5,474 results match your criteria Academic Emergency Medicine[Journal]


D-dimer in Adolescent Pulmonary Embolism.

Acad Emerg Med 2018 Jul 16. Epub 2018 Jul 16.

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, 9980 Euclid Avenue, Cleveland, Ohio, 44195.

Background: D-dimer is used to aid in diagnosing adult pulmonary embolism (PE). D-dimer has not been validated in adolescents. Clinicians must balance the risk of over-testing with that of a missed PE. Read More

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Reliability of HEARTSMAP as a tool for evaluating psychosocial assessment documentation practices in emergency departments for pediatric mental health complaints: A methodological issue.

Acad Emerg Med 2018 Jul 16. Epub 2018 Jul 16.

Clinical Research Development Center, Taleghani and Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

We were interested to read the paper by Gill C and colleagues published in the Jun 2018 issue of Acad Emerg Med. the authors aimed to determine the reliability of HEARTSMAP as a standardized tool for evaluating the quality of psychosocial assessment documentation of pediatric mental health presentations to the emergency department. the inter-rater agreement among reviewers was assessed by using Cohen Kappa statistic. Read More

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Response to:Reliability of HEARTSMAP as a tool for evaluating psychosocial assessment documentation practices in emergency departments for pediatric mental health complaints: a methodological issue.

Acad Emerg Med 2018 Jul 16. Epub 2018 Jul 16.

Division of Emergency Medicine, Department of Pediatrics, BC Children's, Hospital, Vancouver, British Columbia, Canada.

We thank the authors for their interest in our work and highlighting the limitations of the kappa value. Cohen's kappa statistic is calculated as a ratio of observed and expected (chance) agreement, and we concur that this value is dependent on the number of categories and prevalence in each. Indeed, prevalence approaching 0 or 100% results in high chance agreement, which typically reduces or handicaps the kappa value as the authors correctly identified in the example provided. Read More

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Hot Off the Press: A novel algorithm to decrease unnecessary hospitalizations in patients with atrial fibrillation.

Acad Emerg Med 2018 Jul 12. Epub 2018 Jul 12.

University of Western Ontario, Goderich, Ontario, Canada.

This is a retrospective cohort study with a before and after design, comparing the admission rate for patients with AFib during a one-year period before the initiation of a new management algorithm to a one-year period after the algorithm was introduced. Physicians were first instructed to determine whether the AFib was secondary to another important diagnosis, such as sepsis or pulmonary embolism. (These patients were admitted to hospital). Read More

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Development and Validation of a Measure to Assess Patients' Threat Perceptions in the Emergency Department.

Acad Emerg Med 2018 Jul 4. Epub 2018 Jul 4.

Department of Emergency Medicine, Columbia University Medical Center, New York, NY.

Objective: Threat perceptions in the Emergency Department (ED) (e.g., patients' subjective feelings of helplessness or lack of control) during evaluation for an acute coronary syndrome (ACS) are associated with the development of posttraumatic stress disorder (PTSD), and PTSD has been associated with medication nonadherence, cardiac event recurrence, and mortality. Read More

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Multiple Pediatric Head Injury Decision Rules but What Should the Clinician Use?

Acad Emerg Med 2018 Jul 3. Epub 2018 Jul 3.

Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, CA, United States.

Traumatic brain injury (TBI) is the leading cause of traumatic death in children. As many children with TBIs have subtle symptoms and missed or delayed diagnoses may result in increased morbidity, emergency department clinicians must frequently determine which children require emergent cranial computed tomographic (CT) scanning even after apparently minor blunt head trauma. Overuse of CT scans, however, has important drawbacks, including radiation-induced malignancies. Read More

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Building A Longitudinal Cohort From 9-1-1 to 1-Year Using Existing Data Sources, Probabilistic Linkage, and Multiple Imputation: A Validation Study.

Acad Emerg Med 2018 Jul 3. Epub 2018 Jul 3.

Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon.

Objective: To describe and validate construction of a population-based, longitudinal cohort of injured older adults from 911 call to 1-year follow-up using existing data sources, probabilistic linkage, and multiple imputation.

