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Western Journal of Emergency Medicine

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https://www.readbyqxmd.com/read/30013717/a-targeted-mindfulness-curriculum-for-medical-students-during-their-emergency-medicine-clerkship-experience
#1
Arlene S Chung, Rachel Felber, Ethan Han, Tina Mathew, Katie Rebillot, Antonios Likourezos
Introduction: Despite high rates of burnout in senior medical students, many schools provide the majority of their wellness training during the first and second preclinical years. Students planning a career in emergency medicine (EM) may be at particularly high risk of burnout, given that EM has one of the highest burnout rates of all the specialties in the United States We developed an innovative, mindfulness-based curriculum designed to be integrated into a standard EM clerkship for senior medical students to help students manage stress and reduce their risk of burnout...
July 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30013716/teaching-methods-utilized-during-medical-resuscitations-in-an-academic-emergency-department
#2
Lori A Weichenthal, Rawnie Ruegner, Stacy Sawtelle, Danielle Campagne, Crystal Ives, James Comes
Introduction: One important skill that an emergency medicine trainee must learn is the resuscitation of the critically ill patient. There is research describing clinical teaching strategies used in the emergency department (ED), but less is known about specific methods employed during actual medical resuscitations. Our objective was to identify and describe the teaching methods used during medical resuscitations. Methods: This was a prospective study involving review of 22 videotaped, medical resuscitations...
July 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30013715/journal-club-in-residency-education-an-evidence-based-guide-to-best-practices-from-the-council-of-emergency-medicine-residency-directors
#3
Michael Gottlieb, Andrew King, Richard Byyny, Melissa Parsons, John Bailitz
Journal clubs are an important tool for critically appraising articles and keeping up-to-date with the current literature. This paper provides a critical review of the literature on the design and structure of journal clubs in residency education with a focus on preparation, topic selection, implementation, and integration of technology. Recommendations for preparation include developing clearly defined goals and objectives that are agreed upon by all journal club participants; mentorship from experienced faculty members to ensure appropriate article selection, maintenance of structure, and applicability to objectives; distribution of articles to participants 1-2 weeks prior to the scheduled session with reminders to read the articles at predetermined intervals; and the use of a structured critical appraisal tool for evaluating the articles...
July 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30013714/scholarship-in-emergency-medicine-a-primer-for-junior-academics-part-ii-promoting-your-career-and-achieving-your-goals
#4
REVIEW
James Langabeer, Michael Gottlieb, Chadd K Kraus, Shahram Lotfipour, Linda S Murphy, Mark I Langdorf
Scholarship is an important component of success for academic emergency physicians. Scholarship can take many forms, but all require careful planning. In this article, we provide expert consensus recommendations for improving junior faculty's scholarship in emergency medicine (EM). Specific focus is given to promoting your research career, obtaining additional training opportunities, networking in EM, and other strategies for strategically directing a long-term career in academic medicine.
July 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30013713/closing-the-gap-between-entrustment-and-resuscitation
#5
Teresa Camp-Rogers, Douglas Franzen
No abstract text is available yet for this article.
July 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30013712/proceed-with-caution-before-assigning-red-flags-in-residency-applications
#6
COMMENT
Shellie Asher, Kimberly A Kilby
No abstract text is available yet for this article.
July 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30013711/transaminase-and-creatine-kinase-ratios-for-differentiating-delayed-acetaminophen-overdose-from-rhabdomyolysis
#7
Joshua B Radke, Douglas A Algren, James A Chenoweth, Kelly P Owen, Jonathan B Ford, Timothy E Albertson, Mark E Sutter
Introduction: Rhabdomyolysis and delayed acetaminophen hepatotoxicity may be associated with elevated serum transaminase values. Establishing the cause of elevated transaminases may be especially difficult because of limited or inaccurate histories of acetaminophen ingestion. We hypothesized that the comparative ratios of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and creatine kinase (CK) can differentiate acetaminophen hepatotoxicity from rhabdomyolysis. Methods: A retrospective chart review of patients in four hospitals from 2006 to 2011 with a discharge diagnosis of acetaminophen toxicity or rhabdomyolysis was performed...
