journal
https://read.qxmd.com/read/37735346/anti-craving-medications-for-alcohol-use-disorder-treatment-in-the-emergency-department-a-systematic-review-of-direct-evidence-for-seam-grace
#1
REVIEW
Kiran Punia, William Scott, Kriti Manuja, Monica Sabbineni, Kaitryn Campbell, Iris M Balodis, James MacKillop
OBJECTIVES: Alcohol-related concerns commonly present to the emergency department (ED), with a subset of individuals experiencing the symptoms of an alcohol use disorder (AUD). As such, examining the efficacy of pharmacological anti-craving treatment for AUD in the ED is of increasing interest. The objective of this systematic review was to evaluate the direct evidence assessing the efficacy of providing anti-craving medications for AUD treatment in the ED. METHODS: A systematic search was conducted according to the patient-intervention-control-outcome (PICO) question: (P) adults (≥18 years old) presenting to the ED with an AUD (including suspected AUD); (I) anti-craving medications (i...
September 21, 2023: Academic Emergency Medicine
https://read.qxmd.com/read/37731093/a-comparison-of-the-effect-of-patient-specific-vs-weight-based-protocols-to-treat-vaso-occlusive-episodes-voe-in-the-emergency-department
#2
JOURNAL ARTICLE
Paula Tanabe, Stephanie Ibemere, Ava E Pierce, Caroline E Freiermuth, Hayden B Bosworth, Hongqui Yang, Ifeyinwa Osunkwo, James H Paxton, John J Strouse, Joseph Miller, Judith A Paice, Padmaja Veeramreddy, Patricia L Kavanagh, R Gentry Wilkerson, Robert Hughes, Huiman X Barnhart
BACKGROUND: Vaso-occlusive episodes (VOC) cause debilitating pain and are a common cause of emergency department (ED) visits, for people with sickle cell disease (SCD). Strategies for achieving optimal pain control vary widely despite evidence-based guidelines. We tested existing guidelines and hypothesized a patient-specific protocol (PSP) written by their SCD provider, may be more effective than weight-based (WB) dosing of parenteral opiate medication, in relieving pain. METHODS: Prospective, randomized controlled trial comparing a PSP versus WB protocol for patients presenting with VOC to six EDs...
September 20, 2023: Academic Emergency Medicine
https://read.qxmd.com/read/37715734/irregular
#3
JOURNAL ARTICLE
Ian Gleaner
No abstract text is available yet for this article.
September 16, 2023: Academic Emergency Medicine
https://read.qxmd.com/read/37688572/oral-analgesic-for-musculoskeletal-injuries-in-children-a-systematic-review-and-network-meta-analysis
#4
REVIEW
Shu Utsumi, Shunsuke Amagas, Taro Moriwaki, Satoko Uematsu
OBJECTIVE: Pain in pediatric musculoskeletal injuries can lead to increased anxiety, fear, and avoidance of medical care, making analgesic management critical. Therefore, we evaluated analgesic efficacy and adverse effects to select the optimal analgesic agent in pediatric patients with musculoskeletal injuries. METHODS: Four databases were searched from inception to March 2023 for peer-reviewed, open randomized controlled trials (RCTs). Inclusion criteria were: 1) trials with RCT design, 2) children aged 1 month-18 years with musculoskeletal injury, 3) outpatient setting, 4) interventions and control, 5) primary outcome: pain score at 60 and 120 min; secondary outcome: adverse effects, and 6) full-text and peer-reviewed articles...
September 9, 2023: Academic Emergency Medicine
https://read.qxmd.com/read/37684050/the-emergency-department-a-key-pillar-in-the-cancer-care-continuum
#5
JOURNAL ARTICLE
Nicholas R Pettit, Jason J Bischof
No abstract text is available yet for this article.
September 8, 2023: Academic Emergency Medicine
https://read.qxmd.com/read/37682564/characterizing-malpractice-cases-involving-emergency-department-advanced-practice-providers-physicians-in-training-and-attending-physicians
#6
JOURNAL ARTICLE
Peter S Antkowiak, Shin-Yi Lai, Ryan C Burke, Margaret Janes, Tarek Zawi, Nathan I Shapiro, Carlo L Rosen
OBJECTIVE: To evaluate available characteristics and financial costs of malpractice cases among Advanced Practice Providers (Nurse Practitioners and Physician Assistants), trainees (medical students, residents, fellows) and attending physicians. METHODS: A retrospective analysis of claims occurring in the emergency department from January 1, 2010 to December 31, 2019 contained in the Candello database. Cases were classified according to the provider type(s) involved: Nurse Practitioner (NP), Physician Assistant (PA), trainee, or cases which did not identify an extender as being substantially involved in the adverse event that resulted in the case ("no extender")...
