Vital Signs

Moving Beyond Screening: How Emergency Departments Can Help Extinguish the HIV/AIDS Epidemic

Volume 17, Issue 2, March 2016.
Michael Menchine, MD, MPH, et al.

While great strides have been made in diagnostic and treatment strategies, human immunodeficiency
virus (HIV) remains a major public health epidemic. The Centers for Disease Control and Prevention
(CDC) Morbidity and Mortality Weekly Report article, “Vital Signs: HIV Diagnosis, Care, and Treatment
Among Persons Living with HIV – United States, 2011,” highlights current areas of concern regarding
HIV diagnosis and care. The CDC estimates that 1.2 million people in the U.S. are living with HIV.
Of them, 86% have received a diagnosis (14% remain undiagnosed and unaware), but only 40%
are engaged in care and a mere 30% are virally suppressed. Emergency departments (EDs) can
play a major role in combatting the HIV epidemic through regular screening and facilitating linkage
to chronic HIV care. Universal opt-out screening as recommended by the CDC in 2006 has been
shown to be effective but expensive, and has not been widely implemented in EDs nationwide. Costeffective
models and a renewed commitment from ED providers are needed to enhance ED-based HIV
containment strategies.

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Growing Trend of Alternative Tobacco Use Among the Nation’s Youth: A New Generation of Addicts

Volume 17, Issue 2, March 2016.
John R. Marshall, MD, et al.

The Centers for Disease Control and Prevention (CDC) has published significant data and trends
related to the rising epidemic of usage of alternate forms of tobacco among the nation’s youth.
For the first time ever, the use of the electronic cigarette (e-cigarrette) has surpassed traditional
cigarette usage in adolescents. E-cigarettes are battery-operated products designed to deliver
aerosolized nicotine and other flavors to the consumer. Most look like conventional cigarettes
but some resemble everyday items such as pens, USB drives, and memory sticks. In the
following article, we present findings from the CDC’s Morbidity and Mortality Weekly Report with
commentary on the state of this growing epidemic and barriers to effective screening methods.

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Distracted Driving, A Major Preventable Cause of Motor Vehicle Collisions: “Just Hang Up and Drive”

Volume 16, Issue 7, December 2015.
Christopher A. Kahn, MD, MPH, et al.

For years, public health experts have been concerned about the effect of cell phone use on motor
vehicle collisions, part of a phenomenon known as “distracted driving.” The Morbidity and Mortality
Weekly Report (MMWR) article “Mobile Device Use While Driving – United States and Seven European
Countries 2011” highlights the international nature of these concerns. Recent (2011) estimates from
the National Highway Traffic Safety Administration are that 10% of fatal crashes and 17% of injury
crashes were reported as distraction-affected. Of 3,331 people killed in 2011 on roadways in the U.S.
as a result of driver distraction, 385 died in a crash where at least one driver was using a cell phone.
For drivers 15-19 years old involved in a fatal crash, 21% of the distracted drivers were distracted by
the use of cell phones. Efforts to reduce cell phone use while driving could reduce the prevalence of
automobile crashes related to distracted driving. The MMWR report shows that there is much ground to
cover with distracted driving. Emergency physicians frequently see the devastating effects of distracted
driving on a daily basis and should take a more active role on sharing the information with patients,
administrators, legislators, friends and family.

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Prescription Drug Monitoring Programs: Examining Limitations and Future Approaches

Volume 16, Issue 1, January 2015
Christopher A. Griggs, MD, MPH et al.

Prescription drug abuse is a leading cause of accidental death in the United States. Prescription drug monitoring programs (PDMPs) are a popular initiative among policy makers and a key tool to combat the prescription drug epidemic. This editorial discusses the limitations of PDMPs, future approaches needed to improve the effectiveness of PDMPs, and other approaches essential to curbing the rise of drug abuse and overdose.

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Polysubstance Abuse: Alcohol, Opioids and Benzodiazepines Require Coordinated Engagement by Society, Patients, and Physicians

Volume 16, Issue 1, January 2015
Uzor C. Ogbu, MD, PhD et al.

The Centers for Disease Control and Prevention (CDC) has published significant data trends related to substance abuse involving opioid pain relievers (OPR), benzodiazepines and alcohol in the United States. The CDC describes opioid misuse and abuse as an epidemic, with the use of OPR surpassing that of illicit drugs.

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Ethical and Legal Issues

Increasing Suicide Rates Among Middle-age Persons and Interventions to Manage Patients with Psychiatric Complaints

Volume XV, Issue 1, February 2014
Bharath Chakravarthy, MD, MPH et al.

The Centers for Disease Control and Prevention (CDC) has published significant data and trends related to suicide rates in the United States (U.S.). Suicide is the 10th leading cause of death in U.S. adults, and rates are increasing across all geographic regions. There is a significant increase in the suicide rate among adults in the 35–64 age range. We present findings from the CDC’s Morbidity and Mortality Weekly Report (MMWR) with commentary on current resources and barriers to psychiatric care.

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Injury Outcomes Injury Prevention

Emergency Departments and Older Adult Motor Vehicle Collisions

In 2009 the Centers for Disease Control and Prevention reported that there were 33 million licensed drivers 65 years and older in the U.S. This represents a 23 percent increase from 1999, a number that is predicted to double by 2030. Although motor vehicle collisions related to emergency department visits for older adults are lower per capita than for younger adults, the older-adults MVCs require more resources, such as additional diagnostic imaging and increased odds of admission.

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Vital Signs: Fatalities and Binge Drinking Among High School Students: A Critical Issue to Emergency Departments and Trauma Centers

The Centers for Disease Control and Prevention (CDC) has published significant data and trends related to drinking and driving among United States (U.S.) high school students. National data from 1991–2011 shows an overall 54% relative decrease (from 22% to 10.3%) in drinking and driving among U.S. high school students aged ≥ 16 years. In 2011, this still represents approximately 950,000 high school students ages 16–19 years. The decrease in drinking and driving among teens is not fully understood, but is believed to be due to policy developments, enforcement of laws, graduated licenses, and economic impacts…

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Guidelines for Field Triage of Injured Patients: In conjunction with the Morbidity and Mortality Weekly Report published by the Center for Disease Control and Prevention

The Centers for Disease Control and Prevention (CDC) has published significant data and trends related to the national public health burden associated with trauma and injury. In the United States (U.S.), injury is the leading cause of death for persons aged 1–44 years. In 2008, approximately 30 million injuries resulted in an emergency department (ED) evaluation; 5.4 million (18%) of these patients were transported by Emergency Medical Services (EMS). EMS providers determine the severity of injury and begin initial management at the scene.

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Contact Information

WestJEM/ Department of Emergency Medicine
UC Irvine Health

333 The City Blvd. West, Rt 128-01
Suite 640
Orange, CA 92868, USA
Phone: 1-714-456-6389


ISSN: 1936-900X
e-ISSN: 1936-9018

ISSN: 2474-252X

Our Philosophy

Emergency Medicine is a specialty which closely reflects societal challenges and consequences of public policy decisions. The emergency department specifically deals with social injustice, health and economic disparities, violence, substance abuse, and disaster preparedness and response. This journal focuses on how emergency care affects the health of the community and population, and conversely, how these societal challenges affect the composition of the patient population who seek care in the emergency department. The development of better systems to provide emergency care, including technology solutions, is critical to enhancing population health.