Human Trafficking in the Emergency Department: Improving Our Response to a Vulnerable Population

Tiller, MD, et al.

We stress the importance of meeting the needs of the patient while prioritizing the safety of all involved. Additionally, the protocol provides a list of resources for the patient beyond medical care such as emergency housing, legal assistance, and food pantries. The overall purpose of this protocol is to provide coordinated response so that all providers may be consistent in caring for this vulnerable population.

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Provider Workforce

Wellness: Combating Burnout and Its Consequences in Emergency Medicine

Stehman, MD, et al.

Outside of EM, the most successful interventions focus on changes to systems rather than to individual physicians. Within EM, the number of well-structured interventions that have been studied is limited. Future work to achieve the desired culture of wellness within EM requires establishment of a consistent endpoint that serves as a surrogate for clinical significance, addressing contributors to burnout at all levels, and integrating successful interventions into the fabric of EM.

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Oncologic Emergencies: Immune-Based Cancer Therapies and Complications

Long, MD, et al.

Cancer therapies have undergone several recent advancements. Current cancer treatments include immune-based therapies comprised of checkpoint inhibitors, and adoptive immunotherapy; each treatment has the potential for complications that differ from chemotherapy and radiation. This review evaluates immune-based therapies and their complications for emergency clinicians.

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Standards of Care for Children in Emergency Departments: International Federation of Emergency Medicine Agenda for the Care of Children

Gutierrez, MD, et al.

To date, PEM is still an under-represented specialty, with only a dozen countries recognizing it as a distinct specialty, and only half of those offering accredited PEM training program.

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Ethical and Legal Issues

HIPAA Versus CIPA (California Invasion of Privacy Act): Are Physicians Protected from Live Social Media Streaming in the Emergency Department?

Sawyer, MD, et al.

In the current age of ubiquitous Internet connectivity and the ability to share anything on social media at a moment’s notice, it is critical that physicians be aware of laws enacted to protect our safety and integrity as practicing clinicians in the 21st century.

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Impact of Hurricane Harvey on Healthcare Utilization and Emergency Department Operations

Chambers, MD, et al.

The impact of floods on emergency department (ED) operations and patient health has not been well studied. We sought to detail challenges and lessons learned from the severe weather event caused by Hurricane Harvey in Houston, Texas, in August 2017.

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A 2-Question Summative Score Correlates with the Maslach Burnout Inventory

Li-Sauerwine, MD, et al.

The Maslach Burnout Inventory – Human Services Survey (MBI-HSS) is a widely used tool to measure burnout. The objective of this study was to compare the MBI-HSS and a two-question tool to determine burnout in the EM resident population.

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Ridesharing as an Alternative to Ambulance Transport for Voluntary Psychiatric Patients in the Emergency Department

Blome, MD, et al.

Emergency department (ED) crowding is a growing problem. Psychiatric patients have long ED lengths of stay awaiting placement and transportation to a psychiatric facility after disposition.

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Ultrasound Identification of Retrobulbar Hematomas by Emergency Physicians in a Cadaveric Model

Carlin, MD, et al.

Point-of-care ultrasound (POCUS) offers a rapid modality for evaluating a wide variety of ocular pathologies, and prior case reports demonstrate the ability of clinicians to recognize RBH using ultrasound. This study aimed to assess the ability of clinicians at various stages of training to identify a RBH using POCUS in a cadaveric model.

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Can Emergency Physicians Perform Carotid Artery Point-of-Care Ultrasound to Detect Stenosis in Patients with TIA and Stroke? A Pilot Study

Suttie, MD, et al.

We conducted a prospective cohort study on a convenience sample of adult patients presenting to a comprehensive stroke centre with TIA or stroke between June–October 2017. Carotid POCUS was performed.

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Appropriateness of Antibiotic Prescriptions for Urinary Tract Infections

Chardavoyne, BA, et al.

Urinary tract infections (UTI) are a common indication for antibiotic use in the emergency department (ED). With antibiotic resistance on the rise, it is essential that antibiotics be prescribed appropriately for UTIs. Our objective was to evaluate the appropriateness of antibiotic prescriptions by ED providers for uncomplicated cystitis and pyelonephritis.

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Adolescents’ Acceptance of Long-Acting Reversible Contraception After an Educational Intervention in the Emergency Department: A Randomized Controlled Trial

Vayngortin, MD, et al.

This study assessed contraception use among adolescents in the ED and evaluated the impact of an educational video on their interest in and uptake of LARCs.

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Emergency Department Operations

Boarding is Associated with Reduced Emergency Department Efficiency that is not Mitigated by a Provider in Triage

Napoli, MD, et al.

The provider-in-triage (PIT) model has been shown to improve ED throughput, but it is unclear how these improvements are affected by boarding. We sought to assess the effects of boarding on ED throughput and whether implementation of a PIT model mitigated those effects.

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Emergency Department Operations

Impact of Scribes with Flow Coordination Duties on Throughput in an Academic Emergency Department

Thomas, BS, et al.

The objective of this study was to investigate patient LOS in the mid- and low-acuity zones of an academic emergency department (ED) with and without medical scribes.

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Emergency Department Operations

What is a Freestanding Emergency Department? Definitions Differ Across Major United States Data Sources

Herscovici, BS, et al.

Despite the growing number of freestanding emergency departments (FSED) in the United States (US), FSED definitions differ across major US data sources of healthcare facilities and use. We compare these sources and propose a universal definition of FSED (and its two major types) to improve communications regarding these facilities and their patients.

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This Article Corrects: “Assessment of Physician Well-being, Part Two: Beyond Burnout”

Lall, MD, et al.

This Article Corrects: “Assessment of Physician Well-being, Part Two: Beyond Burnout”

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