September 8, 2023: Academic Emergency Medicine
https://read.qxmd.com/read/37656896/routine
#7
JOURNAL ARTICLE
Jonathan Warren
Written a year and a half into the pandemic during a particularly difficult week, this poem explores the moral injury and emotional distress that emergency physicians encounter and must process daily. These repeated microtraumas throughout our day frequently contribute to depersonalization and it is important to recognize those factors that "break the routine" and help to improve physician well-being.
September 1, 2023: Academic Emergency Medicine
https://read.qxmd.com/read/37641846/the-significance-of-historical-troponin-elevation-in-acute-heart-failure-not-as-reassuring-as-previously-assumed
#8
JOURNAL ARTICLE
Nicholas E Harrison, Robert Ehrman, Peter Pang, Sarah Armitage, Aiden Abidov, Daniel Perkins, Johnathon Peacock, Nicholas Montelauro, Sushane Gupta, Mark J Favot, Phillip Levy
BACKGROUND: Historical cardiac troponin (cTn) elevation is commonly interpreted as lessening the significance of current cTn elevations at presentation for acute heart failure (AHF). Evidence for this practice is lacking. Our objective was to determine the incremental prognostic significance of historical cTn elevation compared to cTn elevation and ischemic heart disease (IHD) history at presentation for AHF. METHODS: 341 AHF patients were prospectively enrolled at 5 sites...
August 29, 2023: Academic Emergency Medicine
https://read.qxmd.com/read/37641573/a-qualitative-analysis-of-patients-experiences-with-an-ed-diagnosis-of-gi-cancer
#9
JOURNAL ARTICLE
Alexandra Adams, Sara Heinert, Lauren Sanchez, Alison Karasz, Maria Elena Ramos, Srawani Sarkar, Bruce Rapkin, Haejin In
OBJECTIVES: Optimally, cancer is diagnosed through periodic screening or detection of early symptoms in primary care settings. However, an estimated 23 to 52% of gastrointestinal (GI) cancers are diagnosed in the Emergency Department (ED). Cancer diagnosed in the ED has been associated with worse clinical and patient-reported outcomes even after adjustment for cancer stage. We sought to explore patients' accounts of patient and healthcare system factors related to their diagnosis in the ED and their lived experience of receiving a diagnosis in this setting...
August 29, 2023: Academic Emergency Medicine
https://read.qxmd.com/read/37634126/can-an-individual-be-enrolled-in-more-than-one-clinical-trial-using-exception-from-informed-consent
#10
JOURNAL ARTICLE
Catherine E Ross, Muhammad Asad, Monica E Kleinman, Michael W Donnino
No abstract text is available yet for this article.
August 27, 2023: Academic Emergency Medicine
https://read.qxmd.com/read/37620163/emergency-department-code-stemi-patients-with-initial-ecg-labeled-normal-by-computer-interpretation-a-7-year-retrospective-review
#11
JOURNAL ARTICLE
Jesse T T McLaren, H Pendell Meyers, Stephen W Smith, Lucas B Chartier
No abstract text is available yet for this article.
August 24, 2023: Academic Emergency Medicine
https://read.qxmd.com/read/37620114/a-good-death
#12
JOURNAL ARTICLE
Cedric Dark
No abstract text is available yet for this article.
August 24, 2023: Academic Emergency Medicine
https://read.qxmd.com/read/37607265/efficacy-of-prescribed-opioids-for-acute-pain-after-being-discharged-from-the-emergency-department-a-systematic-review-and-meta-analysis
#13
REVIEW
Raoul Daoust, Jean Paquet, Martin Marquis, David Williamson, Guillaume Fontaine, Jean-Marc Chauny, Amélie Frégeau, Aaron M Orkin, Suneel Upadhye, Justine Lessard, Alexis Cournoyer
BACKGROUND: Opioids are often prescribed for acute pain to emergency department (ED) discharged patients, but there is a paucity of data on their short-term use. The purpose of this study was to synthesize the evidence regarding the efficacy of prescribed opioids compared to non-opioid analgesics for acute pain relief in ED-discharged patients. METHODS: MEDLINE, EMBASE, CINAHL, PsycINFO, CENTRAL, and gray literature databases were searched from inception to January 2023...
August 22, 2023: Academic Emergency Medicine
https://read.qxmd.com/read/37607043/the-chatbot-left-us-speechless
#14
JOURNAL ARTICLE
Jorge L Almodovar, Raj Telhan
No abstract text is available yet for this article.
