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    Are non-pharmacologic pain interventions effective at reducing pain in adult patients visiting the Emergency Department? A Systematic Review and Meta-analysis.
    Acad Emerg Med 2018 Mar 15. Epub 2018 Mar 15.
    Duke University School of Medicine, Durham, North Carolina.
    Study Objective: Pain is a common complaint in the Emergency Department (ED). Its management currently depends heavily on pharmacologic treatment, but evidence suggests non-pharmacologic interventions may be beneficial. The purpose of this systematic review and meta-analysis was to assess whether non-pharmacologic interventions in the ED are effective in reducing pain. Read More

    Knights without Armour.
    Acad Emerg Med 2018 Mar 10. Epub 2018 Mar 10.
    Department Accidents & Emergencies Craigavon Area Hospital, Apartment 15, 72 Beech Heights Belfast, BT7 3LQ, Craigavon, UK.
    Training in Emergency medicine for nearly 5 years, I thought the finish line was getting near and becoming a consultant was just down the corner. I was enjoying work, getting better every day and well appreciated by peers. But little did I know that life had other plans. Read More

    Creation and Implementation of an Outpatient Pathway for Atrial Fibrillation in the Emergency Department Setting: Results of an Expert Panel.
    Acad Emerg Med 2018 Mar 10. Epub 2018 Mar 10.
    Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC.
    Atrial fibrillation and flutter (AF) is a common condition among emergency department (ED) patients in the United States (US). Traditionally, ED care for primary complaints related to AF focus on rate control, and patients are often admitted to an inpatient setting for further care. Inpatient care may include further telemetry monitoring and diagnostic testing, rhythm control, a search for identification of AF etiology, and stroke prophylaxis. Read More

    Love Transcends Disease.
    Acad Emerg Med 2018 Mar 9. Epub 2018 Mar 9.
    Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN.
    In the midst of a typical emergency medicine resident schedule packed with clinical shifts, resident scheduling, scholarly projects, conference scheduling, and family needs, I took time to visit my grandparents. They are in their 90s and because they live so far away, they had yet to meet my 1 year old daughter. Age has caught up to them over the last five years; particularly my grandfather who is in the final stages of Alzheimer's disease. Read More

    Prospective validation of clinical criteria to identify emergency department patients at high risk for adverse drug events.
    Acad Emerg Med 2018 Mar 8. Epub 2018 Mar 8.
    Department of Emergency Medicine, University of Ottawa, 1053 Carling Ave., E-Main Room EM-206 Box 227, Ottawa, Ontario, K1Y 4E9.
    Objectives: Adverse drug events cause or contribute to one in nine emergency department presentations in North America, and are often misdiagnosed. Emergency departments have insufficient clinical pharmacists to complete medication reviews in all incoming patients, even though pharmacist-led medications reviews have been associated with improved health outcomes. Our objective was to validate clinical decision rules to identify patients presenting with adverse drug events so they could be prioritized for pharmacist-led medication review. Read More

    The Association between Daily Posttraumatic Stress Symptoms and Pain over the First 14-days after Injury: An Experience Sampling Study.
    Acad Emerg Med 2018 Mar 7. Epub 2018 Mar 7.
    University of Pittsburgh, Department of Emergency Medicine.
    Objectives: Psychosocial factors and responses to injury modify the transition from acute to chronic pain. Specifically, posttraumatic stress disorder symptoms (PTSS; reexperiencing, avoidance, and hyperarousal symptoms) exacerbate and co-occur with chronic pain. Yet no study has prospectively considered the associations among these psychological processes and pain reports using experience sampling methods (ESM) during the acute aftermath of injury. Read More

    A Multi-site Intervention for Pediatric Community Acquired Pneumonia in Community Settings.
    Acad Emerg Med 2018 Mar 7. Epub 2018 Mar 7.
    Department of Pediatrics, University of Washington, Seattle, WA.
    Objectives: The majority of children with community acquired pneumonia (CAP) are primarily evaluated in community hospital emergency departments (EDs); however, studies on the management of pediatric CAP have largely targeted care provided in free-standing children's hospital EDs or inpatient settings. The objectives of this study were to examine whether implementation of a CAP pathway within three community hospital EDs and inpatient units improved process measures related to appropriate laboratory testing and antibiotic prescribing, and to compare performance on these measures between the community hospitals and a free-standing children's hospital.

