Brief Research Report Archives - Page 4 of 6 - The Western Journal of Emergency Medicine

Social Disconnection Among Older Adults Receiving Care in the Emergency Department

Kandasamy, MPH, et al.

This study describes the prevalence of social disconnection and patient interest in social resources to address social disconnection among older adults receiving emergency department (ED) care.

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Patient Communication

Obtaining History with a Language Barrier in the Emergency Department: Perhaps not a Barrier After All

Litzau, MD, et al.

Our study compared the medical histories obtained by physicians in the emergency department (ED) based on whether the patients primarily spoke English or Spanish.

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Using the Natural Experiment Study Design to Evaluate the Effect of a Change in Doctor’s Roster on Patient Flow in an Emergency Department

Hallas, MD, et al.

The effect of changes in doctors’ rosters is rarely subjected to scientific evaluation. We describe how a natural experiment (NE) study design can be used to evaluate if a managerial decision about doctors’ rosters has an effect on patient flow in an emergency department (ED).

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Cost of Routine Herpes Simplex Virus Infection Visits to U.S. Emergency Departments 2006–2013

Xia, AB, et al.

Little is known about emergency department (ED) utilization for herpes simplex viruses (HSV) types 1 and 2 in the United States. Our goal was to determine the utilization and cost burden associated with HSV infection visits to U.S. EDs in recent years from 2006–2013.

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Initial Standardized Framework for Reporting Social Media Analytics in Emergency Care Research

Roland, PhD, et al.

While tools exist to standardize the reporting of clinical studies and systematic reviews, there is no agreed framework for examining social media–based research. This article presents a publication and appraisal checklist for such work and invites further collaboration in the form of a Delphi technique to clarify, expand, improve, and validate the proposal.

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A Targeted Mindfulness Curriculum for Medical Students During Their Emergency Medicine Clerkship Experience

Chung, MD, et al.

We developed an innovative, mindfulness-based curriculum designed to be integrated into a standard EM clerkship for senior medical students to help students manage stress and reduce their risk of burnout.

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Endemic Infections

Comparing Quick Sequential Organ Failure Assessment Scores to End-tidal Carbon Dioxide as Mortality Predictors in Prehospital Patients with Suspected Sepsis

Hunter, MD, et al.

We conducted a retrospective cohort study among patients transported by emergency medical services to compare the use of ETCO2 ≤ 25 mmHg with qSOFA score of ≥ 2 as a predictor of mortality or diagnosis of severe sepsis in prehospital patients with suspected sepsis.

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Clinical Ultrasound Is Safe and Highly Specific for Acute Appendicitis in Moderate to High Pre-test Probability Patients

Corson-Knowles, MD, et al.

The goal of this study was to determine if a heterogeneous group of emergency physicians (EP) could diagnose acute appendicitis on CUS in patients with a moderate to high pre-test probability.

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Treatment Protocol Assessment

Ruling out Pulmonary Embolism in Patients with High Pretest Probability

Akhter, MD, et al.

We sought to measure the ability of negative computed tomography pulmonary angiography (CTPA) along with negative D-dimer to rule out PE in these high-risk patients.

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Decreased Nursing Staffing Adversely Affects Emergency Department Throughput Metrics

Ramsey, MD, et al.

The effect of nurse staffing on emergency department (ED) efficiency remains a significant area of interest to administrators, physicians, and nurses. We believe that decreased nursing staffing adversely affects key ED throughput metrics.

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Endemic Infections

A Predictive Model Facilitates Early Recognition of Spinal Epidural Abscess in Adults

Artenstein, MD, et al.

Spinal epidural abscess (SEA), a highly morbid and potentially lethal deep tissue infection of the central nervous system has more than tripled in incidence over the past decade. Early recognition at the point of initial clinical presentation may prevent irreversible neurologic injury or other serious, adverse outcomes. To facilitate early recognition of SEA, we developed a predictive scoring model.

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A Tactical Medicine After-action Report of the San Bernardino Terrorist Incident

Bobko, MD, et al.

On December 2, 2015, terrorism landed in Southern California when two perpetrators aligned with the Islamic State (IS), murdered and wounded 38 civilians at the Inland Regional Center of San Bernardino, California.

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By Default: The Effect of Prepopulated Prescription Quantities on Opioid Prescribing in the Emergency Department

Santistevan, MD, et al.

To date, there have been limited studies on the effect of default tablet quantities as part of emergency department (ED) electronic order entry. Our goal was to evaluate opioid prescribing patterns before and after the removal of a default quantity of 20 tablets from ED electronic order entry.

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Emergency Department Frequent Users for Acute Alcohol Intoxication

Klein, MD, et al.

This was a retrospective, observational, cohort study of ED patients presenting for acute alcohol intoxication from 2012 to 2016. The study hospital is a county ED with an annual volume of 100,000 visits and 7,000 visits for alcohol intoxication.