August 22, 2023: Academic Emergency Medicine
https://read.qxmd.com/read/37606997/analysis-of-bias-in-toxicology-screening-of-patients-in-serious-motor-vehicle-accidents
#15
JOURNAL ARTICLE
Neil Singh Bedi, Dolma Tsering, Rachel Raubenhold, Lisa Allee, Eric J Mahoney, Alysse Wurcel, Elena Byhoff
No abstract text is available yet for this article.
August 22, 2023: Academic Emergency Medicine
https://read.qxmd.com/read/37597262/disparities-in-use-of-physical-restraints-at-an-urban-minority-serving-hospital-emergency-department
#16
JOURNAL ARTICLE
Elizabeth C Pino, Felisha Gonzalez, Kerrie P Nelson, Sorraya Jaiprasert, Gina M Lopez
BACKGROUND: Recent reports have identified associations between patient race and ethnicity and use of physical restraint while receiving care in the emergency department (ED). However, no study has assessed this relationship in hospitals primarily treating patients of color and underserved populations. The primary objective of this study was to evaluate the association between race/ethnicity and the use of restraints in an ED population at a minority-serving, safety-net institution. METHODS: For this cross-sectional study, chart review identified all adult patients presenting to the Boston Medical Center ED between January 2018 and April 2021...
August 19, 2023: Academic Emergency Medicine
https://read.qxmd.com/read/37597241/a-mobile-integrated-health-program-for-the-management-of-undifferentiated-acute-complaints-in-older-adults-is-safe-and-feasible
#17
JOURNAL ARTICLE
Laurel O'Connor, Martin Rezneck, Michael Hall, Julie Inzerillo, John P Broach, Edwin Boudreaux
BACKGROUND: Poor care access and lack of proper triage of medical complaints leads to inappropriate use of acute care resources. Mobile Integrated Health (MIH) programs may offer a solution by providing adaptable on-demand care. There is little information describing programs that manage undifferentiated complaints in the community. The objective of this study is to assess the safety and feasibility of an MIH program that responds to the community to manage medical complaints in older adults ...
August 19, 2023: Academic Emergency Medicine
https://read.qxmd.com/read/37597105/editorial-a-closer-examination-of-the-racial-discrepancies-in-ed-cardiac-care
#18
JOURNAL ARTICLE
Chiamara C Anokwute, Paul I Musey
The undercurrent of racial disparities in healthcare is undeniable and remains pervasive despite concerted efforts to mitigate disparities in outcomes. This is well documented in a number of areas including access to care, pain management, as well as the evaluation and management of chest pain. The latest findings from the STOP-CP cohort study call attention yet again to an apparent gap in care between White and non-White patients in the ED evaluation of chest pain. While this is concerning, it also highlights an important question for us as clinicians to reflect upon...
August 19, 2023: Academic Emergency Medicine
https://read.qxmd.com/read/37589203/phenobarbital-for-alcohol-withdrawal-management-in-the-emergency-department-a-systematic-review-of-direct-evidence-for-the-saem-grace-initiative
#19
REVIEW
Kiran Punia, William Scott, Kriti Manuja, Kaitryn Campbell, Iris M Balodis, James MacKillop
OBJECTIVES: Alcohol withdrawal syndrome (AWS) is a commonly presenting condition in the emergency department (ED) and can have severe complications, including mortality. Benzodiazepines are first-line medications for treating AWS, but may be unavailable or insufficient. This systematic review evaluates the direct evidence assessing the utility of phenobarbital for treating AWS in the ED. METHODS: A systematic search was conducted and designed according to the patient-intervention-control-outcome (PICO) question: (P) Adults (≥18 years old) presenting to the ED with alcohol withdrawal; (I) Phenobarbital (including adjunctive); (C) Benzodiazepines or no intervention; (O) AWS complications, admission to a monitored setting, control of symptoms, adverse effects, and adjunctive medications...
August 17, 2023: Academic Emergency Medicine
https://read.qxmd.com/read/37567785/delayed-first-medical-contact-to-reperfusion-time-increases-mortality-in-rural-ems-patients-with-stemi
#20
JOURNAL ARTICLE
Jason P Stopyra, Anna C Snavely, Nicklaus P Ashburn, Michael W Supples, Chadwick D Miller, Simon A Mahler
BACKGROUND: ST-elevation myocardial infarction (STEMI) guidelines recommend an emergency medical service (EMS) first medical contact (FMC) to percutaneous coronary intervention (PCI) time of ≤90 minutes. The primary objective of this study is to evaluate the association between FMC to PCI time and mortality in rural STEMI patients. METHODS: We conducted a cohort study of patients ≥18 years old with STEMI activations from January 2016 to March 2020...
August 11, 2023: Academic Emergency Medicine
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