-of-retinal-detachment-a-systematic-review-and-meta-analysis
#5
Michael Gottlieb, Dallas Holladay, Gary D Peksa
BACKGROUND: Ocular complaints are common presentations to the Emergency Department (ED). Among these, retinal detachment can cause significant vision loss if not rapidly diagnosed and referred for appropriate treatment. Point-of-care ultrasound has been suggested to identify the diagnosis rapidly when the ocular examination is limited or the ophthalmology service is not readily available. However, prior studies were limited by small sample sizes, resulting in wide ranges of potential accuracy...
January 13, 2019: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/30636350/changes-in-pain-score-associated-with-clinically-meaningful-outcomes-in-children-with-acute-pain
#6
Daniel S Tsze, Gerrit Hirschfeld, Carl L von Baeyer, Leonor Suarez, Peter S Dayan
BACKGROUND: Identifying changes in pain score associated with clinically meaningful outcomes is necessary when using self-report measures to assess pain in children. We aimed to determine the changes in pain score associated with a minimum clinically significant difference (MCSD), ideal clinically significant difference (ICSD), and patient-perceived adequate analgesia (PPAA), and to evaluate for differences based on initial pain intensity and patient characteristics. METHODS: Cross-sectional study of children 6-17 and 4-17 years old who were assessed using the Verbal Numerical Rating Scale (VNRS) and Faces Pain Scale-Revised (FPS-R), respectively...
January 13, 2019: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/30632653/high-flow-oxygen-therapy-for-treating-bronchiolitis-in-infants
#7
Isaac Gordon, Ambreen S Khan
Bronchiolitis is the most common reason for hospitalization in infants worldwide. Current recommendations by the American Academy of Pediatrics are for supportive care including maintenance of hydration and oxygen support for hypoxemia. Other interventions such as the use of bronchodilators have failed to show any benefit when compared to supportive care alone. However, it has been proposed that the obstructive process of bronchiolitis that causes increased work of breathing, hypoxia and hypercapnea might respond to the moderate positive pressure provided by high flow oxygen therapy...
January 11, 2019: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/30628138/making-promotion-count-the-gender-perspective-on-behalf-of-the-society-for-academic-emergency-medicine-equity-research-taskforce
#8
LETTER
Tracy E Madsen, Sheryl L Heron, Kirsten Rounds, Dara Kass, Michelle Lall, Kinjal N Sethuraman, Christian Arbelaez, Andra Blomkalns, Basmah Safdar
Women in academic emergency medicine (EM) experience disparities in both compensation and advancement.1-3 Some hypothesized causes of gender disparities include lack of mentorship and resources,4-5 unequal distribution of opportunity,6-7 sexism8 and implicit bias.9-10 Gender differences in academic rank in EM may also be driven by differences in scholarly productivity, slower ascent to leadership among women, attrition from academic medicine, and potentially a lack of adequate support for faculty that have family obligations competing with work,4 though these factors are largely speculative...
January 9, 2019: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/30609119/hot-off-the-press-sgem-237-screening-tool-for-child-sex-trafficking
#9
Christopher Bond, Justin Morgenstern, Corey Heitz, William K Milne
Child Sex Trafficking (CST) is a human rights violation and major global health issue. Many victims of CST seek medical attention during their exploitation and often present to the emergency department. The objective of this study was to apply and evaluate a screening tool for CST in an inner-city pediatric emergency department. This article is protected by copyright. All rights reserved.
January 4, 2019: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/30592101/hospital-observation-upon-reversal-hour-with-naloxone-a-prospective-clinical-prediction-rule-validation-study
#10
Brian M Clemency, William Eggleston, Evan W Shaw, Michael Cheung, Nicholas S Pokoj, Michael A Manka, Donald J Giordano, Laura Serafin, Han Yu, Heather A Lindstrom, David Hostler
OBJECTIVE: St. Paul's Early Discharge Rule was derived to determine which patients could be safely discharged from the emergency department after a 1-hour observation period following naloxone administration for opiate overdose. The rule suggested that patients could be safely discharged if they could mobilize as usual and had a normal oxygen saturation, respiratory rate, temperature, heart rate, and Glasgow Coma Scale score. Validation of the St. Paul's Early Discharge Rule is necessary to ensure that these criteria are appropriate to apply to patients presenting after an unintentional presumed opioid overdose in the context of emerging synthetic opioids and expanded naloxone access...
December 28, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/30585692/corticosteroids-for-treating-pneumonia
#11
Peter Tepler, Shahriar Zehtabchi
Pneumonia remains a major cause of morbidity and mortality in the United States. There is both theoretical and laboratory evidence that corticosteroids may have beneficial effects in pneumonia through local pulmonary and systemic effects. The data for this evidence-based summary is derived from a Cochrane meta-analysis by Stern et al,4 which included 17 trials with 2264 adult and children admitted to the hospital with community-acquired pneumonia. This article is protected by copyright. All rights reserved...
December 26, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/30565798/our-lane-needs-all-of-us
#12
Kristen L Mueller, Megan L Ranney
On November 7, 2018 the NRA responded to "Reducing Firearm Injuries and Deaths in the United States: a Position Paper from the American College of Physicians" by telling doctors to "stay in your lane" and stay out of the discussion of firearm access, regulation, and injury prevention-asserting that this is outside the scope of our practice and experience. This article is protected by copyright. All rights reserved.