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Critical Care

Addition of Audiovisual Feedback During Standard Compressions Is Associated with Improved Ability

Aguilar, MD, et al.

A benefit of in-hospital cardiac arrest is the opportunity for rapid initiation of “high-quality” chest compressions as defined by current American Heart Association (AHA) adult guidelines as a depth 2–2.4 inches, full chest recoil, rate 100–120 per minute, and minimal interruptions with a chest compression fraction (CCF) ≥ 60%. The goal of this study was to assess the effect of audiovisual feedback on the ability to maintain high-quality chest compressions as per 2015 updated guidelines.

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Training in Emergency Obstetrics: A Needs Assessment of U.S. Emergency Medicine Program Directors

Robinson, MD, et al.

While U.S. emergency medicine (EM) residency graduates are required to perform 10 low-risk normal spontaneous vaginal deliveries, little is known about how residencies prepare residents to manage obstetrical emergencies. We sought to profile the current obstetrical training curricula through a survey of U.S. training programs.

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Emergency Department Utilization by Children in the USA, 2010–2011

Goto, MD, et al.

Epidemiological surveillance data for emergency department (ED) visits by children are imperative to guide resource allocation and to develop health policies that advance pediatric emergency care. However, there are sparse population-based data on patient-level information (e.g., the number of children who present to the emergency department [ED]). In this context, we aimed to investigate both the patient- and visit-level rates of ED utilization by children.

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Characterizing New England Emergency Departments by Telemedicine Use

Zachrison, MD, et al.

Telemedicine connects emergency departments (ED) with resources necessary for patient care; its use has not been characterized nationally, or even regionally. Our primary objective was to describe the prevalence of telemedicine use in New England EDs and the clinical applications of use. Secondarily, we aimed to determine if telemedicine use was associated with consultant availability and to identify ED characteristics associated with telemedicine use.

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Emergency Department Operations

Magnetic Resonance Imaging Utilization in an Emergency Department Observation Unit

Sánchez, BA, et al.

Emergency department observation units (EDOUs) are a valuable alternative to inpatient admissions for ED patients needing extended care. However, while the use of advanced imaging is becoming more common in the ED, there are no studies characterizing the use of magnetic resonance imaging (MRI) examinations in the EDOU.

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Pediatric Patients Discharged from the Emergency Department with Abnormal Vital Signs

Winter, MPH, et al.

Children often present to the emergency department (ED) with minor conditions such as fever and have persistently abnormal vital signs. We hypothesized that a significant portion of children discharged from the ED would have abnormal vital signs and that those discharged with abnormal vital signs would experience very few adverse events.

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Pediatric Exposures to Topical Benzocaine Preparations Reported to a Statewide Poison Control System

Vohra, MD, et al.

Topical benzocaine is a local anesthetic commonly used to relieve pain caused by teething, periodontal irritation, burns, wounds, and insect bites. Oral preparations may contain benzocaine concentrations ranging from 7.5% to 20%. Pediatric exposure to such large concentrations may result in methemoglobinemia and secondarily cause anemia, cyanosis, and hypoxia.

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Screening for Victims of Sex Trafficking in the Emergency Department: A Pilot Program

Bryn E. Mumma, MD, MAS, et al.

Our primary objective in this study was to evaluate the feasibility of a screening survey to identify adult victims of sex trafficking in the ED. We also compared the sensitivity of emergency physician concern and a screening survey for identifying sex trafficking victims in the ED and determined the most effective question(s) for identifying adult victims of sex trafficking.

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Difference in R01 Grant Funding Among Osteopathic and Allopathic Emergency Physicians over the Last Decade

Martina Antony, DO, et al.

The aim of the study was to determine if a medical degree disparity exists between those who successfully receive an EM R01 grant and those who do not, and to determine the publication characteristics of those recipients.

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Treatment Protocol Assessment

A Patient-Centered Emergency Department Management Strategy for Sickle-Cell Disease Super-Utilizers

Grant G. Simpson, BS, et al.

A subpopulation of sickle-cell disease patients, termed super-utilizers, presents frequently to emergency departments (EDs) for vaso-occlusive events and may consume disproportionate resources without broader health benefit.

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Cross-Sectional Study of Risky Substance Use by Injured Emergency Department Patients

Valerie Strezsak, MS, et al.

Survey data regarding the prevalence of risky substance use in the emergency department (ED) is not consistent. The objective of this study was to identify the prevalence of risky substance use among injured ED patients based on the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST v3.0).

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“Choosing Wisely” Imaging Recommendations: Initial Implementation in New England Emergency Departments

Ali S. Raja, MD, MBA, MPH, et al,

In June 2016, the American College of Emergency Physicians (ACEP) Emergency Quality Network began its Reduce Avoidable Imaging Initiative, designed to “reduce testing and imaging with low risk patients through the implementation of Choosing Wisely recommendations.”

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