Methods: This was a descriptive cohort study conducted in seven counties in Oregon and Washington from January 1, 2011 through December 31, 2011, with follow-up through December 31, 2012. The primary cohort included all injured adults ≥ 65 years served by 44 EMS agencies. Read More

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Clinical predictors of acute brain injury in carbon monoxide poisoning patients with altered mental status at admission to emergency department.

Acad Emerg Med 2018 Jun 28. Epub 2018 Jun 28.

Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Objectives: Objective screening tool for patients at a high risk of developing acute brain injury (ABI) is necessary for the proper treatment of carbon monoxide (CO) poisoning patients. The aim of this study is to identify clinical factors that could predict ABI due to CO poisoning in patients with an altered mental status.

Methods: A prospectively collected CO poisoning registry at a single academic medical center was retrospectively analyzed. Read More

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June 2018
2 Reads

Providers' perceptions of caring for pediatric patients in community hospital emergency departments: a mixed methods analysis.

Acad Emerg Med 2018 Jun 27. Epub 2018 Jun 27.

Yale University School of Medicine, Department of Pediatrics (Section of Emergency Medicine), and Department of Emergency Medicine.

Background: Approximately 90% of pediatric emergency care is provided in community emergency departments (CEDs) that care for both adults and children. Paradoxically, the majority of pediatric emergency medicine knowledge generation, quality improvement work and clinical training occurs in children's hospitals. There is a paucity of information of perceptions on pediatric care from CED providers. Read More

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Safety of the combination of PERC and YEARS rules in patients with low clinical probability of PE: a retrospective analysis of two large European cohorts.

Acad Emerg Med 2018 Jun 27. Epub 2018 Jun 27.

Emergency Department, Hôpital Pitié-Salpêtrière, APHP, Paris, France.

Background: This study aimed to determine the failure rate of a combination of the PERC and the YEARS rules for the diagnosis of pulmonary embolism (PE) in the emergency department (ED).

Methods: We performed a retrospective analysis of two European cohorts of emergency patients with low gestalt clinical probability of PE (PROPER and PERCEPIC). All patients we included were managed using a conventional strategy (D-dimer test, followed, if positive, by computed tomographic pulmonary angiogram CTPA). Read More

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The Impact of Maryland's Global Budget Payment Reform on Emergency Department Admission Rates in a Single Health System.

Acad Emerg Med 2018 Jun 22. Epub 2018 Jun 22.

Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC.

Background: In 2014, the state of Maryland moved away from fee-for-service payments and into a global budget revenue (GBR) structure where hospitals have a fixed revenue target, independent of patient volume or services provided. We assess the effects of GBR adoption on emergency department (ED) admission decisions among adult encounters.

Methods: We used hospital medical record and billing data from adult ED encounters from January 1, 2011 through December 31, 2015, with four Maryland (MD) hospitals and two District of Columbia (DC) hospitals within the same health system. Read More

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Reliability of HEARTSMAP as a tool for evaluating psychosocial assessment documentation practices in emergency departments for pediatric mental health complaints.

Acad Emerg Med 2018 Jun 20. Epub 2018 Jun 20.

Division of Emergency Medicine, Department of Pediatrics, BC Children's, Hospital, Vancouver, British Columbia, Canada.

Objectives: The goal of this study was to assess the reliability of HEARTSMAP as a standardized tool for evaluating the quality of psychosocial assessment documentation of pediatric mental health presentations to the emergency department. In addition, we report on current documentation practices.

Methods: We conducted a retrospective cross-sectional study of pediatric (up to age 17) mental health-related visits to four emergency departments between April 1, 2013 and March 31, 2014. Read More

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Interruptions in emergency medicine: things are not always what they seem.

Authors:
Scott R Walter

Acad Emerg Med 2018 Jun 20. Epub 2018 Jun 20.

Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University.

