Articles

National Trends in Vital Sign Abnormalities at Arrival to the Emergency Department

Rama A. Salhi, MD, MHS, MSc

Recent reports suggest rising intensity of emergency department (ED) billing practices, sparking concerns that this may represent up-coding. However, it may reflect increasing severity and complexity of care in the ED population. We hypothesize that this in part may be reflected in more severe manifestations of illness as indicated by vital sign abnormalities.

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Utilization and Impact of Pharmacist-led, Urinary Culture Follow-Up After Discharge from the Emergency Department

Danny Pham, PharmD

Urinary tract infections (UTI) are a common reason for an emergency department (ED) visit. The majority of these patients are discharged directly home without a hospital admission. After discharge, emergency physicians have traditionally managed the care of the patient if a change is warranted (as a result of urine culture results). However, in recent years clinical pharmacists in the ED have largely incorporated this task into their standard practice. In our study, we aimed to 1) describe our unique process in having a pharmacist-led, urinary culture follow-up, and 2) compare it to our previous, more traditional process.

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Improving Accessibility in the Emergency Department for Patients with Disabilities: A Qualitative Study

J. Harrison Carmichael, BA

The emergency department (ED) is a critical service area for patients living with disabilities in the United States. Despite this, there is limited research on best practices from the patient experience regarding accommodation and accessibility for those with disabilities. In this study we investigate the ED experience from the perspective of patients living with physical and cognitive disability, as well as visual impairment and blindness, to better understand the barriers to accessibility in the ED for these populations.

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Response to “Comments on Economic Evaluation of Ultrasound-guided Central Venous Catheter Confirmation vs Chest Radiography in Critically Ill Patients: A Labor Cost Model”

Author Affiliation Enyo A. Ablordeppey, MD, MPH Washington University School of Medicine, Department of Anesthesiology, St. Louis, Missouri; Washington University School of Medicine, Department of Emergency Medicine, St. Louis, Missouri Adam M. Koenig, BS Washington University School of Medicine, St. Louis, Missouri Abigail R. Barker, PhD Washington University, Center for Health Economics and Policy at […]

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Comments on “Economic Evaluation of Ultrasound-guided Central Venous Catheter Confirmation vs Chest Radiography in Critically Ill Patients: A Labor Cost Model”

Author Affiliation Samuel Austin, DO University of Maryland School of Medicine, The R Adams Cowley Shock Trauma Center, Department of Surgical Critical Care, Baltimore, Maryland Quincy K. Tran, MD, PhD University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland Ali Pourmand, MD, MPH George Washington University School of Medicine and Health Sciences, […]

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Why Emergency Physicians Should Advocate for Suspension of Title 42 Restrictions on Asylum for US Immigrants

Author Affiliation Kevin Durgun, MD The George Washington University, Department of Emergency Medicine, Washington, DC Emmeline Ha, MD The George Washington University, Department of Emergency Medicine, Washington, DC Natalie Kirilichin, MD The George Washington University, Department of Emergency Medicine, Washington, DC Janice Blanchard, MD The George Washington University, Department of Emergency Medicine, Washington, DC   […]

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Care of Bullet-related Injuries: A Cross-sectional Study of Instructions and Prescriptions Provided on Discharge from the Emergency Department

Jane M. Hayes, MD, MPH

There are more than 80,000 emergency department (ED) visits for non-fatal bullet-related injuries (BRI) per year in the United States. Approximately half of these patients are discharged home from the ED. Our objective in this study was to characterize the discharge instructions, prescriptions, and follow-up plans provided to patients discharged from the ED after BRI.

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Application of Point-of-care Ultrasound for Screening Climbers at High Altitude for Pulmonary B-lines

Shadi Lahham, MD

High-altitude pulmonary edema (HAPE) occurs as a result of rapid ascent to altitude faster than the acclimatization processes of the body. Symptoms can begin at an elevation of 2,500 meters above sea level. Our objective in this study was to determine the prevalence and trend of developing B-lines at 2,745 meters above sea level among healthy visitors over four consecutive days.

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Potentially Critical Driving Situations During “Blue-light” Driving: A Video Analysis

Maria J. Prohn,

Driving with warning lights and sirens is highly demanding for ambulance drivers, and the crash risk is much higher than that during normal driving. In this study our goals were to establish a coding protocol to observe how often and how long potentially critical driving situations (PCDS) occur during “blue-light” driving (driving with emergency response lights) and to describe traffic and environmental conditions preceding and accompanying the PCDS.