July 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30013710/patient-preference-for-pain-medication-in-the-emergency-department-is-associated-with-non-fatal-overdose-history
#8
Lauren K Whiteside, Jason Goldstick, Aaron Dora-Laskey, Laura Thomas, Maureen Walton, Rebecca Cunningham, Amy S B Bohnert
Introduction: Opioid overdose is a major public health problem. Emergency physicians need information to better assess a patient's risk for overdose or opioid-related harms. The purpose of this study was to determine if patient-reported preference for specific pain medications was associated with a history of lifetime overdose among patients seeking care in the emergency department (ED). Methods: ED patients (18-60 years) completed a screening survey that included questions on overdose history, ED utilization, opioid misuse behaviors as measured by the Current Opioid Misuse Measure (COMM), and analgesic medication preferences for previous ED visits for pain with specific responses for preference for hydromorphone (Dilaudid®), morphine, ketorolac (Toradol®), "no preference" or "never visited the ED for pain...
July 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30013709/computed-tomography-risk-disclosure-in-the-emergency-department-a-survey-of-pediatric-emergency-medicine-fellowship-program-leaders
#9
Jennifer R Marin, Karen E Thomas, Angela M Mills, Kathy Boutis
Introduction: Given the potential malignancy risks associated with computed tomography (CT), some physicians are increasingly advocating for risk disclosure to patients/families. Our goal was to evaluate the practices and attitudes of pediatric emergency medicine (PEM) fellowship program leaders' regarding CT radiation-risk disclosure. Methods: We conducted a cross-sectional survey study of the United States and Canadian PEM fellowship directors and associate/assistant directors...
July 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30013708/suffocation-injuries-in-the-united-states-patient-characteristics-and-factors-associated-with-mortality
#10
Roula Sasso, Rana Bachir, Mazen El Sayed
Introduction: Asphyxiation or suffocation injuries can result in multi-organ damage and are a major cause of morbidity and mortality among different age groups. This study aims to describe characteristics of patients presenting with suffocation injuries to emergency departments (EDs) in the United States (U.S.) and to identify factors associated with mortality in this population. Methods: We conducted a retrospective cross-sectional study using the 2013 U.S National Emergency Department Sample database...
July 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30013707/initial-standardized-framework-for-reporting-social-media-analytics-in-emergency-care-research
#11
Damian Roland, Jesse Spurr, Daniel Cabrera
The use of social media platforms to disseminate information, translate knowledge, change clinical care and create communities of practice is becoming increasingly common in emergency and critical care. With this adoption come new lines and methods of inquiry for research in healthcare. While tools exist to standardize the reporting of clinical studies and systematic reviews, there is no agreed framework for examining social media-based research. This article presents a publication and appraisal checklist for such work and invites further collaboration in the form of a Delphi technique to clarify, expand, improve, and validate the proposal...
July 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30013706/anaphylaxis-related-malpractice-lawsuits
#12
Rachel A Lindor, Erika M McMahon, Joseph P Wood, Annie T Sadosty, Eric T Boie, Ronna L Campbell
Introduction: Anaphylaxis continues to cause significant morbidity and mortality. Healthcare providers struggle to promptly recognize and appropriately treat anaphylaxis patients. The goal of this study was to characterize anaphylaxis-related malpractice lawsuits. Methods: We collected jury verdicts, settlements, and court opinions regarding alleged medical malpractice involving anaphylaxis from May 2011 through May 2016 from an online legal database (Thomson Reuters Westlaw)...
July 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30013705/cost-of-routine-herpes-simplex-virus-infection-visits-to-u-s-emergency-departments-2006-2013
#13
Fan Di Xia, Mary Fuhlbrigge, Erica Dommasch, Cara Joyce, Arash Mostaghimi
Introduction: Little is known about emergency department (ED) utilization for herpes simplex viruses (HSV) types 1 and 2 in the United States. Our goal was to determine the utilization and cost burden associated with HSV infection visits to U.S. EDs in recent years from 2006-2013. Methods: We analyzed the Nationwide Emergency Department Sample (NEDS) database, the largest national database of hospital-based ED visits in the U.S., to determine the number of visits and the cost associated with HSV visits from 2006-2013...
July 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30013704/opioid-administration-and-prescribing-in-older-adults-in-u-s-emergency-departments-2005-2015
#14
Erin M Marra, Maryann Mazer-Amirshahi, Peter Mullins, Jesse M Pines
Introduction: We assess trends in opioid administration and prescribing from 2005-2015 in older adults in United States (U.S.) emergency departments (ED). Methods: We analyzed data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) survey from 2005 to 2015. ED visits for painful conditions were selected and stratified by age (18-64, 65-74, 75-84, ≥ 85 years). We analyzed trends in opioid administration in the ED and prescribing at discharge to encounters ≥ 65 and assessed predictors of use using survey-weighted chi-square tests and logistic regression...