We have all felt the cognitive disjuncture of being interrupted during an important task. Most ED physicians will readily proffer the high frequency and/or burden of interruptions during their work, and of the many observational studies of interruptions in healthcare EDs do indeed have high interruption rates[2]. In experimental psychology, where many of these ideas originated, there is plenty of evidence that interruptions negatively affect performance. Read More

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The HEART Pathway Randomized Controlled Trial One Year Outcomes.

Acad Emerg Med 2018 Jun 19. Epub 2018 Jun 19.

Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, NC.

Objective: To determine the impact of the HEART Pathway on healthcare utilization and safety outomes at 1 year in patients with acute chest pain.

Methods: Adult Emergency Department (ED) patients with chest pain (N=282) were randomized to the HEART Pathway or usual care. In the HEART Pathway arm, ED providers used the HEART score and troponin measures (0 and 3-hours) to risk stratify patients. Read More

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Factors Associated with Patient Involvement in Emergency Care Decisions: A Secondary Analysis of the Chest Pain Choice Multicenter Randomized Trial.

Acad Emerg Med 2018 Jun 15. Epub 2018 Jun 15.

Department of Emergency Medicine, Rochester, MN.

Background: Shared decision-making in the Emergency Department (ED) can increase patient engagement for patients presenting with chest pain. However, little is known regarding which factors are associated with actual patient involvement in decision-making or patients' desired involvement in emergency care decisions. We examined which factors were associated with patients' actual and desired involvement in decision-making among ED chest pain patients. Read More

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Dissecting the Evidence on Aortic Catastrophe.

Acad Emerg Med 2018 Jun 14. Epub 2018 Jun 14.

Wayne State University School of Medicine, Department of Emergency Medicine; Detroit Medical Center/Sinai-Grace Hospital.

Acute aortic dissection presents a diagnostic challenge for Emergency Physicians. Use of recently published "high-risk" features to identify patients as truly high-risk may lead to over-testing. This article is protected by copyright. Read More

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June 2018
1 Read

Diagnosing acute aortic dissection : Both an artery and a science.

Authors:
Robert Ohle

Acad Emerg Med 2018 Jun 14. Epub 2018 Jun 14.

The Department of Emergency Medicine, Health Science North Research Institute, Northern Ontario School of Medicine, Sudbury, Ontario, Canada.

Thank you very much for your interest in our paper. We agree that retrospective nature of this study in isolation does not provide proof of a hypothesis. However taken in context of the evidence as quoted in the paper and the new prospective trial by Nazerian et al, we believe it adds to the conversation that classically reported high risk features do in fact change the likelihood of acute aortic dissection. Read More

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Patient Preferences regarding Shared Decision-making in the Emergency Department: Findings from a multi-site survey.

Acad Emerg Med 2018 Jun 13. Epub 2018 Jun 13.

Department of Emergency Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY.

Objectives: As Shared Decision-Making (SDM) has received increased attention as a method to improve the patient-centeredness of emergency department (ED) care, we sought to determine patients' desired level of involvement in medical decisions and their perceptions of potential barriers and facilitators to SDM in the ED.

Methods: We surveyed a cross-sectional sample of adult ED patients at three academic medical centers across the United States. The survey included 32 items regarding patient involvement in medical decisions including a modified Control Preference Scale (CPS) and questions about barriers and facilitators to SDM in the ED. Read More

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First Timers.

Authors:
Rob McMickle

Acad Emerg Med 2018 Jun 12. Epub 2018 Jun 12.

David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, California, United States.

I never had the chance to introduce myself to Ms. Jones. She was without a pulse the night she was wheeled into our emergency room by EMS personnel after arresting during dinner with her family. Read More

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Understanding Emergency Medicine Physicians Multitasking Behaviors Around Interruptions.

Acad Emerg Med 2018 Jun 11. Epub 2018 Jun 11.

MedStar Institute for Innovation, National Center for Human Factors in Healthcare, 3007 Tilden St. NW, Suite 7L, Washington, D.C, 20008, USA.