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Medical Malpractice and Diagnostic Errors in Japanese Emergency Departments

Taiju Miyagami, MD, PhD

Emergency departments (ED) are unpredictable and prone to diagnostic errors. In addition, non-emergency specialists often provide emergency care in Japan due to a lack of certified emergency specialists, making diagnostic errors and associated medical malpractice more likely. While several studies have investigated the medical malpractice related to diagnostic errors in EDs, only a few have focused on the conditions in Japan. This study examines diagnostic error-related medical malpractice lawsuits in Japanese EDs to understand how various factors contribute to diagnostic errors.

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Prevalence and Risk Factors of Insomnia and Sleep-aid Use in Emergency Physicians in Japan: Secondary Analysis of a Nationwide Survey

Takuyo Chiba, MD

Emergency physicians (EP) are suspected to have a high prevalence of insomnia and sleep-aid use. Most prior studies about sleep-aid use in EPs have been limited by low response rates. In this study our aim was to investigate the prevalence of insomnia and sleep-aid use among early-career Japanese EPs and assess the factors associated with insomnia and sleep-aid use.

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Characteristics of Emergency Medicine Specimen Bank Participants Compared to the Overall Emergency Department Population

Alexis Vest, BS

Biorepositories lack diversity both demographically and with regard to the clinical complaints of patients enrolled. The Emergency Medicine Specimen Bank (EMSB) seeks to enroll a diverse cohort of patients for discovery research in acute care conditions. Our objective in this study was to determine the differences in demographics and clinical complaints between participants in the EMSB and the overall emergency department (ED) population.

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2021 SAEM Consensus Conference Proceedings: Research Priorities for Implementing Emergency Department Screening for Social Risks and Needs

Mackensie Yore, MD, MS

Despite literature on a variety of social risks and needs screening interventions in emergency department (ED) settings, there is no universally accepted or evidence-based process for conducting such interventions. Many factors hamper or promote implementation of social risks and needs screening in the ED, but the relative impact of these factors and how best to mitigate/leverage them is unknown.

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Video Education Intervention in the Emergency Department

Nancy Jacobson, MD

After discharge from the emergency department (ED), pain management challenges parents, who have been shown to undertreat their children’s pain. Our goal was to evaluate the effectiveness of a five-minute instructional video for parents on pain treatment in the home setting to address common misconceptions about home pediatric pain management.

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Factors Associated with Neuroimaging Abnormalities in Children with Afebrile Seizure: A Retrospective Multicenter Study

Seungho Woo, MD

Neuroimaging is recommended for patients with seizures to identify intracranial pathology. However, emergency physicians should consider the risks and benefits of neuroimaging in pediatric patients because of their need for sedation and greater sensitivity to radiation than adults. The purpose of this study was to identify associated factors of neuroimaging abnormalities in pediatric patients experiencing their first afebrile seizure.

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Effects of an Online Community Peer-support Intervention on COVID-19 Vaccine Misinformation Among Essential Workers: Mixed-methods Analysis

Dominic Arjuna Ugarte, MD

Public health efforts to reduce the spread of coronavirus disease 2019 (COVID-19) have been plagued by vaccine hesitancy and misinformation. Social media has contributed to spreading misinformation by creating online environments where people find information or opinions that reinforce their own. Combating misinformation online will be essential to prevent and manage the spread of COVID-19. It is of particular urgency to understand and address misinformation and vaccine hesitancy among essential workers, such as healthcare workers, because of their frequent interactions with and influence upon the general population. Using data from an online community pilot randomized controlled trial designed to increase requests for COVID-19 vaccine information among frontline essential workers, we explored the topics discussed on the online community related to COVID-19 and COVID-19 vaccination to better understand current misinformation and vaccine hesitancy.

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The Standardized Letter of Evaluation: How We Perceive the Quiet Student

John K. Quinn, MD

The Standardized Letter of Evaluation (SLOE) is an emergency medicine (EM)-specific assessment designed to help EM residency programs differentiate applicants. We became interested in SLOE-narrative language referencing personality when we observed less enthusiasm for applicants described as “quiet” in their SLOEs. In this study our objective was to compare how quiet-labeled, EM-bound applicants were ranked compared to their non-quiet peers in the global assessment (GA) and anticipated rank list (ARL) categories in the SLOE.

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Gamification of POCUS: Are Students Learning?

Frances M Russell, MD

While gamification of point-of-care ultrasound (POCUS) is well received by learners, little is known about the knowledge gained from material taught during these events. We set out to determine whether a POCUS gamification event improved knowledge of interpretation and clinical integration of POCUS.

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

CPC-EM
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.