December 19, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/30549375/changes-in-sex-race-and-ethnic-origin-of-emergency-medicine-resident-physicians-from-2007-2017
#13
LETTER
Christopher L Bennett, David A McDonald, Shelley Hurwitz, Hui Zheng, Eric Nadel, Megan L Ranney
Diversity among residents in particular, and among the emergency medicine workforce in general, is a goal of both specialty societies and accrediting agencies.1,2 The proportion of medical students and residents who self-identify as female has increased over the last few decades, but the proportion who are racial and ethnic minorities remains low.3-6 The percentage of emergency physicians and emergency medicine residents who are women and minorities are known to be lower than that of the general population...
December 14, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/30548977/study-enrollment-when-pre-consent-is-utilized-for-a-randomized-trial-of-two-treatments-for-acute-agitation-in-the-emergency-department
#14
Jon B Cole, Lauren R Klein, Samuel Mullinax, Kimberly D Nordstrom, Brian E Driver, Michael P Wilson
BACKGROUND: Acute agitation in the ED represents a danger to both patients and their caregivers. Medication is often needed, and few high-quality randomized trials have evaluated the optimal drugs for this vulnerable population. In the United States, as of 2017, randomized trials of drugs cannot be conducted under Waiver of Consent (46 CFR 45.116), and Exception From Informed Consent trials (21 CFR 50.24) are limited to life-threatening conditions, are onerous, and require filing an investigational new drug application with the FDA...
December 13, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/30537337/prehospital-double-sequential-defibrillation-a-matched-case-control-study
#15
Julian G Mapp, Alan J Hans, Anthony M Darrington, Elliot M Ross, Calvin C Ho, David A Miramontes, Stephen A Harper, David A Wampler
STUDY OBJECTIVES: The goal of our study is to determine if prehospital double sequential defibrillation (DSD) is associated with improved survival to hospital admission in the setting of refractory ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT). METHODS: This project is a matched case-control study derived from prospectively collected Quality Assurance/Quality Improvement (QA/QI) data obtained from the San Antonio Fire Department out-of-hospital cardiac arrest database between JAN 2013 and DEC 2015...
December 10, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/30537219/early-endovascular-thrombectomy-for-large-vessel-ischemic-stroke-reduces-disability-at-90-days
#16
Mona Al Banna, Christopher D Streib
Anterior circulation large vessel occlusion (LVO) of the internal carotid or middle cerebral artery is one of the most devastating ischemic stroke subtypes. Prior to 2015, evidence supporting endovascular thrombectomy for acute ischemic stroke was limited. This was due to multiple factors, including low recanalization rates with previous generation thrombectomy devices, inadequate neuroimaging inclusion criteria (patients enrolled in trials lacked target LVO and/or had large pre-existing core infarcts), and selection bias-patients considered most likely to benefit from thrombectomy underwent the procedure outside of clinical trials...
December 8, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/30480346/hot-off-the-press-a-systematic-review-and-meta-analysis-of-ketamine-as-an-alternative-to-opioids-for-acute-pain-in-the-emergency-department
#17
Corey Heitz, Justin Morgenstern, Christopher Bond, William K Milne
Ketamine has been studied as an alternative to opioids for acute pain in the emergency department setting. This review compares the effectives of intravenous ketamine at a dose of <0.5mg/kg to opioids for acute pain in adult patients. Measurements were taken within 60 minutes of administration. Ketamine was found to have similar effectiveness to opioids. Increased, but short-lived, side effects were seen with ketamine.
November 27, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/30461127/the-2018-academic-emergency-medicine-consensus-conference-aligning-the-pediatric-emergency-medicine-research-agenda-to-reduce-health-outcome-gaps
#18
Paul Ishimine, Kathleen Adelgais, Isabel Barata, Jean Klig, Maybelle Kou, Prashant Mahajan, Chris Merritt, Michael J Stoner, Robert Cloutier, Rakesh Mistry, Kurt R Denninghoff
Emergency care providers share a compelling interest in developing an effective patient-centered, outcomes-based research agenda that can decrease variability in pediatric outcomes. The 2018 Academic Emergency Medicine Consensus Conference, "Aligning the Pediatric Emergency Medicine Research Agenda to Reduce Health Outcome Gaps (AEMCC)," aimed to fulfill this role. This conference convened major thought leaders and stakeholders to introduce a research, scholarship, and innovation agenda for pediatric emergency care specifically to reduce health outcome gaps...
November 21, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/30461126/vaccines-for-preventing-influenza-in-healthy-individuals
#19
Sally Liang
Influenza is an acute respiratory infection that imposes a heavy burden on society. The illness itself usually lasts a few days but the residual symptoms of cough and malaise can last for weeks. In addition, it can cause complications such as otitis media, pneumonia, secondary bacterial pneumonia, exacerbations of chronic respiratory disease, bronchiolitis, febrile seizures, Reye's syndrome, and myocarditis.1 Vaccines have been developed in attempt to minimize the effects of influenza. However, given the yearly antigenic changes of the virus, a new vaccine has to be developed, produced, and administered to the population every year...
November 21, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/30428150/reduction-of-computed-tomography-use-for-pediatric-closed-head-injury-evaluation-at-a-non-pediatric-community-emergency-department
#20
Melissa S Puffenbarger, Fahd A Ahmad, Michelle Argent, Hongjie Gu, Charles Samson, Kimberly S Quayle, Jacqueline M Saito
OBJECTIVE: The purpose of this study was to determine if implementation of a Pediatric Emergency Care Applied Research Network (PECARN)-based closed head injury assessment tool could safely decrease computed tomography (CT) use for pediatric head injury evaluation at a non-pediatric community emergency department (ED). METHODS: A quality improvement project was initiated at a non-pediatric community ED to implement an institution-specific, Pediatric Emergency Care Applied Research Network (PECARN)-based Pediatric Closed Head Injury Assessment Tool...
November 14, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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