Background: Interruptions can adversely impact human performance, particularly in fast-paced and high-risk environments such as the emergency department (ED). Understanding physician behaviors before, during, and after interruptions is important to the design and promotion of safe and effective workflow solutions. However, traditional human factors based interruption models do not accurately reflect the complexities of real-world environments like the ED and may not capture multiple interruptions and multitasking. Read More

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June 2018
3 Reads

Pediatric Emergency Research Canada (PERC): Patient/Family-Informed Research Priorities for Pediatric Emergency Medicine.

Acad Emerg Med 2018 Jun 6. Epub 2018 Jun 6.

Department of Pediatrics, Emergency Medicine and Community Health Sciences, University of Calgary, Alberta Children's Hospital and Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.

Background: A growing body of literature supports patient and public involvement in the design, prioritization and dissemination of research and evidence based medicine. The objectives of this project were to engage patients and families in developing a prioritized list of research topics for Pediatric Emergency Medicine (PEM) and to compare results with prior research prioritization initiatives in the ED (emergency department) setting.

Methods: We utilized a systematic process to combine administrative data on frequency of patient presentations to the ED with multiple stakeholder input including an initial stakeholder survey followed by a modified Delphi consensus methodology consisting of two web-based surveys and a face-to-face meeting. Read More

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Characteristics of Children and Adolescents Diagnosed with HIV By Targeted and Diagnostic Testing in a Children's Hospital Network.

Acad Emerg Med 2018 Jun 5. Epub 2018 Jun 5.

Department of Pediatrics, Division of Emergency Medicine, Emory University School of Medicine, Atlanta, GA.

Across the United States (US), rates of new human immunodeficiency virus (HIV) diagnosis have declined . Despite this, adolescents have experienced increases in HIV diagnosis rates . It is estimated that half of adolescents are unaware of their diagnosis and that, on average, they are infected with HIV for nearly 3 years prior to diagnosis . Read More

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Predictors of Oral Antibiotic Treatment Failure for Nonpurulent Skin and Soft Tissue Infections in the Emergency Department.

Acad Emerg Med 2018 Jun 5. Epub 2018 Jun 5.

Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada.

Background: Current guideline recommendations for optimal management of nonpurulent skin and soft tissue infections (SSTIs) are based on expert consensus. There is a lack of evidence to guide emergency physicians regarding selection of patients for oral versus intravenous antibiotic therapy. The primary objective was to identify predictors associated with oral antibiotic treatment failure. Read More

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Caught in a Double Bind: A Woman's Job Search Experience.

Authors:
Katelyn Moretti

Acad Emerg Med 2018 Jun 2. Epub 2018 Jun 2.

Brown University, 55 Claverick St. 2nd Floor, Providence, RI, 02903.

I consider myself an empowered woman. Growing up I was told there is nothing I should not do because of my gender. I entered a male dominated field in medicine and graduated from a predominantly male residency. Read More

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Hot Off the Press: SGEM #218. Excited Delirium: A Systematic Review.

Acad Emerg Med 2018 Jun 1. Epub 2018 Jun 1.

Department of Emergency Medicine, University of Western Ontario, London, Ontario, Canada.

This systematic review provides an assessment of the excited delirium syndrome (ExDS), including definition, epidemiology, pathophysiology, and management. Sixty-six relevant articles were included with significant heterogeneity of selected studies and poor overall quality. A quantitative meta-analysis could not be performed because there remains no clear definition for ExDS, however, this study does provide useful information regarding epidemiology, pathophysiology, and treatment of ExDS. Read More

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June 2018
1 Read

Caught in a Double Bind: A Woman's Job Search Experience by Katelyn Moretti.

Authors:
Brian J Zink

Acad Emerg Med 2018 Jun 2. Epub 2018 Jun 2.

Department of Emergency Medicine, University of Michigan, 1500 E. Medical Center Drive, TC B1 354 Ann Arbor, MI48109.

Life sometimes creates interesting confluences, and these should not be ignored. I was the Chair who sat on the other side of the desk during the job interview of the author of this remarkable essay. I hired her, and her husband. Read More

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Use of a National Database to Assess Pediatric Emergency Care Across United States Emergency Departments.

