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American college emergency physicians

Paul I Musey, John A Lee, Cassandra A Hall, Jeffrey A Kline
BACKGROUND: Approximately 80% of patients presenting to emergency departments (ED) with chest pain do not have any true cardiopulmonary emergency such as acute coronary syndrome (ACS). However, psychological contributors such as anxiety are thought to be present in up to 58%, but often remain undiagnosed leading to chronic chest pain and ED recidivism. METHODS: To evaluate ED provider beliefs and their usual practices regarding the approach and disposition of patients with low risk chest pain associated with anxiety, we constructed a 22-item survey using a modified Delphi technique...
March 14, 2018: BMC Emergency Medicine
Lane M Smith, Chadwick D Miller
Acute aortic dissection (AAD) sits at the intersection of rare, deadly, and expensive to diagnose conditions. It is a disease that every emergency physician (EP) considers on a daily basis, but encounters only a handful during a career. Considerable attention has been given to this disease after the American Heart Association, American College of Cardiology, and 10 cosponsoring professional societies published the 2010 thoracic aortic disease guidelines to improve the missed or delayed treatment of AAD (1)...
March 2, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Sofie Rahman Morgan, Nicole M Acquisto, Zlatan Coralic, Vicki Basalyga, Matthew Campbell, John J Kelly, Kevin Langkiet, Claire Pearson, Erick Sokn, Michael Phelan
The emergency department (ED) is a fast-paced, high-risk, and often overburdened work environment. Formal policy statements from several notable organizations, including the American College of Emergency Physicians (ACEP) and the American Society of Health-System Pharmacists (ASHP), have recognized the importance of clinical pharmacists in the emergency medicine (EM) setting. EM clinical pharmacists work alongside emergency physicians and nurses at the bedside to optimize pharmacotherapy, improve patient safety, increase efficiency and cost-effectiveness of care, facilitate antibiotic stewardship, educate patients and clinicians, and contribute to scholarly efforts...
January 31, 2018: American Journal of Emergency Medicine
Lee Benjamin, Karen Frush, Kathy Shaw, Joan E Shook, Sally K Snow
No abstract text is available yet for this article.
March 2018: Annals of Emergency Medicine
Naureen Farook, L Cochon, A D Bode, B P Langer, A A Baez
BACKGROUND: Accurate identification of patients at risk of major adverse cardiac events (MACE) places a substantial burden on emergency physicians (EPs). Bayesian nomogram for risk stratification in low- to intermediate-risk cardiovascular patients has not been investigated previously. OBJECTIVE: The objective of this study was to develop a comparative diagnostic model using Bayesian statistics for exercise treadmill test (ETT) and stress echocardiogram (ECHO) to calculate post-test diagnostic risk of MACE using HEART (history, electrocardiogram, age, risk factors, and troponin) risk score as predictor of pretest probability...
February 2018: Journal of Emergency Medicine
Giacomo Strapazzon, Oliver Reisten, Fabien Argenone, Ken Zafren, Greg Zen-Ruffinen, Gordon L Larsen, Inigo Soteras
Canyoning is a recreational activity that has increased in popularity in the last decade in Europe and North America, resulting in up to 40% of the total search and rescue costs in some geographic locations. The International Commission for Mountain Emergency Medicine convened an expert panel to develop recommendations for on-site management and transport of patients in canyoning incidents. The goal of the current review is to provide guidance to healthcare providers and canyoning rescue professionals about best practices for rescue and medical treatment through the evaluation of the existing best evidence, focusing on the unique combination of remoteness, water exposure, limited on-site patient management options, and technically challenging terrain...
February 5, 2018: Wilderness & Environmental Medicine
Alexis Danielle Vick, Aaron Baugh, Julie Lambert, Allison A Vanderbilt, Evan Ingram, Richard Garcia, Reginald F Baugh
A growing body of research illustrates the importance of aligning efforts across the operational continuum to achieve diversity goals. This alignment begins with the institutional mission and the message it conveys about the priorities of the institution to potential applicants, community, staff, and faculty. The traditional themes of education, research, and service dominate most medical school mission statements. The emerging themes of physician maldistribution, overall primary-care physician shortage, diversity, and cost control are cited less frequently...
