Population Health Policy Archives - The Western Journal of Emergency Medicine

Endemic Infections

Dengue, Zika and Chikungunya: Emerging Arboviruses in the New World

Jessica Patterson, MD et al.

The arboviruses that cause dengue, chikungunya, and Zika illnesses have rapidly expanded across the globe in recent years, with large-scale outbreaks occurring in Western Hemisphere territories in close proximity to the United States (U.S.). In March 2016, the Centers for Disease Control and Protection (CDC) expanded its vector surveillance maps for A. aegypti and A. albopictus, the mosquito vectors for these arboviruses.

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Characterization of Chemical Suicides in the United States and Its Adverse Impact on Responders and Bystanders

Ayana R. Anderson, MPH

A suicide trend that involves mixing household chemicals to produce hydrogen sulfide or hydrogen cyanide, commonly referred to as a detergent, hydrogen sulfide, or chemical suicide is a continuing problem in the United States (U.S.). Because there is not one database responsible for tracking chemical suicides, the actual number of incidents in the U.S. is unknown. To prevent morbidity and mortality associated with chemical suicides, it is important to characterize the incidents that have occurred in the U.S.

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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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Healthcare Utilization

Alternative Destination Transport? The Role of Paramedics in Optimal Use of the Emergency Department

Michael M. Neeki, DO, MS et al.

Alternative destination transportation by emergency medical services (EMS) is a subject of hot debate between those favoring all patients being evaluated by an emergency physician (EP) and those recognizing the need to reduce emergency department (ED) crowding. This study aimed to determine whether paramedics could accurately assess a patient’s acuity level to determine the need to transport to an ED.

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Healthcare Utilization

Utility of Chest Radiography in Emergency Department Patients Presenting with Syncope

Matthew L. Wong, MD, MPH et al.

Syncope has myriad etiologies, ranging from benign to immediately life threatening. This frequently leads to over testing. Chest radiographs (CXR) are among these commonly performed tests despite their uncertain diagnostic yield. The objective is to study the distribution of normal and abnormal chest radiographs in patients presenting with syncope, stratified by those who did or did not have an adverse event at 30 days

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Variation of Blunt Traumatic Injury with Age in Older Adults: Statewide Analysis 2011–14

Emily Earl-Royal, MD, MPH et al.

Traumatic injury is a leading cause of death and disability in adults ≥ 65 years old, but there are few epidemiological studies addressing this issue. The aim of this study was to assess how characteristics of blunt traumatic injuries in adults ≥ 65 vary by age.

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U.S. Food and Drug Administration: Review for the Emergency Physician of Approval Process and Limitations

Nadia Zuabi, BS et al.

Emergency physicians (EP) frequently are exposed to promotion for drugs and devices through professional organizations and meetings, journals, and direct-to-consumer pharmaceutical advertising (DTCPA). To provide optimum patient care through evidence-based medicine, it is critical to be aware of the processes that regulate these drugs.

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Use of Physician Concerns and Patient Complaints as Quality Assurance Markers in Emergency Medicine

Kiersten L. Gurley, MD et al.

The value of using patient- and physician-identified quality assurance (QA) issues in emergency medicine remains poorly characterized as a marker for emergency department (ED) QA. The objective of this study was to determine whether evaluation of patient and physician concerns is useful for identifying medical errors resulting in either an adverse event or a near-miss event.

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Adapting the I-PASS Handoff Program for Emergency Department Inter-Shift Handoffs

Author Affiliation James A. Heilman, MD Oregon Health & Science University, Department of Emergency Medicine, Portland, Oregon Moira Flanigan, BS Oregon Health & Science University, Department of Emergency Medicine, Portland, Oregon Anna Nelson, MD, PhD Oregon Health & Science University, Department of Emergency Medicine, Portland, Oregon Tom Johnson, MD, PhD Oregon Health & Science University, […]

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Critical Care

Autoinjectors Preferred for Intramuscular Epinephrine in Anaphylaxis and Allergic Reactions

Ronna L. Campbell, MD, PhD et al.

Epinephrine is the treatment of choice for anaphylaxis. We surveyed emergency department (ED) healthcare providers regarding two methods of intramuscular (IM) epinephrine administration (autoinjector and manual injection) for the management of anaphylaxis and allergic reactions and identified provider perceptions and preferred method of medication delivery.

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Hours and Miles: Patient and Health System Implications of Transfer for Psychiatric Bed Capacity

Amy M. O’Neil, MD et al.

An increasing number of behavioral health (BH) patients are presenting to the emergency department (ED) while BH resources continue to decline. This situation-may lead to more external transfers to find care.

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Impact of Prior Therapeutic Opioid Use by Emergency Department Providers on Opioid Prescribing Decisions

Adam C. Pomerleau, MD et al.

Our study sought to examine the opioid analgesic (OA) prescribing decisions of emergency department (ED) providers who have themselves used OA therapeutically and those who have not. A second objective was to determine if OA prescribing decisions would differ based on the patient’s relationship to the provider.

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Opioid Dependent Malingerer with Self-Induced Sepsis

Kelly A. Kesler, MD et al.

A 21-year-old woman was admitted to the emergency department (ED) with severe sepsis. Both the mechanism of infection and organisms discovered were unusual.

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E-cigarette Blast Injury: Complex Facial Fractures and Pneumocephalus

Benjamin A. Archambeau, DO et al.

Electronic cigarettes (also known as e-cigarettes or e-cigs) are becoming a popular method of recreational nicotine use over recent years. The growth of new brands and devices has been outpacing the FDA’s ability to regulate them. As a result, some of these devices fail without warning, most likely from malfunction of the lithium-ion batteries that are in close proximity to volatile compounds within the device.

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