    Methods: Through a multi-disciplinary approach (including general emergency medicine (EM) providers, pediatric fellowship trained EM providers, and pediatric hospitalists), a CAP pathway was designed and implemented at three community hospitals in January and February 2016. Read More

    Acad Emerg Med 2018 Mar 6. Epub 2018 Mar 6.
    Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio.
    The hallways of the Emergency Department are filled with patients during influenza season. Our patient is rushed to imaging with work-boots left-behind as his placeholder. This article is protected by copyright. Read More

    Patient preferences for diagnostic testing in the emergency department: a cross-sectional study.
    Acad Emerg Med 2018 Mar 5. Epub 2018 Mar 5.
    Departments of Emergency Medicine and Neurology, University of Michigan Health System, Ann Arbor, MI.
    Background: Diagnostic testing is common during emergency department visits. Little is understood about patient preferences for such testing. We hypothesized that a patient's willingness to undergo diagnostic testing is influenced by the potential benefit, risk, and personal cost. Read More

    What's Next for Acute Heart Failure Research: A Call for Multi-Disciplinary Collaborations.
    Acad Emerg Med 2018 Mar 5. Epub 2018 Mar 5.
    University of Pennsylvania Perelman School of Medicine, 3400 Spruce Street5 Maloney, 19104, Philadelphia, Pennsylvania, United States.
    We read with interest the recent contribution by Collins and colleagues[1] identifying high priority areas for future research in acute heart failure (AHF). We agree that a coordinated, multi- disciplinary approach to designing, implementing and funding future research is necessary if we hope to advance a field that has resisted change for 40 years. The role of ED physicians and cardiologists in the care of AHF cannot be underestimated, but the majority of patients with AHF are cared for by hospitalists and we believe that there is much to be gained by engaging hospitalists and other inpatient providers in this process. Read More

    Effect of a Data-Driven Intervention on Opioid Prescribing Intensity Among Emergency Department Providers: A Randomized Controlled Trial.
    Acad Emerg Med 2018 Mar 2. Epub 2018 Mar 2.
    Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
    Objective: Little is known about accuracy of provider self-perception of opioid prescribing. We hypothesized that an intervention asking emergency department (ED) providers to self-identify their opioid prescribing practices compared to group norms-and subsequently providing them with their actual prescribing data-would alter future prescribing compared to controls.

    Methods: This was a prospective, multi-center randomized trial in which all attending physicians, residents, and advanced practice providers at four EDs were randomly assigned to either no intervention or a brief data-driven intervention during which providers were: (1) asked to self-identify and explicitly report to research staff their perceived opioid prescribing in comparison to their peers, and then (2) given their actual data with peer group norms for comparison. Read More

    Acute Aortic Dissection: Is There Something Better than Physician Gestalt?
    Acad Emerg Med 2018 Mar 2. Epub 2018 Mar 2.
    Emergency Medicine, Wake Forest School of Medicine, Medical Center Blvd. 27157, Winston-Salem, North Carolina.
    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). Read More

    Confronting the Opioid Crisis by Taking a Long Look in the Mirror…and at our Peers.
    Acad Emerg Med 2018 Mar 2. Epub 2018 Mar 2.
    Cook County Health and Hospitals System, Chicago, IL.
    National attention to our current opioid epidemic continues to increase at a numbing pace. According to the latest estimates from the Centers for Disease Control and Prevention (CDC), opioids claim 115 lives per day in the United States [1]. Although black market fentanyl and other street synthetics are getting some blame for these deaths, recent data confirm that prescription opioids remain a large contributor to our opioid problem [2]. Read More

    Systematic review and meta-analysis of outcomes of patients with subsegmental pulmonary embolism with and without anticoagulation treatment.
    Acad Emerg Med 2018 Mar 2. Epub 2018 Mar 2.
    Department of Emergency Medicine Department of Cellular and Integrative Physiology, Indiana University School of Medicine, 720 Eskenazi Avenue Indianapolis, IN, 46202.
    Background: This systematic review addresses the controversy over the decision to anticoagulate patients with subsegmental pulmonary embolism (SSPE).

