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Western Journal of Emergency Medicine

https://read.qxmd.com/read/38801052/prevalence-and-characteristics-of-emergency-department-visits-by-pregnant-people-an-analysis-of-a-national-emergency-department-sample-2010-2020
#1
JOURNAL ARTICLE
Carl Preiksaitis, Monica Saxena, Jiaqi Zhang, Andrea Henkel
INTRODUCTION: The number and characteristics of pregnant patients presenting to the emergency department (ED) has not been well described. Our objective in this study was to determine the prevalence and characteristics of pregnant patients presenting to EDs in the US between 2010-2020. METHODS: We completed a retrospective, cross-sectional study of patient encounters at hospital-based EDs in the US from 2010-2020. Using the ED subsample of the National Hospital Ambulatory Medical Care Survey (NHAMCS) we identified ED visits for female patients aged 15-44 years...
May 2024: Western Journal of Emergency Medicine
https://read.qxmd.com/read/38801051/relationship-of-beta-human-chorionic-gonadotropin-to-ectopic-pregnancy-detection-and-size
#2
JOURNAL ARTICLE
Duane M Eisaman, Nicole E Brown, Sarah Geyer
INTRODUCTION: Ectopic pregnancies are a significant cause of morbidity and mortality in the first trimester of pregnancy. Hospital protocols requiring a specific beta-human chorionic gonadotropin (β-hCG) level to qualify for diagnostic testing (pelvic ultrasound) can delay diagnosis and treatment. In this study we sought to determine the relationship between β-hCG level and the size of ectopic pregnancy with associated outcomes. METHODS: We performed a retrospective case review of patients diagnosed with ectopic pregnancy in an urban, academic emergency department specializing in obstetrical care, from January 1, 2015-December 31, 2017...
May 2024: Western Journal of Emergency Medicine
https://read.qxmd.com/read/38801050/trauma-informed-care-training-in-trauma-and-emergency-medicine-a-review-of-the-existing-curricula
#3
REVIEW
Cecelia Morra, Kevin Nguyen, Rita Sieracki, Ashley Pavlic, Courtney Barry
BACKGROUND AND OBJECTIVES: Greater lifetime exposure to psychological trauma correlates with a higher number of health comorbidities and negative health outcomes. However, physicians often are not specifically trained in how to care for patients with trauma, especially in acute care settings. Our objective was to identify implemented trauma-informed care (TIC) training protocols for emergency and/or trauma service physicians that have both sufficient detail that they can be adapted and outcome data indicating positive impact...
May 2024: Western Journal of Emergency Medicine
https://read.qxmd.com/read/38801049/public-health-interventions-in-the-emergency-department-a-framework-for-evaluation
#4
JOURNAL ARTICLE
Elisabeth Fassas, Kyle Fischer, Stephen Schenkel, John David Gatz, Daniel B Gingold
Emergency departments (ED) in the United States serve a dual role in public health: a portal of entry to the health system and a safety net for the community at large. Public health officials often target the ED for public health interventions due to the perception that it is uniquely able to reach underserved populations. However, under time and resource constraints, emergency physicians and public health officials must make calculated decisions in choosing which interventions in their local context could provide maximal impact to achieve public health benefit...
May 2024: Western Journal of Emergency Medicine
https://read.qxmd.com/read/38801048/patient-related-factors-associated-with-potentially-unnecessary-transfers-for-pediatric-patients-with-asthma-a-retrospective-cohort-study
#5
JOURNAL ARTICLE
Gregory A Peters, Rebecca E Cash, Scott A Goldberg, Jingya Gao, Lily M Kolb, Carlos A Camargo
BACKGROUND/OBJECTIVE: Asthma is a common chronic medical condition among children and the most common diagnosis associated with interfacility transports for pediatric patients. As many as 40% of pediatric transfers may be unnecessary, resulting in potential delays in care and unnecessary costs. Our objective was to identify the patient-related factors associated with potentially unnecessary transfers for pediatric patients with asthma. METHODS: We used patient care data from the California Department of Health Care Access and Information patient discharge and emergency department (ED) datasets to capture ED visits where a pediatric patient (age 2-17 years) presented with asthma and was transferred to another ED or acute care hospital...
