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JOURNAL ARTICLE
Sriram Ramgopal, Robert J Sepanski, Christian Martin-Gill
STUDY OBJECTIVE: To compare Pediatric Advanced Life Support (PALS) vital signs criteria to empirically derived vital signs cut-points for predicting out-of-hospital interventions in children. METHODS: We performed a cross-sectional study of pediatric encounters (<18 years) using the 2019 to 2020 datasets of the National Emergency Medical Services Information System, which we randomly divided into equal size derivation and validation samples. We developed age-based centile curves for initial heart rate, respiratory rate, and systolic blood pressure using generalized additive models for location, scale, and shape, which we evaluated in the validation sample...
November 16, 2022: Annals of Emergency Medicine
#2
JOURNAL ARTICLE
Andrew Posen, Adam Bursua, Renee Petzel
STUDY OBJECTIVE: To evaluate the dose-dependent comparative safety and effectiveness between weight-based and alternative dosing strategies for diltiazem in atrial fibrillation with rapid ventricular response. METHODS: This retrospective cohort study included adult patients presenting to the emergency department with atrial fibrillation with rapid ventricular response who received treatment with intravenous diltiazem. Groups were retrospectively categorized according to the initial dose: low (<0...
November 16, 2022: Annals of Emergency Medicine
#3
JOURNAL ARTICLE
Erik S Anderson, Evan Rusoja, Joshua Luftig, Monish Ullal, Ranjana Shardha, Henry Schwimmer, Alexandra Friedman, Christian Hailozian, Andrew A Herring
STUDY OBJECTIVE: We implemented a whole person care-informed intervention delivered by substance use navigators (SUN) for emergency department (ED) patients with substance use disorders. METHODS: This was an implementation study of adult patients discharged from 3 public hospital EDs between September 1, 2021 through January 31, 2022 with cocaine, methamphetamine, alcohol, and opioid use-related diagnoses. The primary effectiveness outcome was treatment engagement within 30 days of ED discharge among patients with and without the SUN intervention...
November 16, 2022: Annals of Emergency Medicine
#4
JOURNAL ARTICLE
Charikleia S Vrettou, Vassilis G Giannakoulis, Parisis Gallos, Anastasia Kotanidou, Ilias I Siempos
STUDY OBJECTIVE: Despite the almost universal administration of supplemental oxygen in patients presenting in the emergency department with severe traumatic brain injury, optimal early oxygenation levels are unknown. Therefore, we aimed to examine the effect of different early oxygenation levels on the clinical outcomes of patients presenting in the emergency department with severe traumatic brain injury. METHODS: We performed a secondary analysis of the Resuscitation Outcomes Consortium Traumatic Brain Injury Hypertonic Saline randomized controlled trial by including patients with Glasgow Coma Scale ≤8...
November 16, 2022: Annals of Emergency Medicine
#5
JOURNAL ARTICLE
Dana D Im, Kirstin W Scott, Arjun K Venkatesh, Luis F Lobon, David S Kroll, Elizabeth A Samuels, Michael P Wilson, Scott Zeller, Leslie S Zun, Kathleen C Clifford, Kori S Zachrison
As a primary access point for crisis psychiatric care, the emergency department (ED) is uniquely positioned to improve the quality of care and outcomes for patients with psychiatric emergencies. Quality measurement is the first key step in understanding the gaps and variations in emergency psychiatric care to guide quality improvement initiatives. Our objective was to develop a quality measurement framework informed by a comprehensive review and gap analysis of quality measures for ED psychiatric care. We conducted a systematic literature review and convened an expert panel in emergency medicine, psychiatry, and quality improvement to consider if and how existing quality measures evaluate the delivery of emergency psychiatric care in the ED setting...
November 16, 2022: Annals of Emergency Medicine
#6
EDITORIAL
Katie Pettit, Carly Eastin, Carl Pafford
No abstract text is available yet for this article.