    Methods: We searched Ovid MEDLINE, PubMed, Embase, the Cochrane Library, Scopus, Web of Science, ClinicalTrials . gov, Google Scholar and bibliographies in March 2017. Read More

    Assessing the effect of a medical toxicologist in the care of rattlesnake envenomated patients.
    Acad Emerg Med 2018 Mar 2. Epub 2018 Mar 2.
    Weill Cornell College of Medicine in Qatar and Hamad Medical Corporation, Department of Emergency Medicine, Doha, Qatar.
    Rattlesnake envenomation is an important problem in the United States, and the management of these envenomations can be complex. Despite these complexities, however, the majority of such cases are managed without the involvement of a medical toxicologist. The primary objective of this study is to evaluate the impact of a medical toxicology service on the length of stay of such patients. Read More

    Impact of Jahnigen / GEMSSTAR Scholarships on Careers of Recipients in Emergency Medicine and on Development of Geriatric Emergency Medicine.
    Acad Emerg Med 2018 Mar 1. Epub 2018 Mar 1.
    The Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA.
    Background: The Jahnigen Career Development Awards program was launched in 2002 with private funding and transformed into the Grants for Early Medical/Surgical Specialists' Transition to Aging Research (GEMSSTAR) program in 2011 through support from the National Institute on Aging and medical specialty professional societies. The Jahnigen / GEMSSTAR program has provided grants to early career physician-scientists from 10 surgical and related medical specialties to initiate and sustain research careers in the geriatric aspect of their discipline. From 2002-2016, there were 20 Jahnigen / GEMSSTAR recipients in Emergency Medicine (EM). Read More

    Reduction of Parenteral Opioid Use in Community Emergency Departments Following Implementation of Treatment Guidelines.
    Acad Emerg Med 2018 Mar 1. Epub 2018 Mar 1.
    Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
    Objective: Opioid prescribing guidelines are commonly seen as part of the solution to America's opioid epidemic. However, the effectiveness of specific treatment guidelines on altering opioid prescribing in the Emergency Department (ED) is unclear. We examined provider ordering patterns before and after implementation of opioid use guidelines for ED patients overall and the specific subsets of ED patients with either chronic opioid use or fracture. Read More

    Gender Bias in the Management of Patients Still Exists.
    Acad Emerg Med 2018 Feb 26. Epub 2018 Feb 26.
    Emergency Medicine, UT Southwestern Medical Center, Dallas, TX.
    In this volume of Academic Emergency Medicine, Humphries et al, report that females with cardiac chest pain and cardiac troponin levels above the 99percentile are less likely to receive guideline recommended care for an acute coronary syndrome (ACS). By using strict criteria, the authors attempted to adjust for differences in presentation and adding to existing literature showing that gender bias exists even when objective criteria are used. This article is protected by copyright. Read More

    Mental Health-Related Emergency Department Visits Associated with Cannabis in Colorado.
    Acad Emerg Med 2018 Feb 24. Epub 2018 Feb 24.
    University of Colorado, School of Medicine Department of Family Medicine Aurora, CO, United States.
    Dsfintroduction: Cannabis legalization in Colorado resulted in increased cannabis-associated healthcare utilization. Our objective was to examine co-occurrence of cannabis and mental health diagnostic coding in Colorado emergency department (ED) discharges and replicate the study in a subpopulation of ED visits where cannabis involvement and psychiatric diagnosis were confirmed through medical review.

    Methods: We collected state-wide ED ICD-9-CM diagnoses from the Colorado Hospital Association and a subpopulation of ED visits from a large, academic hospital from 2012 to 2014. Read More

    Homelessness and Emergency Medicine: Furthering the Conversation.
    Acad Emerg Med 2018 Feb 21. Epub 2018 Feb 21.
    Department of Emergency Medicine, Emory University, Atlanta, GA.
    We thank the authors for their interest in our work, for their recommendations for future research, and for the insight they add to the national context of homelessness and emergency medicine. We agree with the authors that Emergency Departments (EDs) across the US have a critical role to play in shedding light on the life-threatening consequences of housing deprivation and in advocating for measures to improve the health of homeless persons, housing being chief among them. We are aware that this is a daunting task-one that pushes the limits of our specialty and challenges us to think differently about health and health care. Read More