May 2024: Western Journal of Emergency Medicine
https://read.qxmd.com/read/38801047/support-for-thrombolytic-therapy-for-acute-stroke-patients-on-direct-oral-anticoagulants-mortality-and-bleeding-complications
#6
JOURNAL ARTICLE
Paul Koscumb, Luke Murphy, Matthew Talbott, Shiva Nuti, George Golovko, Hashem Shaltoni, Dietrich Jehle
BACKGROUND: Alteplase (tPA) is the initial treatment for acute ischemic stroke. Current tPA guidelines exclude patients who took direct oral anticoagulants (DOAC) within the prior 48 hours. In this propensity-matched retrospective study we compared acute ischemic stroke patients treated with tPA who had received DOACs within 48 hours of thrombolysis to those not previously treated with DOACs, regarding three outcomes: mortality; intracranial hemorrhage (ICH); and need for acute blood transfusions (as a marker of significant blood loss)...
May 2024: Western Journal of Emergency Medicine
https://read.qxmd.com/read/38801046/public-beliefs-about-accessibility-and-quality-of-emergency-departments-in-germany
#7
JOURNAL ARTICLE
Jens Klein, Sarah Koens, Martin Scherer, Annette Strauß, Martin Härter, Olaf von dem Knesebeck
BACKGROUND: It is well established that emergency department (ED) crowding leads to worse health outcomes. Although various patient surveys provide information about reasons to visit EDs, less is known in terms of beliefs about EDs among the general population. This study examines public beliefs regarding accessibility and quality of EDs and their associations with social characteristics (gender, age, education, immigration background) as well as knowledge about emergency care services and health literacy...
May 2024: Western Journal of Emergency Medicine
https://read.qxmd.com/read/38801045/sexually-transmitted-infection-co-testing-in-a-large-urban-emergency-department
#8
JOURNAL ARTICLE
James S Ford, Joseph C Morrison, Jenny L Wagner, Disha Nangia, Stephanie Voong, Cynthia G Matsumoto, Tasleem Chechi, Nam Tran, Larissa May
INTRODUCTION: The incidence of sexually transmitted infections (STI) increased in the United States between 2017-2021. There is limited data describing STI co-testing practices and the prevalence of STI co-infections in emergency departments (ED). In this study, we aimed to describe the prevalence of co-testing and co-infection of HIV, hepatitis C virus (HCV), syphilis, gonorrhea, and chlamydia, in a large, academic ED. METHODS: This was a single-center, retrospective cross-sectional study of ED patients tested for HIV, HCV, syphilis, gonorrhea or chlamydia between November 27, 2018-May 26, 2019...
May 2024: Western Journal of Emergency Medicine
https://read.qxmd.com/read/38801044/operation-cover-saint-louis-covid-19-vaccine-in-the-emergency-room-impact-of-a-vaccination-program-in-the-emergency-department
#9
JOURNAL ARTICLE
Brian T Wessman, Julianne Yeary, Helen Newland, Randy Jotte
INTRODUCTION: Coronavirus 2019 (COVID-19) inequitably impacted minority populations and regions with limited access to healthcare resources. The Barnes-Jewish Emergency Department in St. Louis, MO, serves such a population. The COVID-19 vaccine is an available defense to help achieve community immunity. The emergency department (ED) is a potential societal resource to provide access to a vaccination intervention. Our objective in this study was to describe and evaluate a novel ED COVID-19 vaccine program, including its impact on the local surrounding underserved community...
May 2024: Western Journal of Emergency Medicine
https://read.qxmd.com/read/38801043/changing-incidence-and-characteristics-of-photokeratoconjunctivitis-during-the-covid-19-pandemic
#10
JOURNAL ARTICLE
Yu-Shiuan Lin, Chih-Cheng Lai, Yu-Chang Liu, Shu-Chun Kuo, Shih-Bin Su
INTRODUCTION: Photokeratoconjunctivitis (PKC) is primarily caused by welding. However, inappropriate use of germicidal lamps, which have been widely used following the COVID-19 outbreak, can also cause PKC. Our goal in this study was to investigate the incidence of and changes in the causes of PKC during the coronavirus 2019 (COVID-19) pandemic. METHODS: We conducted a single-center, retrospective observational study. The health records of patients who visited the emergency department in a tertiary care hospital from January 1, 2018-December 31, 2021 and were diagnosed with PKC, were reviewed...