2018: Advances in Medical Education and Practice
Brit Long, Jennifer Robertson, Alex Koyfman, Kurian Maliel, Justin R Warix
BACKGROUND: Atrial fibrillation (AF) is an abnormal heart rhythm which may lead to stroke, heart failure, and death. Emergency physicians play a role in diagnosing AF, managing symptoms, and lessening complications from this dysrhythmia. OBJECTIVE: This review evaluates recent literature and addresses ED considerations in the management of AF. DISCUSSION: Emergency physicians should first assess patient clinical stability and evaluate and treat reversible causes...
January 30, 2018: American Journal of Emergency Medicine
Michael W Manning, Eric W Bean, Andrew C Miller, Suzanne J Templer, Richard S Mackenzie, David M Richardson, Kristin A Bresnan, Marna R Greenberg
Introduction: The Association of American Medical Colleges' (AAMC) initiative for Core Entrustable Professional Activities for Entering Residency includes as an element of Entrustable Professional Activity 13 to "identify system failures and contribute to a culture of safety and improvement." We set out to determine the feasibility of using medical students' action learning projects (ALPs) to expedite implementation of evidence-based pathways for three common patient diagnoses in the emergency department (ED) setting (Atrial fibrillation, congestive heart failure, and pulmonary embolism)...
January 2018: Western Journal of Emergency Medicine
Stephen J Wolf, Saadia Akhtar, Eric Gross, David Barnes, Michael Epter, Jonathan Fisher, Maria Moreira, Michael Smith, Hans House
Introduction: The American College of Emergency Physicians (ACEP) and the Council of Emergency Medicine Residency Directors (CORD) were invited to contribute to the 2016 Accreditation Council for Graduate Medical Education's (ACGME) Second Resident Duty Hours in the Learning and Working Environment Congress . We describe the joint process used by ACEP and CORD to capture the opinions of emergency medicine (EM) educators on the ACGME clinical and educational work hour standards, formulate recommendations, and inform subsequent congressional testimony...
January 2018: Western Journal of Emergency Medicine
William J Powers, Alejandro A Rabinstein, Teri Ackerson, Opeolu M Adeoye, Nicholas C Bambakidis, Kyra Becker, José Biller, Michael Brown, Bart M Demaerschalk, Brian Hoh, Edward C Jauch, Chelsea S Kidwell, Thabele M Leslie-Mazwi, Bruce Ovbiagele, Phillip A Scott, Kevin N Sheth, Andrew M Southerland, Deborah V Summers, David L Tirschwell
BACKGROUND AND PURPOSE: The purpose of these guidelines is to provide an up-to-date comprehensive set of recommendations for clinicians caring for adult patients with acute arterial ischemic stroke in a single document. The intended audiences are prehospital care providers, physicians, allied health professionals, and hospital administrators. These guidelines supersede the 2013 guidelines and subsequent updates. METHODS: Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statements Oversight Committee, representing various areas of medical expertise...
March 2018: Stroke; a Journal of Cerebral Circulation
Henry A Curtis, Karen Trang, Kevin W Chason, Paul D Biddinger
Introduction Great demands have been placed on disaster medicine educators. There is a need to develop innovative methods to educate Emergency Physicians in the ever-expanding body of disaster medicine knowledge. The authors sought to demonstrate that video-based learning (VBL) could be a promising alternative to traditional learning methods for teaching disaster medicine core competencies. Hypothesis/Problem The objective was to compare VBL to traditional lecture (TL) for instructing Emergency Medicine residents in the American College of Emergency Physicians (ACEP; Irving, Texas USA) disaster medicine core competencies of patient triage and decontamination...
January 10, 2018: Prehospital and Disaster Medicine
Agnes Y Y Lee
Evidence-based clinical practice guidelines are available to provide guidance to clinicians in managing patients living with cancer-associated venous thromboembolism (VTE). While most are developed using rigorous methods and grounded by systematic reviews of the literature, their recommendations do differ because of differences in their grading criteria and interpretation of the data. This can be confusing to practicing clinicians. Also, guidelines are often out of date and cannot keep pace with publications because of the lengthy processes and extensive resources required for completion...