    Homelessness and Emergency Medicine: Where Do We Go From Here?
    Acad Emerg Med 2018 Feb 17. Epub 2018 Feb 17.
    Maria C. Raven, Department of Emergency Medicine, University of California San Francisco, San Francisco, California.
    In many emergency departments (EDs) around the country, providers care for patients experiencing homelessness on every single shift. Despite its proven impact on health, housing status is not a routine part of the history taken by most emergency providers, and in many cases providers are unaware that they are caring for someone who has no stable home. Patients experiencing homelessness have unique needs spanning acute and chronic illness, injury, behavioral health diagnoses, and material deprivation. Read More

    Hot off the Press: SGEM#197: Cannulation in the ED.
    Acad Emerg Med 2018 Feb 16. Epub 2018 Feb 16.
    Markham Stouffville Hospital, Emergency Medicine.
    This is a prospective before-after study comparing peripheral intravenous cannulation (PIVC) placement and usage rates following a 10 week long multimodal intervention provided to medical and nursing staff working in a tertiary emergency department (ED). The intervention focused on improving appropriate use of PIVCs in an emergency setting by emphasizing to clinicians that a PIVC should only be placed if it was believed there was more than an 80% chance that it would be used. Patients were eligible for the study if they presented to the ED and were >18 years of age. Read More

    From Ruling Out to Ruling In: Putting POCUS in Focus.
    Acad Emerg Med 2018 Feb 10. Epub 2018 Feb 10.
    Emory University School of Medicine, Atlanta, Georgia.
    Over the past twenty years, the Emergency Department (ED) has transformed from a location that managed patients with acute life-threatening illness or injury to an acute diagnostic center. The advent of rapid and accurate imaging, novel biomarkers, and other innovations concurrent with effects from financial and social forces has supported the development of an acute care system focused on "ruling out" low-frequency, high-mortality events such as acute myocardial infarction, stroke, pulmonary embolism, and aortic dissection. This search for "true-negatives" may result from malpractice fears, readily available technology, or most likely, clinician and patient discomfort with uncertainty. Read More

    The accuracy and prognostic value of point-of-care ultrasound for nephrolithiasis in the emergency department: A Systematic Review and Meta-Analysis.
    Acad Emerg Med 2018 Feb 10. Epub 2018 Feb 10.
    University of Calgary, Department of Emergency Medicine.
    Introduction: Point-of-care ultrasound (POCUS) has been suggested as an initial investigation in the management of renal colic. Our objectives were: 1) to determine the accuracy of POCUS for the diagnosis of nephrolithiasis, and 2) to assess its prognostic value in the management of renal colic.

    Methods: The review protocol was registered to the PROSPERO database (CRD42016035331). Read More

    Economic Analysis of Diagnostic Imaging in Pediatric Patients with Suspected Appendicitis.
    Acad Emerg Med 2018 Feb 10. Epub 2018 Feb 10.
    Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY.
    Objective: The use of computed tomography (CT) and ultrasound (US) in patients with acute abdominal pain has substantial variation across pediatric emergency departments (ED). This study compares the cost of diagnosing and treating suspected appendicitis across a multi-center network of children's hospitals.

    Methods: This study is a secondary analysis using de-identified data of a prospective, observational study of patients with suspected appendicitis at nine pediatric EDs. Read More

    Prospective validation and refinement of a decision rule to obtain CXR in patients with non-traumatic chest pain in the ED.
    Acad Emerg Med 2018 Feb 10. Epub 2018 Feb 10.
    St. Luke's University Health Network, Department of Emergency Medicine, Bethlehem, PA.
    Objectives: To prospectively validate and refine previously published criteria to determine the potential utility of chest x-ray (CXR) in the evaluation and management of patients presenting to the emergency department (ED) with non-traumatic chest pain.

    Methods: A prospective observational study was performed of patients presenting to three EDs in the US with a chief complaint of non-traumatic chest pain. Previously defined high-risk history and exam elements were combined into a refined decision rule and these elements were recorded for each patient by the ED physician. Read More

    Effectiveness of a specialized brief intervention for at-risk drinkers in an Emergency Department. Short term results of a randomized controlled trial.
    Acad Emerg Med 2018 Feb 8. Epub 2018 Feb 8.
    Addictive Behaviors Unit, Clinical Neuroscience Institute, Hospital Clínic, Villarroel, 170 08036, Barcelona, Spain.
    Background And Aims: SBIRT programmes (Screening Brief Intervention and Referral to Treatment) have been developed, evaluated and shown to be effective, particularly in primary care and general practice. Nevertheless, effectiveness of SBIRT in emergency departments (ED) has not been clearly established. We aimed to evaluate the feasibility and efficacy of an SBIRT programme conducted by highly specialized professionals in the ED of a tertiary hospital. Read More