July 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30013703/using-the-natural-experiment-study-design-to-evaluate-the-effect-of-a-change-in-doctor-s-roster-on-patient-flow-in-an-emergency-department
#15
Peter Hallas, Dan Brun Pedersen
Introduction: The effect of changes in doctors' rosters is rarely subjected to scientific evaluation. We describe how a natural experiment (NE) study design can be used to evaluate if a managerial decision about doctors' rosters has an effect on patient flow in an emergency department (ED). We hypothesized that an extra doctor each morning from 6 a.m. (i.e., a modified "casino shift") might improve the productivity of a hospital's ED. Methods: This was an NE observational study using data on patient flow in the ED of Zealand University Hospital, Denmark, between April 1, 2016, and April 1, 2017...
July 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30013702/simple-changes-to-emergency-department-workflow-improve-analgesia-in-mechanically-ventilated-patients
#16
Derek L Isenberg, Katrina M Kissman, Ellie P Salinski, Mark A Saks, Loreen B Evans
Introduction: In 2013 the Society for Critical Care Medicine (SCCM) published guidelines for the management of pain and agitation in the intensive care unit (ICU). These guidelines recommend using an analgesia-first strategy in mechanically ventilated patients as well as reducing the use of benzodiazepines. Benzodiazepines increase delirium in ICU patients thereby increasing ICU length of stay. We sought to determine whether a simple educational intervention for emergency department (ED) staff, as well as two simple changes in workflow, would improve adherence to the SCCM guidelines...
July 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30013701/a-randomized-comparison-of-in-hospital-rescuer-positions-for-endotracheal-intubation-in-a-difficult-airway
#17
Joanna M Le Parc, Jason J Bischof, Andrew M King, Sarah Greenberger, David P Way, Ashish R Panchal, Geoffrey I Finnegan, Thomas E Terndrup
Introduction: Emergency endotracheal intubation (ETI) is a common and critical procedure performed in both prehospital and in-hospital settings. Studies of prehospital providers have demonstrated that rescuer position influences ETI outcomes. However, studies of in-hospital rescuer position for ETI are limited. While we adhere to strict standards for the administration of ETI, we posited that perhaps requiring in-hospital rescuers to stand for ETI is an obstacle to effectiveness. Our objective was to compare in-hospital emergency medicine (EM) trainees' performance on ETI delivered from both the seated and standing positions...
July 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30013700/paramedic-out-of-hospital-cardiac-arrest-case-volume-is-a-predictor-of-return-of-spontaneous-circulation
#18
Jenna E Tuttle, Michael W Hubble
Introduction: Many factors contribute to the survival of out-of-hospital cardiac arrest (OHCA). One such factor is the quality of resuscitation efforts, which in turn may be a function of OHCA case volume. However, few studies have investigated the OHCA case volume-survival relationship. Consequently, we sought to develop a model describing the likelihood of return of spontaneous circulation (ROSC) as a function of paramedic cumulative OHCA experience. Methods: We conducted a statewide retrospective study of cardiac arrest using the North Carolina Prehospital Care Reporting System...
July 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30013699/systemwide-clinical-ultrasound-program-development-an-expert-consensus-model
#19
Robert Strony, Jennifer R Marin, John Bailitz, Anthony J Dean, Mike Blaivas, Vivek Tayal, Chris Raio, Rachel Liu, Aimee Woods, Michael Zwank, Matthew Fields, Alyssa Abo, Stan Wu, Tarina Kang, Teresa Liu, Megan Leo, Courtney Smalley, Jerry Chiricolo, Mikaela Chilstrom, Resa E Lewiss
Clinical ultrasound (CUS) is integral to the practice of an increasing number of medical specialties. Guidelines are needed to ensure effective CUS utilization across health systems. Such guidelines should address all aspects of CUS within a hospital or health system. These include leadership, training, competency, credentialing, quality assurance and improvement, documentation, archiving, workflow, equipment, and infrastructure issues relating to communication and information technology. To meet this need, a group of CUS subject matter experts, who have been involved in institution- and/or systemwide clinical ultrasound (SWCUS) program development convened...
July 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30013698/geospatial-clustering-of-opioid-related-emergency-medical-services-runs-for-public-deployment-of-naloxone
#20
Daniel A Dworkis, Scott G Weiner, Vincent T Liao, Danielle Rabickow, Scott A Goldberg
Introduction: The epidemic of opioid use disorder and opioid overdose carries extensive morbidity and mortality and necessitates a multi-pronged, community-level response. Bystander administration of the opioid overdose antidote naloxone is effective, but it is not universally available and requires consistent effort on the part of citizens to proactively carry naloxone. An alternate approach would be to position naloxone kits where they are most needed in a community, in a manner analogous to automated external defibrillators...
July 2018: Western Journal of Emergency Medicine
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