May 2024: Western Journal of Emergency Medicine
https://read.qxmd.com/read/38801042/association-between-sexually-transmitted-infections-and-the-urine-culture
#11
JOURNAL ARTICLE
Johnathan M Sheele, Carolyn Mead-Harvey, Nicole R Hodgson
INTRODUCTION: Bacterial urinary tract infections (UTI) and some sexually transmitted infections (STI) can have overlapping signs and symptoms or nonspecific findings, such as pyuria on urinalysis. Furthermore, results from the urine culture and the nucleic acid amplification test for an STI may not be available during the clinical encounter. We sought to determine whether gonorrhea, chlamydia, and trichomoniasis are associated with bacteriuria, information that might aid in the differentiation of STIs and UTIs...
May 2024: Western Journal of Emergency Medicine
https://read.qxmd.com/read/38801041/best-practices-for-treating-blind-and-visually-impaired-patients-in-the-emergency-department-a-scoping-review
#12
REVIEW
Kareem Hamadah, Mary Velagapudi, Juliana J Navarro, Andrew Pirotte, Chris Obersteadt
INTRODUCTION: Blind and visually impaired individuals, an under-represented population of the emergency department (ED), possess comorbidities and have a higher chance of in-hospital sequelae, including falls. This potentially vulnerable population, if not treated mindfully, can be subject to decreased quality of care, recurrent and/or longer hospitalizations, persistence of health issues, increased incidence of falls, and higher healthcare costs. For these reasons, it is crucial to implement holistic practices and train clinicians to treat blind and visually impaired patients in the ED setting...
May 2024: Western Journal of Emergency Medicine
https://read.qxmd.com/read/38801040/the-utility-of-dot-phrases-and-smartphrases-in-improving-physician-documentation-of-interpreter-use
#13
JOURNAL ARTICLE
Katrin Jaradeh, Elaine Hsiang, Malini K Singh, Christopher R Peabody, Steven Straube
BACKGROUND: Patients with limited English proficiency (LEP) experience significant healthcare disparities. Clinicians are responsible for using and documenting their use of certified interpreters for patient encounters when appropriate. However, the data on interpreter use documentation in the emergency department (ED) is limited and variable. We sought to assess the effects of dot phrase and SmartPhrase implementation in an adult ED on the rates of documentation of interpreter use. METHODS: We conducted an anonymous survey asking emergency clinicians to self-report documentation of interpreter use...
May 2024: Western Journal of Emergency Medicine
https://read.qxmd.com/read/38801039/imaging-in-a-pandemic-how-lack-of-intravenous-contrast-for-computed-tomography-affects-emergency-department-throughput
#14
JOURNAL ARTICLE
Wayne A Martini, Clinton E Jokerst, Nicole Hodsgon, Andrej Urumov
INTRODUCTION: During the coronavirus 2019 pandemic, hospitals in the United States experienced a shortage of contrast agent, much of which is manufactured in China. As a result, there was a significantly decreased amount of intravenous (IV) contrast available. We sought to determine the effect of restricting the use of IV contrast on emergency department (ED) length of stay (LOS). METHODS: We conducted a single-institution, retrospective cohort study on adult patients presenting with abdominal pain to the ED from March 7-July 5, 2022...
May 2024: Western Journal of Emergency Medicine
https://read.qxmd.com/read/38801038/geographic-location-and-corporate-ownership-of-hospitals-in-relation-to-unfilled-positions-in-the-2023-emergency-medicine-match
#15
JOURNAL ARTICLE
Zachary J Jarou, Angela G Cai, Leon Adelman, David J Carlberg, Sara P Dimeo, Jonathan Fisher, Todd Guth, Bruce M Lo, Laura Oh, Rahul Puttagunta, Gillian R Schmitz
INTRODUCTION: In the 2023 National Resident Matching Program (NRMP) match, there were 554 unfilled emergency medicine (EM) positions before the Supplemental Offer and Acceptance Program (SOAP). We sought to describe features of EM programs that participated in the match and the association between select program characteristics and unfilled positions. METHODS: The primary outcome measures included the proportion of positions filled in relation to state and population density, hospital ownership type, and physician employment model...