    Implementation of a Novel Algorithm to Decrease Unnecessary Hospitalizations in Patients Presenting to a Community Emergency Department With Atrial Fibrillation.
    Acad Emerg Med 2018 Jan 31. Epub 2018 Jan 31.
    Methods Consultants, Ypsilanti, MI.
    Objectives: Atrial fibrillation (AFib) is the most common dysrhythmia in the United States. Patients seen in the emergency department (ED) in rapid AFib are often started on intravenous rate-controlling agents and admitted for several days. Although underlying and triggering illnesses must be addressed, AFib, intrinsically, is rarely life-threatening and can often be safely managed in an outpatient setting. Read More

    A comparison of care delivered in hospital-based and freestanding emergency departments.
    Acad Emerg Med 2018 Jan 30. Epub 2018 Jan 30.
    Pritzker School of Law and Kellogg School of Management Northwestern University, Chicago, IL.
    Objective: We compare case-mix, hospitalization rates, length of stay (LOS), and resource use in independent freestanding emergency departments (FSEDs) and hospital-based emergency departments (H-EDs).

    Methods: Data from 74 FSEDs (2013-5) in Texas and Colorado, were compared to H-ED data from the 2013-14 National Hospital Ambulatory Medical Care Survey. In the unrestricted sample, large differences in visit characteristics (e. Read More

    Accuracy of Computed Tomography in Diagnosis of Intra-abdominal Injuries in Stable Patients with Anterior Abdominal Stab Wounds: A Systematic Review and Meta-Analysis.
    Acad Emerg Med 2018 Jan 25. Epub 2018 Jan 25.
    Department of Emergency Medicine Kings County Hospital Center, State University of New York Downstate Medical Center.
    Background: Work-up for patients presenting to the Emergency Department (ED) following an anterior abdominal stab wound (AASW) has been debated since the 1960s. Experts agree that patients with peritonitis, evisceration, or hemodynamic instability should undergo immediate laparotomy (LAP), however, workup of stable, asymptomatic or non-peritoneal, patients is not clearly defined.

    Objectives: To evaluate the accuracy of computed tomography of abdomen and pelvis (CTAP) for diagnosis of intra-abdominal injuries requiring Therapeutic Laparotomy (THER-LAP) in ED patients with AASW. Read More

    Scapular fractures in the Pan-scan Era.
    Acad Emerg Med 2018 Jan 11. Epub 2018 Jan 11.
    Department of Emergency Medicine, The University of California San Francisco.
    Background: Scapular fractures have been traditionally taught to be associated with significant injuries and major morbidity. As we demonstrated with sternal fracture, pulmonary contusion and rib fracture, increased chest CT utilization and head-to-pelvis CT (pan-scan) protocols in blunt trauma evaluation, however, may diagnose minor, clinically irrelevant scapular fractures, possibly rendering previous teachings obsolete.

    Objectives: To determine the 1) percentages of scapular fractures seen on chest CT only (SOCTO) versus seen on both CXR and CT and of isolated scapular fracture (scapular fracture without other thoracic injuries), 2) frequencies of associated thoracic injury with scapular fracture, and 3) proportion of patients admitted, mortality, hospital length of stay, and injury severity scores (ISS), comparing four patient groups: scapular fracture, non-scapular fracture, scapular fracture SOCTO, and isolated scapular fracture. Read More

    Effectiveness of Interventions to Decrease Image Ordering for Low Back Pain Presentations in the Emergency Department: A Systematic Review.
    Acad Emerg Med 2018 Jan 8. Epub 2018 Jan 8.
    Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada.
    Background: Low back pain (LBP) is an extremely frequent reason for patients to present to an emergency department (ED). Despite evidence against the utility of imaging, simple and advanced imaging (i.e. Read More

    Development of a Patient Decision Aid for Syncope in the Emergency Department: the SynDA Tool.
    Acad Emerg Med 2017 Dec 30. Epub 2017 Dec 30.
    Department of Emergency Medicine, Mount Sinai Medical Center, New York, NY.
    Objectives: The objective was to develop a patient decision aid (DA) to promote shared decision making (SDM) for stable, alert patients who present to the emergency department (ED) with syncope.

