Review Article Archives - Page 2 of 4 - The Western Journal of Emergency Medicine

Provider Workforce

Assessment of Physician Well-being, Part Two: Beyond Burnout

Lall, MD, MHS, et al.

In this second part of the series, we identify and describe assessment tools related to wellness, quality of life, resilience, coping skills, and other positive states.

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Diagnosis and Management of Oncologic Emergencies

Klemencic, MD, et al.

In this article we will cover neutropenic fever, tumor lysis syndrome, hypercalcemia of malignancy, and hyperviscosity syndrome. After reading this article the reader should be much more confident in the diagnosis, evaluation, and management of these oncologic emergencies.

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The Crashing Obese Patient

Parker, MD, MS, et al.

This article focuses on critical components in the resuscitation of the crashing obese patient in the emergency department, namely intubation, mechanical ventilation, circulatory resuscitation, and pharmacotherapy.

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Evaluation and Management of Septic Arthritis and its Mimics in the Emergency Department

Long, MD, et al.

Septic arthritis is a dangerous medical condition associated with significant morbidity and mortality. This narrative review presents the emergency medicine evaluation and management, as well as important medical conditions that may mimic this disease.

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Opportunities for Research in Mental Health Emergencies: Executive Summary and Methodology

Wilson, MD, PhD, et al.

To address this important problem, the Coalition on Psychiatric Emergencies convened a research consensus conference in December 2016 consisting of clinical researchers, clinicians from emergency medicine, psychiatry and psychology, and representatives from governmental agencies and patient advocacy groups.

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Emergency Medicine Research Priorities for Early Intervention for Substance Use Disorders

Hawk, MD, MHS, et al.

Patients with substance use disorders (SUDs) frequently seek emergency care, and the emergency department (ED) may be their only point of contact with the healthcare system. While the ED visit has been increasingly recognized as providing opportunity for interventions around substance use, many questions remain.

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A Research Agenda for the Assessment and Management of Acute Behavioral Changes in Elderly Emergency Department Patients

Shenvi, MD, PhD, et al.

This manuscript is the product of a breakout session on “Special Populations: Agitation in the Elderly” from the 2016 Coalition on Psychiatric Emergencies’ first Research Consensus Conference on Acute Mental Illness.

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A Research Agenda for Assessment and Management of Psychosis in Emergency Department Patients

Peltzer-Jones, PsyD, RN, et al.

This article is the product of a subgroup considering “Special Populations: Psychotic Spectrum Disorders,” from the 2016 Coalition on Psychiatric Emergencies first Research Consensus Conference on Acute Mental Illness.

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American Heart Association/American Stroke Association Deletes Sections from 2018 Stroke Guidelines

McCoy, MD, et al.

This article will inform the emergency medicine (EM) healthcare professional of the recent correction of the updated stroke guidelines, identify which sections have been removed (deleted), and will provide a brief summary of the pertinent updates (that have not been deleted) to the 2018 stroke guidelines that have particular relevance to the EM community.

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Scholarship in Emergency Medicine: A Primer for Junior Academics Part I: Writing and Publishing

Gottlieb, MD, et al.

In this article, we provide expert consensus recommendations on four key challenges faced by junior faculty: writing the paper; selecting contributors and the importance of authorship order; journal selection and indexing; and responding to critiques.

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Measuring Scholarly Productivity: A Primer for Junior Faculty. Part III: Understanding Publication Metrics

Murphy, MLIS, et al.

This paper provides an understanding of new, alternative metrics that can be used to promote scientific progress in a transparent and timely manner.

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Critical Care

Left Ventricular Assist Device Management in the Emergency Department

Trinquero, MD, et al.

It is critical for emergency physicians to be knowledgeable of current ventricular assist devices (VAD), and to be able to troubleshoot associated complications and optimally treat patients with emergent pathology. Special consideration must be taken when managing patients with VADs including device inspection, alarm interpretation, and blood pressure measurement.

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The Misunderstood Coagulopathy of Liver Disease: A Review for the Acute Setting

Harrison, MD.

The author performed a review of the literature related to the utility of INR in cirrhotic patients using several scientific search engines.

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Population Health Research Design

Understanding the Use of Composite Endpoints in Clinical Trials

McCoy, MD, MPH.

Researchers have been increasingly using composite endpoints in lieu of the customary single primary endpoint. Although statistically treated like a single primary endpoint, composite endpoints provide unique challenges for patient care. If used or interpreted incorrectly, they have the potential for detrimental impact on patient care on a large scale. This paper defines composite endpoints, discusses the rationale for their use, and provides a practical approach to understand whether they should be used in medical decision-making.

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Scholarship in Emergency Medicine: A Primer for Junior Academics: Part II: Promoting Your Career and Achieving Your Goals

Langabeer, PhD, et al.

