Editorial Archives - The Western Journal of Emergency Medicine

Endemic Infections

Sex- and Gender-specific Observations and Implications for COVID-19

Walter, MD, et al.

Angiotensin-converting enzyme 2 (ACE2) and its role in viral transmission and associated morbidity has also been a topic of recent COVID-19 associated discussion. ACE2 receptors on pulmonary endothelium serve as a main entry point for coronavirus.

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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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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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Another Perspective on Cannabis and Emergency Medicine in Colorado

Heard, MD, et al.

This editorial is written in response to Roberts BA. Legalized Cannabis in Colorado Emergency Departments: A Cautionary Review of Negative Health and Safety Effects.

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Case for Open Access and the Current Situation with the University of California and Elsevier

Renaud, M.Ed, et al.

In recent months, the University of California has gained significant attention for taking a strong stance in support of open access publishing of UC research as it negotiates new agreements with major journal publishers.

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We Need Our Village: CORD’s Response to the ACGME’s Common Program Requirements

Moreira, MD, et al.

Until 2019, the Emergency Medicine ACGME (Accreditation Council for Graduate Medical Education) program requirements stated that institutions were required to provide protected non-clinical time for core faculty. Specifically, core faculty could not be required to generate clinical or other income to support that protection. These core faculty could not average more than 28 clinical hours per week, or 1344 clinical hours per year. In the new proposed program requirements, the requirement to ensure this non-clinical time has been removed.

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Design Your Clinical Workplace to Facilitate Competency-Based Education

Caretta-Weyer, MD, MHPE, et al.

The true intent of the ACGME Milestones is to represent the developmental trajectory of a resident over time. The variability in faculty ratings, which may initially seem frustrating, are instead intentionally important to the process of monitoring development in our trainees. There is no perfect assessment tool and there will be variability in assessments. And that’s okay.

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Show Me the Money: Successfully Obtaining Grant Funding in Medical Education

Gottlieb, MD, et al.

This paper provides an overview of the importance of grant funding within medical education, followed by a stepwise discussion of strategies for creating a successful grant application for medical education-based proposals.

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The Evolving Definition of Education Scholarship: What the Clinician Educator Needs to Know

Ander, MD, et al.

Medical education is faced with a growing number of challenges. The playing field that most of us know and recognize has been evolving over the past decade.

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Clinical Reasoning: Defining It, Teaching It, Assessing It, Studying It

Gruppen, PhD, et al.

Like the fable of the blind men and the elephant, each of whom, feeling a different part of the elephant, described it in very different ways, clinical reasoning is a vast, complex construct that is described and used in different ways by different people

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Treatment Protocol Assessment

Even the Thinnest Salami Contains Some Meat

Walsh, MB, et al.

This study is a secondary analysis of a subset of patients admitted to the hospital or pediatric intensive care unit in the Multicenter Airway Research Collaboration (http://www.emnet-usa.org).

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In the U.S. “Healthcare” Is Now Strictly a Business Term

Sawyer, MD.

Healthcare organizes doctors and patients into a system where that relationship can be financially exploited and as much money extracted as often as possible by hospitals, clinics, health insurers, the pharmaceutical industry, and medical device manufacturers.

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Isolated Hand Palsy in National Institutes of Health Stroke Scale (NIHSS): Is It Useful?

Siniscalchi, MD, et al.

The meaning of stroke-survivor recovery should be described by more sophisticated measures than are required by simple dichotomous end points, i.e., mortality or stroke recurrence.

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Just Missing the Mark: Discharging High-risk Atrial Fibrillation / Flutter without Thromboprophylaxis

Thompson, MD, et al.

In this issue of WestJEM, Smith and colleagues present a prospective observational evaluation of anticoagulation prescribing practices in non-valvular AF. Patients presenting to one of seven Northern California EDs with AF at high risk for stroke were eligible unless admitted, not part of Kaiser Permanente of Northern California (KPNC), or already prescribed anticoagulation

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Impact Factor for WestJEM

Langdorf, MD.