November 16, 2022: Annals of Emergency Medicine
#7
JOURNAL ARTICLE
Kerstin de Wit, Fayad Al-Haimus, Yang Hu, Rick Ikesaka, Noel Chan, Quazi Ibrahim, Joshua Klyn, Natasha Clayton, Federico Germini
STUDY OBJECTIVE: We prospectively assessed the diagnostic accuracy of YEARS and a modified age-adjusted clinical decision rule ("Adjust-Unlikely") for pulmonary embolism (PE) testing in the emergency department. METHODS: This study was conducted in tertiary care Canadian emergency departments. When the D-dimer was <500 ng/ml, PE was excluded. Pulmonary imaging for PE was performed when the D-dimer was ≥500 ng/ml. Patients were followed for 30 days, and PE outcomes were independently adjudicated...
November 10, 2022: Annals of Emergency Medicine
#8
EDITORIAL
Jason Haukoos, Kiran Faryar, Sarah Rowan
No abstract text is available yet for this article.
November 10, 2022: Annals of Emergency Medicine
#9
EDITORIAL
Michael D April, Adit A Ginde
No abstract text is available yet for this article.
November 3, 2022: Annals of Emergency Medicine
#10
JOURNAL ARTICLE
Nicholas M Mohr, Eliezer Santos Leon, Jestin N Carlson, Brian Driver, Anusha Krishnadasan, Karisa K Harland, Patrick Ten Eyck, William R Mower, Tyler M Foley, Kelli Wallace, L Clifford McDonald, Preeta K Kutty, Scott Santibanez, David A Talan
STUDY OBJECTIVE: To describe endotracheal intubation practices in emergency departments by staff intubating patients early in the coronavirus disease 2019 (COVID-19) pandemic. METHODS: Multicenter prospective cohort study of endotracheal intubations conducted at 20 US academic emergency departments from May to December 2020, stratified by known or suspected COVID-19 status. We used multivariable regression to measure the association between intubation strategy, COVID-19 known or suspected status, first-pass success, and adverse events...
November 3, 2022: Annals of Emergency Medicine
#11
JOURNAL ARTICLE
David H Gordon, Alexander Bracey
No abstract text is available yet for this article.
November 2, 2022: Annals of Emergency Medicine
#12
JOURNAL ARTICLE
Caleb E Ward, Gia M Badolato, Michael F Taylor, Kathleen M Brown, Joelle N Simpson, James M Chamberlain
STUDY OBJECTIVE: Many Emergency Medical Services (EMS) agencies have developed alternative disposition processes for patients with nonemergency problems, but there is a lack of evidence demonstrating EMS clinicians can accurately determine acuity in pediatric patients. Our study objective was to determine EMS and other stakeholders' ability to identify low acuity pediatric EMS patients. METHODS: We conducted a prospective, observational study of children transported to a pediatric emergency department by EMS...
November 2, 2022: Annals of Emergency Medicine
#13
EDITORIAL
Michael Gottlieb, Ololade O Akinfemiwa, Teresa E Davis
No abstract text is available yet for this article.
November 2, 2022: Annals of Emergency Medicine
#14
REVIEW
Michael Gottlieb, Stephen Alerhand
No abstract text is available yet for this article.
November 2, 2022: Annals of Emergency Medicine
#15
Bryan Feinstein, Jonathan Kelley, Paul Blackburn, Patrick Connell
We report a case of cardioversion that was successfully performed on a patient during cold water immersion. The patient deteriorated into unstable ventricular tachycardia while being treated for heatstroke. We elected to perform synchronized cardioversion without first removing the patient from the immersion body bag. The patient survived and was discharged neurologically intact on hospital day 5. There were no evident deleterious effects to the staff, the patient, or the equipment. To our knowledge, this is the first case report in the literature demonstrating the electrical cardioversion of a patient immersed in water...
