Archives

Cannabis in Homes with Children: A Survey on Use, Storage, and Attitudes

Gimelli, A.

The recent legalization of cannabis in California has the potential to affect cannabis prevalence in households with children. This eventuality, combined with suboptimal cannabis storage practices, could lead to adverse effects such as unintentional pediatric ingestion, which occurred in Colorado after legalization. Our objective was to assess prevalence and storage practices of cannabis in households with children, and attitudes on use and storage education in a state that has legalized cannabis.

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Toxicologic Exposures in California Emergency Departments in 2011 and Its Risk Factors

Loftipour, S.

Toxicologic exposures (TE) are a major preventable public health issue, with most cases due to unintentional causes. Although these cases are well documented and reported via the National Poison Data System, there is little information regarding toxicologic exposure cases in the emergency department (ED). The aim of this study was to identify demographic groups at risk for potential poisoning.

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Inpatient Outcomes Following a Return Visit to the Emergency Department: A Nationwide Cohort Study

Tsai, CL.

Emergency department (ED) revisits are traditionally used to measure potential lapses in emergency care. However, recent studies on in-hospital outcomes following ED revisits have begun to challenge this notion. We aimed to examine inpatient outcomes and resource use among patients who were hospitalized following a return visit to the ED using a national database.

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Radiology Education Among Emergency Medicine Residencies: A National Needs Assessment

Villa, SE.

Radiology training is an important component of emergency medicine (EM) education, but its delivery has been variable. Program directors have reported a lack of radiology skills in incoming interns. A needs assessment is a crucial first step toward improving radiology education among EM residencies. Our objective was to explore the current state of radiology education in EM residency programs.

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Does the Medical Student Performance Evaluation Change the Decision to Invite Residency Applicants?

Thimm, TN.

Although emergency medicine (EM) residency program directors (PD) have multiple sources to evaluate each applicant, some programs await the release of the medical student performance evaluation (MSPE) to extend interview offers. While prior studies have demonstrated that MSPE content is variable and selectively positive, no prior work has evaluated the impact of the MSPE on the likelihood to invite (LTI) applicants for a residency interview. This study aimed to evaluate how information in the MSPE impacted LTI, with the hypothesis that changes in LTI would be relatively rare based on MSPE review alone.

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National Survey of Point-of-Care Ultrasound Scholarly Tracks in Emergency Medicine Residency Programs

Alerhand, S.

Residency scholarly tracks are educational programs, designed to help trainees develop an area of expertise. Although the breadth of residency point-of-care ultrasound (POCUS) education has developed considerably in recent years, there is no literature to date describing scholarly tracks specifically in POCUS. In this study we sought to determine the prevalence, characteristics, and outcomes of POCUS scholarly tracks in emergency medicine (EM).

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Mobile Crisis Outreach and Emergency Department Utilization: A Propensity Score-matched Analysis

Vakkalanka, JP.

Mental health and substance use disorder (MHSUD) patients in the emergency department (ED) have been facing increasing lengths of stay due to a shortage of inpatient beds. Previous research indicates mobile crisis outreach (MCO) reduces long ED stays for MHSUD patients. Our objective was to assess the impact of MCO contact on future ED utilization.

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Endemic Infections

Impact of COVID-19 and Shelter in Place on Volume and Type of Traumatic Injuries

Murrett, J.

Very little is known about the effects of the novel coronavirus (COVID-19) pandemic and its associated social distancing practices on trauma presentations to the emergency department (ED). This study aims to assess the impact of a city-wide stay at home order on the volume, type, and outcomes of traumatic injuries at urban EDs.

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Endemic Infections

Mortality Variations of COVID-19 from Different Hospital Settings During Different Pandemic Phases: A Multicenter Retrospective Study

Chou, EH.

Diverse coronavirus disease 2019 (COVID-19) mortalities have been reported but focused on identifying susceptible patients at risk of more severe disease or death. This study aims to investigate the mortality variations of COVID-19 from different hospital settings during different pandemic phases.

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Endemic Infections

Efficacy of Various Facial Protective Equipment for Infection Control in a Healthcare Setting

Dinsmore, J.

The coronavirus 2019 (COVID-19) pandemic has reinforced the importance of facial protection against droplet transmission of diseases. Healthcare workers wear personal protection equipment (PPE), including face shields and masks. Plastic face shields may have advantages over regular medical masks. Although many designs of face shields exist, there is a paucity of evidence regarding the efficacy of shield designs against droplet transmissions. There is even less published evidence comparing various face shields. Due to the urgency of the pandemic and the health and safety of healthcare workers, we aimed to study the efficacy of various face shields against droplet transmission.

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Endemic Infections

A Global Survey of Emergency Department Responses to the COVID-19 Pandemic

Mahajan, P.

Emergency departments (ED) globally are addressing the coronavirus disease 2019 (COVID-19) pandemic with varying degrees of success. We leveraged the 17-country, Emergency Medicine Education & Research by Global Experts (EMERGE) network and non-EMERGE ED contacts to understand ED emergency preparedness and practices globally when combating the COVID-19 pandemic.

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Endemic Infections

Patient Perceptions of Drive-through Medical Treatment Facilities During the COVID-19 Pandemic

Stuart, S.