In this article, we provide expert consensus recommendations for improving junior faculty’s scholarship in emergency medicine (EM). Specific focus is given to promoting your research career, obtaining additional training opportunities, networking in EM, and other strategies for strategically directing a long-term career in academic medicine.

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Altered Mental Status: Current Evidence-based Recommendations for Prehospital Care

Sanello, MD, et al.

We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of a patient with an acute change in mental status and to compare these recommendations against the current protocols used by the 33 EMS agencies in the State of California.

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Emergency Physicians at War

Muck, MD, et al.

This narrative review summarizes the history, contributions, and lessons learned by EPs during OEF-A/OIF and describes changes to daily clinical practice of EM derived from the combat environment.

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Peritoneal Dialysis in Austere Environments: An Emergent Approach to Renal Failure Management

Gorbatkin, MD, et al.

Peritoneal dialysis (PD) is a means of renal replacement therapy (RRT) that can be performed in remote settings with limited resources, including regions that lack electrical power.

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Optimal Implementation of Prescription Drug Monitoring Programs in the Emergency Department

Elder, MD, et al.

This article describes one method, prescription drug monitoring programs (PDMP), through the lens of how to optimize use for emergency departments (ED). EDs have rapidly become a central location to combat opioid abuse and drug diversion. PDMPs can provide emergency physicians with comprehensive prescribing information to improve clinical decisions around opioids.

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Critical Care

Nasal Cannula Apneic Oxygenation Prevents Desaturation During Endotracheal Intubation: An Integrative Literature Review

Gleason, MS, et al.

We conducted a literature review of nasal-cannula apneic oxygenation during intubation, focusing on two components: oxygen saturation during intubation, and oxygen desaturation time. We performed an electronic literature search from 1980 to November 2017, using PubMed, Elsevier, ScienceDirect, and EBSCO.

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Ultrasound-Guided Peripheral Intravenous Line Placement: A Narrative Review of Evidence-based Best Practices

Gottlieb, MD, et al.

Peripheral intravenous line placement is a common procedure in emergency medicine. Ultrasound guidance has been demonstrated to improve success rates, as well as decrease complications and pain. This paper provides a narrative review of the literature focusing on best practices and techniques to improve performance with this procedure. We provide an evidence-based discussion of preparation for the procedure, vein and catheter selection, multiple techniques for placement, and line confirmation.

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Population Health Research Design

Understanding the Intention-to-treat Principle in Randomized Controlled Trials

McCoy, MD.

If an intervention is truly effective (truth), an intention-to-treat analysis will provide an unbiased estimate of the efficacy of the intervention at the level of adherence in the study. This article will review the “intention-to-treat” principle and its converse, “per-protocol” analysis, and illustrate how using the wrong method of analysis can lead to a significantly biased assessment of the effectiveness of an intervention.

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Population Health Research Design

Sex as a Biological Variable in Emergency Medicine Research and Clinical Practice: A Brief Narrative Review

McGregor, MD, et al.

The National Institutes of Health recently highlighted the significant role of sex as a biological variable (SABV) in research design, outcome and reproducibility, mandating that this variable be accounted for in all its funded research studies. We use three case-based scenarios in acute myocardial infarction, acute ischemic stroke and important considerations in pharmacologic therapy administration to highlight available data on SABV in evidence-based research to provide the EM community with an important foundation for future integration of patient sex in the delivery of emergency care as gaps in research are filled.

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Critical Care

Sepsis Definitions: The Search for Gold and What CMS Got Wrong

Kalantari, DO, et al.

On October 1, 2015, the United States Centers for Medicare and Medicaid Services (CMS) issued a core measure addressing the care of septic patients. These core measures are controversial among healthcare providers. This article will address that there is no gold standard definition for sepsis, severe sepsis or septic shock and the CMS-assigned definitions for severe sepsis and septic shock are premature and inconsistent with evidence-based definitions.

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Pitfalls in Electrocardiographic Diagnosis of Acute Coronary Syndrome in Low-Risk Chest Pain

Semhar Z. Tewelde, MD, et al.

Less than half of patients with a chest pain history indicative of acute coronary syndrome have a diagnostic electrocardiogram (ECG) on initial presentation to the emergency department. The physician must dissect the ECG for elusive, but perilous, characteristics that are often missed by machine analysis.

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Ethical and Legal Issues

Optimizing the Use of a Precious Resource: The Role of Emergency Physicians in a Humanitarian Crisis

Parveen K. Parmar, MD, MPH, et al.

Emergency physicians (EP) are uniquely suited to provide care in crises as a result of their broad training, ability to work quickly and effectively in high-pressure, austere settings, and their inherent flexibility. While emergency medicine training is helpful to support the needs of crisis-affected and displaced populations, it is not in itself sufficient. In this article we review what an EP should carefully consider prior to deployment.

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