I want to take this opportunity to update our readers, reviewers, and supporters regarding the growth and stature of the Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health (WestJEM). We continue to grow and thrive, extending our scope and reach throughout the nation and the world.

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Societal Impact on Emergency Care

Why Emergency Physicians Should Care About the Salton Sea

Marshall, MD.

Currently, emergency departments in Imperial County treat three times more pediatric asthma visits than elsewhere in California.5,6 Recently, there has been new governmental, academic, and community interest in this issue, and as emergency physicians we have a unique opportunity to become involved in the health of the Salton Sea as well as the surrounding community.

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Societal Impact on Emergency Care

Why the EMTALA Mandate for Emergency Care Does not Equal Healthcare “Coverage”

Nicolas T. Sawyer, MD, MBA.

House GOP members Rep. Mark Meadows (R-NC) and Rep. Raúl Labrador (R-ID) recently made alarming and misleading statements about American emergency departments’ role in U.S. healthcare.

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Community Paramedicine: 911 Alternative Destinations Are a Patient Safety Issue

Author Affiliation Nick T. Sawyer, MD, MBA University of California, Davis, Department of Emergency Medicine, Sacramento, California; California American College of Emergency Physicians Board of Directors John D. Coburn, MD The Permanente Medical Group, South Sacramento Kaiser, Department of Emergency Medicine, Sacramento, California; California American College of Emergency Physicians Board of Directors Under-triage is a […]

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Management of Sickle Cell Disease Super Utilizers

Author Affiliation Gary A. Johnson, MD SUNY Upstate Medical University, Department of Emergency Medicine, Syracuse, New York Much attention has been directed toward super utilizers of emergency department (ED) and hospital services. Often these patients have a chronic illness with significant potential for acute morbidity. In many settings, adults with sickle cell disease (SCD) […]

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Blog and Podcast Watch: Cutaneous Emergencies

Andrew Grock, MD, et al.

The WestJEM Blog and Podcast Watch presents high quality open-access educational blogs and podcasts in emergency medicine (EM) based on the ongoing Academic Life in Emergency Medicine (ALiEM) Approved Instructional Resources (AIR) and AIR-Professional series.

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Injury Prevention

Are Usual and Customary Charges Reasonable?

R. Myles Riner, MD

An editorial about the use of usual and customary charges for out-of-network benefit determinations.

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Why the Watchdog Won’t Bite: U.S. Food and Drug Administration Challenges

Joe Lex, MD

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Emergency Medicine Scholarship in the Digital Age

Emergency Medicine Scholarship in the Digital Age
Langdorf, MD, MHPE, et al.

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Growing a Specialty-Specific Community of Practice in Education Scholarship

Volume 16, Issue 6, November 2015.
Jeffrey N. Love, MD, et al.

Emergency medicine (EM) educators have many
masters. These include our hospital administrations who
expect efficient patient care reflecting the priorities of safety
and quality, the accreditation council for graduate medical
education which has introduced a new competency-based
standard by which our learners must be educated, and last but
not least, our learners that are using new educational modalities
based on expanding digital platforms. To be successful,
educators must satisfy each of these masters against the
backdrop of increasing regulations, decreasing funding and
information technology that appears to decrease our time with
patients and perhaps learners in clinical practice.

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Emergency Medicine: On the Frontlines of Medical Education Transformation

Volume 16, Issue 6, November 2015.
Eric S. Holmboe, MD

Emergency medicine (EM) has always been on the frontlines of healthcare in the United States.
I experienced this reality first hand as a young general medical officer assigned to an emergency
department (ED) in a small naval hospital in the 1980s. For decades the ED has been the only site
where patients could not be legally denied care. Despite increased insurance coverage for millions of
Americans as a result of the Affordable Care Act, ED directors report an increase in patient volumes
in a recent survey.1
EDs care for patients from across the socioeconomic spectrum suffering from a
wide range of clinical conditions. As a result, the ED is still one of few components of the American
healthcare system where social justice is enacted on a regular basis. Constant turbulence in the
healthcare system, major changes in healthcare delivery, technological advances and shifting
demographic trends necessitate that EM constantly adapt and evolve as a discipline in this complex
environment.

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