    Methods: Using input from patients, clinicians, and experts in the field of syncope, health care design, and SDM, we created a prototype of a paper-based DA to engage patients in the disposition decision (admission vs. discharge) after an unremarkable ED evaluation for syncope. Read More

    Sex Differences in Diagnoses, Treatment, and Outcomes for Emergency Department Patients With Chest Pain and Elevated Cardiac Troponin.
    Acad Emerg Med 2017 Dec 23. Epub 2017 Dec 23.
    Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
    Objective: While sex differences in the treatment and outcomes of subjects with acute coronary syndromes are well documented, little is known about the impact of cardiac troponin (cTn) levels obtained in the emergency department (ED) on the observed sex differences. We sought to determine whether cTn levels by chest pain features modify sex differences in diagnosis, treatment, and outcomes in patients presenting with chest pain suggestive of ischemia.

    Methods: All adults presenting to two hospitals in Vancouver, Canada, between May 2008 and March 2013 with ischemic chest pain and with cTn testing were included in the study. Read More

    Protocolized Laboratory Screening for the Medical Clearance of Psychiatric Patients in the Emergency Department: A Systematic Review.
    Acad Emerg Med 2017 Dec 20. Epub 2017 Dec 20.
    Department of Emergency Medicine, Kings County Hospital Center, Brooklyn, NY.
    Objective: Emergency department (ED) patients with psychiatric chief complaints undergo medical screening to rule out underlying or comorbid medical illnesses prior to transfer to a psychiatric facility. This systematic review attempts to determine the clinical utility of protocolized laboratory screening for the streamlined medical clearance of ED psychiatric patients by determining the clinical significance of individual laboratory results.

    Methods: We searched PubMed, Embase, and Scopus using the search terms "emergency department, psychiatry, diagnostic tests, laboratories, studies, testing, screening, and clearance" up to June 2017 for studies on adult psychiatric patients. Read More

    Opening of Psychiatric Observation Unit Eases Boarding Crisis.
    Acad Emerg Med 2017 Dec 20. Epub 2017 Dec 20.
    Department of Emergency Medicine, New Haven, CT.
    Objectives: The objective of this study was to evaluate the effect of a psychiatric observation unit in reducing emergency department (ED) boarding and length of stay (LOS) for patients presenting with primary psychiatric chief complaints. A secondary outcome was to determine the effect of a psychiatric observation unit on inpatient psychiatric bed utilization.

    Methods: This study was a before-and-after analysis conducted in a 1,541-bed tertiary care academic medical center including an adult ED with annual census over 90,000 between February 2013 and July 2014. Read More

    Material Needs of Emergency Department Patients: A Systematic Review.
    Acad Emerg Med 2018 Mar 5;25(3):330-359. Epub 2018 Feb 5.
    Ronald O. Perelman Department of Emergency Medicine, NYU School of Medicine, New York, NY.
    Background: Interest in social determinants of health (SDOH) has expanded in recent years, driven by a recognition that such factors may influence health outcomes, services use, and health care costs. One subset of SDOH is material needs such as housing and food. We conducted a systematic review of the literature on material needs among emergency department (ED) patients in the United States. Read More

    Key High-efficiency Practices of Emergency Department Providers: A Mixed-methods Study.
    Acad Emerg Med 2017 Dec 18. Epub 2017 Dec 18.
    Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA.
    Objective: The objective of this study was to determine specific provider practices associated with high provider efficiency in community emergency departments (EDs).

    Methods: A mixed-methods study design was utilized to identify key behaviors associated with efficiency. Stage 1 was a convenience sample of 16 participants (ED medical directors, nurses, advanced practice providers, and physicians) identified provider efficiency behaviors during semistructured interviews. Read More

    Effectiveness of Implementing Evidence-based Interventions to Reduce C-spine Image Ordering in the Emergency Department: A Systematic Review.
    Acad Emerg Med 2017 Dec 19. Epub 2017 Dec 19.
    Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada.
    Objectives: Appropriate use of imaging for adult patients with cervical spine (C-spine) injuries in the emergency department (ED) is a longstanding issue. Guidance for C-spine ordering exists; however, the effectiveness of the decision support implementation in the ED is not well studied. This systematic review examines the implementation and effectiveness of evidence-based interventions aimed at reducing C-spine imaging in adults presenting to the ED with neck trauma. Read More

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