May 2024: Western Journal of Emergency Medicine
https://read.qxmd.com/read/38801037/emergency-department-spo-2-fio-2-ratios-correlate-with-mechanical-ventilation-and-intensive-care-unit-requirements-in-covid-19-patients
#16
JOURNAL ARTICLE
Gary Zhang, Michael J Burla, Benjamin B Caesar, Carolyne R Falank, Peter Kyros, Victoria C Zucco, Aneta Strumilowska, Daniel C Cullinane, Forest R Sheppard
BACKGROUND: Patients with coronavirus 2019 (COVID-19) are at high risk for respiratory dysfunction. The pulse oximetry/fraction of inspired oxygen (SpO2 /FiO2 ) ratio is a non-invasive assessment of respiratory dysfunction substituted for the PaO2 :FiO2 ratio in Sequential Organ Failure Assessment scoring. We hypothesized that emergency department (ED) SpO2 /FiO2 ratios correlate with requirement for mechanical ventilation in COVID-19 patients. Our objective was to identify COVID-19 patients at greatest risk of requiring mechanical ventilation, using SpO2 /FiO2 ratios...
May 2024: Western Journal of Emergency Medicine
https://read.qxmd.com/read/38801036/implementation-and-evaluation-of-a-bystander-naloxone-training-course
#17
JOURNAL ARTICLE
Scott G Weiner, Scott A Goldberg, Cheryl Lang, Molly Jarman, Cory J Miller, Sarah Li, Ewelina W Stanek, Eric Goralnick
INTRODUCTION: Bystander provision of naloxone is a key modality to reduce opioid overdose-related death. Naloxone training courses are available, but no standardized program exists. As part of a bystander empowerment course, we created and evaluated a brief naloxone training module. METHODS: This was a retrospective evaluation of a naloxone training course, which was paired with Stop the Bleed training for hemorrhage control and was offered to administrative staff in an office building...
May 2024: Western Journal of Emergency Medicine
https://read.qxmd.com/read/38801035/factors-associated-with-acute-telemental-health-consultations-in-older-veterans
#18
JOURNAL ARTICLE
Erica C Koch, Michael J Ward, Alvin D Jeffery, Thomas J Reese, Chad Dorn, Shannon Pugh, Melissa Rubenstein, Jo Ellen Wilson, Corey Campbell, Jin H Han
INTRODUCTION: The United States Veterans Health Administration is a leader in the use of telemental health (TMH) to enhance access to mental healthcare amidst a nationwide shortage of mental health professionals. The Tennessee Valley Veterans Affairs (VA) Health System piloted TMH in its emergency department (ED) and urgent care clinic (UCC) in 2019, with full 24/7 availability beginning March 1, 2020. Following implementation, preliminary data demonstrated that veterans ≥65 years old were less likely to receive TMH than younger patients...
May 2024: Western Journal of Emergency Medicine
https://read.qxmd.com/read/38801034/addressing-system-and-clinician-barriers-to-emergency-department-initiated-buprenorphine-an-evaluation-of-post-intervention-physician-outcomes
#19
JOURNAL ARTICLE
Jacqueline J Mahal, Polly Bijur, Audrey Sloma, Joanna Starrels, Tiffany Lu
INTRODUCTION: Emergency departments (ED) are in the unique position to initiate buprenorphine, an evidence-based treatment for opioid use disorder (OUD). However, barriers at the system and clinician level limit its use. We describe a series of interventions that address these barriers to ED-initiated buprenorphine in one urban ED. We compare post-intervention physician outcomes between the study site and two affiliated sites without the interventions. METHODS: This was a cross-sectional study conducted at three affiliated urban EDs where the intervention site implemented OUD-related electronic note templates, clinical protocols, a peer navigation program, education, and reminders...
May 2024: Western Journal of Emergency Medicine
https://read.qxmd.com/read/38596934/reply-to-factors-associated-with-overutilization-of-computed-tomography-cervical-spine-imaging
#20
JOURNAL ARTICLE
Karl Chamberlin
No abstract text is available yet for this article.
March 2024: Western Journal of Emergency Medicine
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