January 3, 2018: Thrombosis Research
Taylor Steuber
Appropriate treatment of venous thromboembolism (VTE) is critical to minimizing long-term morbidity and mortality. The emergence of direct oral anticoagulants (DOACs) has provided clinicians with expanded therapeutic options for patients with VTE, and as a result, updated practice guidelines released by the American College of Chest Physicians favor DOACs over traditional anticoagulants, such as warfarin. The newest DOAC, betrixaban, received FDA approval in 2017, with an indication for VTE prophylaxis in hospitalized adults...
December 2017: American Journal of Managed Care
José Manuel Ramírez Aranda, Chris van Weel, Felicity Goodyear-Smith
There is little or no role for primary care and family medicine in current health reforms in Mexico. However, robust evidence shows that primary care helps prevent morbidity and mortality and increases health equity. Mexico has participated in several international meetings sponsored by the World Organization of National Colleges, Academies and Academic Associations and the North American Primary Care Research Group that are aimed at increased understanding of national health systems and the need to strengthen primary care for improved health outcomes...
November 2017: Journal of the American Board of Family Medicine: JABFM
Makini Chisolm-Straker, Cathleen Willging, Adrian D Daul, Shannon McNamara, S Cham Sante, Daniel G Shattuck, Cameron S Crandall
STUDY OBJECTIVE: We explore self-reported knowledge, attitudes, and behaviors of emergency physicians in regard to the care of transgender and gender-nonconforming patients to identify opportunities to improve care of this population. METHODS: From July to August 2016, we electronically surveyed the American College of Emergency Physicians' Emergency Medicine Practice-Based Research Network of 654 active emergency physician participants. We performed frequency tabulations to analyze the closed-ended response items...
February 2018: Annals of Emergency Medicine
Ravi V Gottumukkala, McKinley Glover, Brian J Yun, Jonathan D Sonis, Mannudeep K Kalra, Alexi Otrakji, Ali S Raja, Anand M Prabhakar
PURPOSE: Determine the incidence, management, and impact on patient disposition of allergic-like contrast reactions (ALCR) to intravenous iodinated contrast in the emergency department (ED). METHODS: All ED patients who developed an ALCR following contrast-enhanced CT (CECT) from June 2011-December 2016 were retrospectively identified. Medical records were reviewed and reaction severity, management, and disposition were quantified using descriptive statistics. The total number of consecutive CECTs performed in the ED were available from June 2011-March 2016 and were used to derive ALCR incidence over that time period...
October 12, 2017: American Journal of Emergency Medicine
Susan B Promes, Jonathan M Glauser, Michael D Smith, Sam S Torbati, Michael D Brown
No abstract text is available yet for this article.
November 2017: Annals of Emergency Medicine
Aaron Bowers, Chase Meyer, Shannon Hillier, Mark Blubaugh, Brie Roepke, Michelle Farabough, Joshua Gordon, Matt Vassar
BACKGROUND: It is estimated that as many as 1 in 10 individuals who complete suicide had been seen in emergency departments within the prior 2months. However, very little evidence underlies the current recommendations on managing patients with suicidal ideation presenting to the emergency department. The American College of Emergency Physicians (ACEP) and Veterans Affairs/Department of Defense (VA/DoD) have developed clinical practice guidelines for the screening and treatment of patients with suicidal ideation who present to emergency departments...
September 28, 2017: American Journal of Emergency Medicine
Abena Y Tannor
BACKGROUND: Low back pain (LBP) has a prevalence of 84% in Africa. The commonest form of imaging is plain lumbar spine x-ray. It gives a radiation dose equivalent to 65 times a chest x-ray dose and sends one of the highest doses to the human reproductive organs. The commonest cause of LBP in Africa is degenerative disease. X-ray findings do not change mode of treatment yet most physicians still routinely request for x-rays. METHODS: This is a systematic review of databases including The Cochrane, CINAHL plus, AMED, and MEDLINE...
March 2017: Ghana Medical Journal
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