Acad Emerg Med 2018 Jun 2. Epub 2018 Jun 2.

Division of Emergency Medicine, Boston Children's Hospital, Boston, MA.

Objectives: Differences in emergency care for children exist between general and pediatric emergency departments (EDs). Some pediatric quality measures are available but are not routinely employed nationwide. We sought to create a short list of applied measures that would provide a starting point for EDs to measure pediatric emergency care quality and to compare care between general and pediatric EDs for these measures. Read More

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Implementation and Preliminary Results of an Emergency Department Nontargeted, Opt-Out Hepatitis C Virus Screening Program.

Acad Emerg Med 2018 May 31. Epub 2018 May 31.

Internal Medicine/Section of Infectious Diseases, and Pediatrics, Boston, MA, USA.

Background: Emergency Department (ED) visits provide an opportunity for hepatitis C virus (HCV) screening for patients who otherwise might be tested. We report on a novel nontargeted, opt-out HCV screening and linkage-to-care program implemented in an urban ED.

Methods: This is a descriptive analysis from 3 months (November 2016-January 2017) of a nontargeted, opt-out ED HCV screening and linkage-to-care program among patients at least 13 years old undergoing phlebotomy for clinical purposes. Read More

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May 2018
3 Reads

Measuring Emergency Care Survival: The Implications of Risk-Adjusting for Race and Poverty.

Acad Emerg Med 2018 May 31. Epub 2018 May 31.

Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.

Objectives: We determined the impact of including race, ethnicity, and poverty in risk adjustment models for emergency care sensitive conditions mortality that could be used for hospital pay-for-performance initiatives. We hypothesized that adjusting for race, ethnicity, and poverty would bolster rankings for hospitals that cared for a disproportionate share of non-white, Hispanic, or poor patients.

Methods: We performed a cross-sectional analysis patients admitted from the emergency department to 157 hospitals in Pennsylvania with trauma, sepsis, stroke, cardiac arrest, and ST-elevation myocardial infarction. Read More

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Parenteral Antipsychotic Choice and Its Association With Emergency Department Length of Stay for Acute Agitation Secondary to Alcohol Intoxication.

Acad Emerg Med 2018 May 31. Epub 2018 May 31.

Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN.

Background: Acute agitation secondary to alcohol intoxication frequently requires parenteral sedatives for patient and caregiver safety. Antipsychotics play a prominent role; however, no consensus exists regarding the ideal agent. One important consideration when evaluating the choice of antipsychotic is its association with emergency department (ED) length of stay (LOS). Read More

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May 2018
2 Reads

Implementation of an Opioid Detoxification Management Pathway Reduces Emergency Department Length of Stay.

Acad Emerg Med 2018 May 25. Epub 2018 May 25.

Vanderbilt University Medical Center, Nashville, TN.

Objectives: With the rise of opioid use in the United States, the increasing demand for treatment for opioid use disorders presents both a challenge and an opportunity to develop new care pathways for emergency department (ED) patients seeking opioid detoxification. We set out to improve the care of patients presenting to our ED seeking opioid detoxification by implementing a standardized management pathway and to measure the effects of this intervention.

Methods: We conducted a before-after study of the effects of an opioid detoxification management pathway on ED length of stay (EDLOS), use of resources (social worker consultation, laboratory tests obtained), and return visits to the same ED within 30 days of discharge. Read More

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May 2018
2 Reads

Global Emergency Medicine: A review of the literature from 2017.

Acad Emerg Med 2018 May 23. Epub 2018 May 23.

Department of Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, RI.

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, 17,722 articles written in three languages were identified by our electronic search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM. Read More

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Hot Off the Press: SGEM #215 Aortic Dissection-Love Will Tear Us Apart.

Acad Emerg Med 2018 May 21. Epub 2018 May 21.

University of Western Ontario, Goderich, Ontario, Canada.

This systematic review provides an assessment of the diagnostic accuracy of various historical, physical, and clinical examination features for aortic dissection. Nine articles were included, with moderate to high heterogeneity. Limitations to general practice include risk of selection bias and partial verification bias. Read More

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Test Characteristics of Point of Care Ultrasound for the Diagnosis of Retinal Detachment in the Emergency Department.