November 2, 2022: Annals of Emergency Medicine
#16
JOURNAL ARTICLE
Sophie Terp, Zach Reichert, Elizabeth Burner, Jasmeen Randhawa, Sarah Axeen, Michael Messina, Daniel A Dworkis, Michael Menchine, Chun Nok Lam, Josh Banerjee, Brad Spellberg, Sanjay Arora
STUDY OBJECTIVE: To describe characteristics and outcomes of coronavirus disease (COVID-19) patients with new supplemental oxygen requirements discharged from a large public urban emergency department (ED) with supplemental oxygen. METHODS: This observational case series describes the characteristics and outcomes of 360 consecutive COVID-19 patients with new supplemental oxygen requirements discharged from a large urban public ED between April 2020 and March 2021 with supplemental oxygen...
November 2, 2022: Annals of Emergency Medicine
#17
JOURNAL ARTICLE
Thomas E Akie, Malkeet Gupta, Robert M Rodriguez, Gregory W Hendey, Jake L Wilson, Alexandra K Quinones, William R Mower
STUDY OBJECTIVE: We evaluated the emergency department providers' ability to detect skull fractures in pediatric patients presenting with blunt head trauma. METHODS: This was a secondary analysis of the National Emergency X-Radiography Utilization Study (NEXUS) Head computed tomography (CT) validation study. Demographics and clinical characteristics were analyzed for pediatric patients. Radiologist interpretations of head CT imaging were abstracted and cataloged...
October 31, 2022: Annals of Emergency Medicine
#18
JOURNAL ARTICLE
Gregory P Wu, Boris Shkolnik
No abstract text is available yet for this article.
October 31, 2022: Annals of Emergency Medicine
#19
JOURNAL ARTICLE
Christopher W Jones, Xinming An, Yinyao Ji, Mochuan Liu, Donglin Zeng, Stacey L House, Francesca L Beaudoin, Jennifer S Stevens, Thomas C Neylan, Gari D Clifford, Tanja Jovanovic, Sarah D Linnstaedt, Laura T Germine, Kenneth A Bollen, Scott L Rauch, John P Haran, Alan B Storrow, Christopher Lewandowski, Paul I Musey, Phyllis L Hendry, Sophia Sheikh, Brittany E Punches, Michael S Lyons, Michael C Kurz, Robert A Swor, Meghan E McGrath, Lauren A Hudak, Jose L Pascual, Mark J Seamon, Elizabeth M Datner, Erica Harris, Anna M Chang, Claire Pearson, David A Peak, Roland C Merchant, Robert M Domeier, Niels K Rathlev, Brian J O'Neil, Paulina Sergot, Leon D Sanchez, Steven E Bruce, Mark W Miller, Robert H Pietrzak, Jutta Joormann, Deanna M Barch, Diego A Pizzagalli, John F Sheridan, Jordan W Smoller, Steven E Harte, James M Elliott, Karestan C Koenen, Kerry J Ressler, Ronald C Kessler, Samuel A McLean
STUDY OBJECTIVE: To derive and initially validate a brief bedside clinical decision support tool that identifies emergency department patients at high risk of substantial, persistent posttraumatic stress symptoms after a motor vehicle collision. METHODS: Derivation (n=1,282, 19 ED sites) and validation (n=282, 11 separate ED sites) data were obtained from adults prospectively enrolled in the Advancing Understanding of RecOvery afteR traumA study who were discharged from the ED after motor vehicle collision-related trauma...
October 31, 2022: Annals of Emergency Medicine
#20
JOURNAL ARTICLE
Demetrios N Kyriacou, Philip Greenland, Mohammad A Mansournia
Causal diagrams are used in biomedical research to develop and portray conceptual models that accurately and concisely convey assumptions about putative causal relations. Specifically, causal diagrams can be used for both observational studies and clinical trials to provide a scientific basis for some aspects of multivariable model selection. This methodology also provides an explicit framework for classifying potential sources of bias and enabling the identification of confounder, collider, and mediator variables for statistical analyses...
October 31, 2022: Annals of Emergency Medicine
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