Articles Archives - Page 16 of 40 - The Western Journal of Emergency Medicine

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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Evaluating the Diversity of Emergency Medicine Foundation (EMF) Grant Recipients in the Last Decade

Gordon, MD, et al.

To study diversity of researchers and barriers to success among Emergency Medicine Foundation (EMF) grant recipients in the last 10 years.

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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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Endemic Infections

Scabies: Application of the Novel Identify-Isolate-Inform Tool for Detection and Management

Cheng, MD, et al.

Scabies is a highly contagious, globally prevalent, parasitic skin infestation caused by Sarcoptes scabiei var. hominis, also known as the itch mite. There have been outbreaks not only in the developing world, but also in the developed world among refugees and asylum seekers.

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Endemic Infections

2019-nCoV: The Identify-Isolate-Inform (3I) Tool Applied to a Novel Emerging Coronavirus

Koenig, MD, et al.

This paper reports a modification of the 3I Tool for use in the initial detection and management of patients under investigation for 2019-nCoV. After initial assessment for symptoms and epidemiological risk factors, including travel to affected areas and exposure to confirmed 2019-nCoV patients within 14 days, patients are classified in a risk-stratified system.

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Using Tenecteplase for Acute Ischemic Stroke: What Is the Hold Up?

Zitek, MD, et al.

This narrative review evaluates the literature and addresses the practical issues with regards to the use of tenecteplase versus alteplase for acute ischemic stroke, and it recommends that physicians consider tenecteplase rather than alteplase for thrombolysis of acute ischemic stroke.

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Human Papillomavirus Awareness, Vaccine Status, and Risk Factors in Female Emergency Patients

Walter, MD, et al.

This study sought to gather information pertaining to HPV and cervical cancer risk factors, awareness of HPV and the vaccine, as well as HPV vaccine uptake in female patients presenting to an ED.

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Healthcare Utilization

Changes in Emergency Department Care Intensity from 2007–16: Analysis of the National Hospital Ambulatory Medical Care Survey

Chou, MD, MPH, et al.

The goal of this analysis was to examine the changes in ED care intensity in this context through the changes in ED patient population and ED care provided.

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Safety and Efficacy of Hospital Utilization of Tranexamic Acid in Civilian Adult Trauma Resuscitation

Neeki, DO, et al.

Patients with trauma-induced coagulopathies may benefit from the use of antifibrinolytic agents, such as tranexamic acid (TXA). This study evaluated the safety and efficacy of TXA in civilian adults hospitalized with traumatic hemorrhagic shock.

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Critical Care

Screening for QT Prolongation in the Emergency Department: Is There a Better “Rule of Thumb?”

Rischall, MD, et al.

Many emergency clinicians rely on the “rule of thumb” or “Half the RR” rule (Half-RR) as an initial screening method, but prior studies have shown that the Half-RR rule performs poorly as compared to other QT assessment methods. We sought to characterize the problems associated with the Half-RR rule and find a modified screening tool to more safely assess the QT interval of ED patients for prolonged QT.

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Bridging the Gap in Emergency Medicine in Pakistan

Saleem, MBBS, et al.

Pakistan has an increasing need for a strong emergency care system as emergency conditions – acute cardiovascular disease, road injuries, and stroke – form the top 10 leading causes of death.

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Penalties for Emergency Medical Treatment and Labor Act Violations Involving Obstetrical Emergencies

Terp, MD, MPH, et al.

The Emergency Medical Treatment and Labor Act (EMTALA) was intended to prevent inadequate, delayed, or denied treatment of emergent conditions by emergency departments (ED). While controversies exist regarding the scope of the law, there is no question that EMTALA applies to active labor, a key tenet of the statute and the only medical condition – labor – specifically included in the title of the law.

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The EMTALA Loophole in Psychiatric Care

Schmalz, MD, MPH, et al.

Overhead page: “Code Gray in bed 32.” You find an agitated, combative, and clearly frightened woman in her thirties.

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Provider Workforce

Public Performance Metrics: Driving Physician Motivation and Performance

Jen, MD, et al.

Our objective was to determine whether displaying public performance metrics of physician triage data could drive intangible motivators and improve triage performance in the ED.

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Provider Workforce

#MeToo in EM: A Multicenter Survey of Academic Emergency Medicine Faculty on Their Experiences with Gender Discrimination and Sexual Harassment

Lu, MD, et al.

Gender-based discrimination and sexual harassment of female physicians are well documented. The #MeToo movement has brought renewed attention to these problems. This study examined academic emergency physicians’ experiences with workplace gender discrimination and sexual harassment.

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Emergency Department Clinicians’ Attitudes Toward Opioid Use Disorder and Emergency Department-initiated Buprenorphine Treatment: A Mixed-Methods Study

Im, MD, et al.

Emergency department (ED) visits related to opioid use disorder (OUD) have increased nearly twofold over the last decade. Treatment with buprenorphine has been demonstrated to decrease opioid-related overdose deaths. In this study, we aimed to better understand ED clinicians’ attitudes toward the initiation of buprenorphine treatment in the ED.

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