Acad Emerg Med 2018 May 18. Epub 2018 May 18.

Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada.

Previous studies of point of care ultrasound (POCUS) have reported high sensitivities and specificities for retinal detachment (RD). Our primary objective was to assess the test characteristics of POCUS performed by a large heterogeneous group of emergency physicians (EPs) for the diagnosis of RD.

Methods: This was a prospective diagnostic test assessment of POCUS performed by EPs with varying ultrasound experience on a convenience sample of emergency department (ED) patients presenting with flashes or floaters in one or both eyes. Read More

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Pain One Week After an Emergency Department Visit for Acute Low Back Pain Is Associated With Poor Three-month Outcomes.

Acad Emerg Med 2018 May 16. Epub 2018 May 16.

Department of Emergency Medicine and Medical College, Albert Einstein College of Medicine, Montefiore Health, Bronx, NY.

Background: Low back pain (LBP) is responsible for more than 2.5 million visits to U.S. Read More

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May 2018
1 Read

Financial Viability of Emergency Department Observation Unit Billing Models.

Acad Emerg Med 2018 May 16. Epub 2018 May 16.

Department of Emergency Medicine, Emory University, Atlanta, GA.

Background: Outpatients receive observation services to determine the need for inpatient admission. These services are usually provided without the use of condition-specific protocols and in an unstructured manner, scattered throughout a hospital in areas typically designated for inpatient care. Emergency department observation units (EDOUs) use protocolized care to offer an efficient alternative with shorter lengths of stay, lower costs, and higher patient satisfaction. Read More

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Emergency Department Discharge of Pulmonary Embolus Patients.

Acad Emerg Med 2018 May 14. Epub 2018 May 14.

Stony Brook School of Medicine, Stony Brook, NY.

Background: Hospitalization for low-risk pulmonary embolism (PE) is common, expensive, and of questionable benefit.

Objective: The objective was to determine if low-risk PE patients discharged from the emergency department (ED) on rivaroxaban require fewer hospital days compared to standard of care (SOC).

Methods: Multicenter, open-label randomized trial in low-risk PE defined by Hestia criteria. Read More

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Integrating Point-of-care Testing Into a Community Emergency Department: A Mixed-methods Evaluation.

Acad Emerg Med 2018 May 13. Epub 2018 May 13.

Department of Emergency Medicine, Northwell Health, Manhasset, NY.

Objective: Point-of-care testing (POCT) is a commonly used technology that hastens the time to laboratory results in emergency departments (ED). We evaluated an ED-based POCT program on ED length of stay (LOS) and time to care, coupled with qualitative interviews of local ED stakeholders.

Methods: We conducted a mixed-methods study (2012-2016) to examine the impact of POCT in a single, community ED. Read More

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Welcome to SAEM18!

Authors:

Acad Emerg Med 2018 May;25 Suppl 1:S5-S7

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2018 Annual Meeting Supplement.

Authors:

Acad Emerg Med 2018 May;25 Suppl 1:S8-S298

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Understanding Pediatric Caretakers' Views on Obtaining Medical Care for Low-acuity Illness.

Acad Emerg Med 2018 May 9. Epub 2018 May 9.

Department of Pediatrics, Perelman School of Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA.

Background: A significant proportion of low-acuity emergency department (ED) visits are by patients under 18 years of age. Results from prior interventions designed to reduce low-acuity pediatric ED use have been mixed or poorly sustained, perhaps because they were not informed by patient and caretakers' perspectives. The objective of this study was to explore caretaker decision-making processes, values, and priorities when deciding to seek care. Read More

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Commentary: 2018 Stroke Guidelines.

Authors:
Andrew D Perron

Acad Emerg Med 2018 May 8. Epub 2018 May 8.

Maine Medical Center, Portland, ME.

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In Reply.

Acad Emerg Med 2018 May 8. Epub 2018 May 8.