The cumulative burden of coronavirus disease 2019 (COVID-19) on the United States’ healthcare system is substantial. To help mitigate this burden, novel solutions including telehealth and dedicated screening facilities have been used. However, there is limited data on the efficacy of such models and none assessing patient comfort levels with these changes in healthcare delivery. The aim of our study was to evaluate patients’ perceptions of a drive-through medical treatment system in the setting of the COVID-19 pandemic.

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Endemic Infections

Use of Telemedicine to Expedite and Expand Care During COVID-19

Shah, M.

The novel coronavirus disease 2019 (COVID-19) created challenges with access to care including increased burden on healthcare systems and potential exposure risks for vulnerable patients. To address these needs, Rush University Medical Center created a virtual, urgent care program specifically designed to address these challenges during the COVID-19 pandemic.

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WestJEM Will No Longer Use the Term “Provider” to Refer to Physicians

Phillips, A.

Increasingly, the lay and academic press has blurred the titles and roles of those who deliver various aspects of healthcare. This development confuses patients and fails to acknowledge the substantial differences in training and clinical experience.1

Therefore, beginning with the next issue, the Western Journal of Emergency Medicine will no longer publish the term “provider” in reference to physicians except as required to reference specific laws or formal program names. The decision to formally and publicly expunge a term from our written language should not be – and was not –taken lightly. Yet the evidence overwhelmingly supports the scientific and professional obligation of the Journal to accurately and respectfully refer to healthcare professionals of all degree types and roles. As we strive to phase out use of this term, we encourage other journals to do the same.

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Risk Factors of Fall-Related Emergency Department Visits by Fall Location of Older Adults in the US

Kelekar, U.

Prior evidence indicates that predictors of older adult falls vary by indoor-outdoor location of the falls. While a subset of United States’ studies reports this finding using primary data from a single geographic area, other secondary analyses of falls across the country do not distinguish between the two fall locations. Consequently, evidence at the national level on risk factors specific to indoor vs outdoor falls is lacking.

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Endemic Infections

Emergency Department-initiated High-flow Nasal Cannula for COVID-19 Respiratory Distress

Jarou, ZJ.

Patients with coronavirus disease 2019 (COVID-19) can develop rapidly progressive respiratory failure. Ventilation strategies during the COVID-19 pandemic seek to minimize patient mortality. In this study we examine associations between the availability of emergency department (ED)-initiated high-flow nasal cannula (HFNC) for patients presenting with COVID-19 respiratory distress and outcomes, including rates of endotracheal intubation (ETT), mortality, and hospital length of stay.

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Clinical, Operational, and Socioeconomic Analysis of EMS Bypass of the Closest Facility for Pediatric Asthma Patients

Finlay, E.

Pediatric hospital care is becoming increasingly regionalized, with fewer facilities providing inpatient care for common conditions such as asthma. That trend has major implications for emergency medical services (EMS) medical care and operations because EMS historically transports patients to the closest facility. This study describes EMS transport patterns of pediatric asthma patients in greater depth, including an analysis of facility bypass rates and the association of bypass with demographics and clinical outcomes.

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A Review of COVID-19-Related Publications and Lag Times During the First Six Months of the Year 2020

Carvalho, CJ.

Considering the need for information regarding approaches to prevention and treatment of coronavirus disease 2019 (COVID-19), we sought to determine publication lag times of COVID-19-related original research articles published in top general medicine and emergency medicine (EM) journals. We further sought to characterize the types of COVID-19 publications within these journals.

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The FAST VIP (First Aid for Severe Trauma “Virtual” in-Person) Educational Study

Goolsby, CA.

Trauma is the leading cause of death for young Americans. Increased school violence, combined with an emphasis on early hemorrhage control, has boosted demand to treat injuries in schools. Meanwhile, coronavirus disease 2019 (COVID-19) has made educating the public about trauma more difficult. A federally funded high school education program in development, called First Aid for Severe Trauma™ (FAST™), will teach students to aid the severely injured. The program will be offered in instructor-led, web-based, and blended formats. We created a program to prepare high school teachers to become FAST instructors via “virtual” in-person (VIP) instruction. We used a webinar followed by VIP skills practice, using supplies shipped to participants’ homes. To our knowledge, no prior studies have evaluated this type of mass, widely distributed, VIP education.

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Management of Minor Traumatic Brain Injury in an ED Observation Unit

Wheatley, MA.

Traumatic intracranial hemorrhages (TIH) have traditionally been managed in the intensive care unit (ICU) setting with neurosurgery consultation and repeat head CT (HCT) for each patient. Recent publications indicate patients with small TIH and normal neurological examinations who are not on anticoagulation do not require ICU-level care, repeat HCT, or neurosurgical consultation. It has been suggested that these patients can be safely discharged home after a short period of observation in emergency department observation units (EDOU) provided their symptoms do not progress.

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Contact Information

WestJEM/ Department of Emergency Medicine
UC Irvine Health

3800 W Chapman Ave Ste 3200
Orange, CA 92868, USA
Phone: 1-714-456-6389
Email: editor@westjem.org

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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.