Department of Emergency Medicine, Brigham & Women's Hospital, Boston, MA.

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Causes of Shortness of Breath in the Acute Patient: A National Study.

Acad Emerg Med 2018 May 8. Epub 2018 May 8.

Department of Emergency Medicine and Philip R. Lee Institute for Health Policy Studies, University of California at San Francisco, San Francisco, CA.

Background: Dyspnea is a common and ambiguous complaint that results in 3.4 million emergency department (ED) visits annually. While learners may encounter lists of differential diagnoses to consider while in training, often these lists are not empirically based. Read More

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Bedside Sonography Performed by Emergency Physicians to Detect Appendicitis in Children.

Acad Emerg Med 2018 May 8. Epub 2018 May 8.

Emergency Department, CHU Ste-Justine, Montréal, Québec, Canada.

Objective: The aim of this study was to evaluate the ability of emergency physicians with various levels of point-of-care ultrasound (POCUS) experience to detect appendicitis with POCUS among children visiting a pediatric emergency department (ED).

Methods: A prospective cohort study was conducted in an urban, tertiary care pediatric ED. Children aged 2 to 18 years old who presented with acute abdominal pain suggesting appendicitis were included. Read More

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May 2018
1 Read

Validation of the Brief Confusion Assessment Method for Screening Delirium in Elderly Medical Patients in a German Emergency Department.

Acad Emerg Med 2018 May 8. Epub 2018 May 8.

Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Background: Delirium is frequent in elderly patients presenting in the emergency department (ED). Despite the severe prognosis, the majority of delirium cases remain undetected by emergency physicians (EPs). At the time of our study there was no valid delirium screening tool available for EDs in German-speaking regions. Read More

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May 2018
1 Read

Improving an Outpatient Pathway for the Emergency Management of Atrial Fibrillation and Flutter.

Acad Emerg Med 2018 May 8. Epub 2018 May 8.

Department of Internal Medicine, University of Nevada, Reno, NV.

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Immune-related Adverse Events in Cancer Patients.

Acad Emerg Med 2018 May 5. Epub 2018 May 5.

Clinical Research Division, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA.

The U.S. Food and Drug Administration has approved immune checkpoint inhibitors and chimeric antigen receptor T cells (CAR-T cells) as immunotherapy strategies for cancer. Read More

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May 2018
1 Read

Automated Pulmonary Embolism Risk Classification and Guideline Adherence for Computed Tomography Pulmonary Angiography Ordering.

Acad Emerg Med 2018 Apr 30. Epub 2018 Apr 30.

Ronald O. Perelman Department of Emergency Medicine, NYU School of Medicine, New York, NY.

Background: The assessment of clinical guideline adherence for the evaluation of pulmonary embolism (PE) via computed tomography pulmonary angiography (CTPA) currently requires either labor-intensive, retrospective chart review or prospective collection of PE risk scores at the time of CTPA order. The recording of clinical data in a structured manner in the electronic health record (EHR) may make it possible to automate the calculation of a patient's PE risk classification and determine whether the CTPA order was guideline concordant.

Objectives: The objective of this study was to measure the performance of automated, structured data-only versions of the Wells and revised Geneva risk scores in emergency department (ED) encounters during which a CTPA was ordered. Read More

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Complex Febrile Seizures, Lumbar Puncture, and Central Nervous System Infections: A National Perspective.

Acad Emerg Med 2018 Apr 27. Epub 2018 Apr 27.

Department of Emergency Medicine and Cardiovascular Research Institute, Integrated Biosciences Center, Wayne State University School of Medicine, Detroit, MI.

Objectives: The objective was to determine the national lumbar puncture (LP) practice patterns relative to the incidence of central nervous system (CNS) infections among children presenting to the emergency department (ED) with complex febrile seizures (CFS).

Methods: This was a retrospective study of ED visits for CFS from 2007 to 2014 in patients aged 0 to 5 years using a national sample. Primary outcomes include the frequency of LP, incidence of CNS infections, and ED disposition. Read More

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April 2018
11 Reads