Epidemiology of Patients with Head Injury at a Tertiary Hospital in Rwanda
Introduction: Traumatic injuries disproportionately affect populations in low and middle-income countries (LMIC) where head injuries predominate. The Rwandan Ministry of Health (MOH) has dramatically improved access to emergency services by rebuilding its health infrastructure. The MOH has strengthened the nation ’s acute emergency response by renovating emergency departments (ED), developing the field of emergency medicine as a specialty, and establishing a prehospital care service: Service d’Aide Medicale Urgente (SAMU). Despite the prevalence of traumatic injury in LMIC and the evolving emergency serv ice in...
Source: Western Journal of Emergency Medicine - September 17, 2021 Category: Emergency Medicine Source Type: research

WestJEM Full-Text Issue
(Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - September 8, 2021 Category: Emergency Medicine Source Type: research

Call For Emergency Action to Limit Global Temperature Increases, Restore Biodiversity, and Protect Health Wealthy nations must do much more, much faster
(Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - September 7, 2021 Category: Emergency Medicine Source Type: research

Enroller Experience and Parental Familiarity of Disease Influence Participation in a Pediatric Trial
In this study we investigated demographic, clinical, and environmental factors associated with likelihood of parental permission for enrollment in a study of therapies for diabetic ketoacidosis (DKA) in children.Methods: We analyzed data from patients and parents who were approached for enrollment in the Pediatric Emergency Care Applied Research Network (PECARN) Fluid Therapies Under Investigation in DKA (FLUID) trial at one major participating center. We determined the influence of various factors on patient enrollment, including gender, age, distance from home to hospital, insurance status, known vs new onset of diabetes...
Source: Western Journal of Emergency Medicine - September 7, 2021 Category: Emergency Medicine Source Type: research

Mobile Crisis Outreach and Emergency Department Utilization: A Propensity Score-matched Analysis
We report descriptive statistics and... (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - September 3, 2021 Category: Emergency Medicine Source Type: research

WestJEM Will No Longer Use the Term “Provider” to Refer to Physicians
WestJEM Will No Longer Use the Term “Provider” to Refer to Physicians (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - September 2, 2021 Category: Emergency Medicine Source Type: research

This Article Corrects: ”Assessment of Physician Well-being, Part One: Burnout and Other Negative States”
This Article Corrects: ”Assessment of Physician Well-being, Part One: Burnout and Other Negative States” (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - September 2, 2021 Category: Emergency Medicine Source Type: research

A Multivariable Model of Parent Satisfaction, Pain, and Opioid Administration in a Pediatric Emergency Department
We examined data from a tertiary pediatric care facility. A health survey questionnaire was administered after ED discharge to capture the outcome of parental likelihood of providing a positive facility rating. We abstracted patient demographic, clinical, and top diagnostic information using electronic health records.... (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - September 2, 2021 Category: Emergency Medicine Source Type: research

Impact of COVID-19 and Shelter in Place on Volume and Type of Traumatic Injuries
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.Methods: The study was a retrospective chart review of all patients who presented to the ED of an urban Level I Trauma Center and its urban community affiliate in the time period during the 30 days before the institution of city-wide shelter-in-place (preSIP) order and 60 days after the shelter-in-place (SIP) order and the date-matched time periods in the preceding year. Volume and mechanism of traumatic injuries were compared using paired T-tests.  Results: There was a signi...
Source: Western Journal of Emergency Medicine - September 2, 2021 Category: Emergency Medicine Source Type: research

Cervical Spine Injuries in Older Patients with Falls Found on Magnetic Resonance Imaging After Computed Tomography
In this study we aimed to determine the rate of traumatic abnormalities on cervical spine magnetic resonance imaging (MRI) after a normal cervical spine computed tomography (CT) in older patients with ground-level falls. We hypothesized that MRI is low yield following a normal physical examination and normal CT after a ground-level fall. Methods: This was a retrospective cohort study of patients 65 years and older evaluated with a cervical spine MRI following a ground-level fall. Inclusion criteria included age 65 years and older, ground-level fall, normal cervical spine CT followed by a cervical spine MRI. We abstrac...
Source: Western Journal of Emergency Medicine - September 2, 2021 Category: Emergency Medicine Source Type: research

Radiology Education Among Emergency Medicine Residencies: A National Needs Assessment
Introduction: 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.Methods: This was a cross-sectional survey study of all Accreditation Council for Graduate Medical Education-accredited EM programs in the United States. Program leadership completed an online survey consisting of multip...
Source: Western Journal of Emergency Medicine - September 2, 2021 Category: Emergency Medicine Source Type: research

Mortality Variations of COVID-19 from Different Hospital Settings During Different Pandemic Phases: A Multicenter Retrospective Study
This study aims to investigate the mortality variations of COVID-19 from different hospital settings during different pandemic phases.Methods: We retrospectively included adult ( ≥18 years) patients who visited emergency departments (ED) of five hospitals in the state of Texas and who were diagnosed with COVID-19 between March–November 2020. The included hospitals were dichotomized into urban and suburban based on their geographic location. The primary outcome was mortal ity that occurred either during hospital admission or within 30 days after the index ED visit. We used multivariable logistic regression to inves...
Source: Western Journal of Emergency Medicine - September 2, 2021 Category: Emergency Medicine Source Type: research

Evaluation of the Initial General Ward Early Warning Score and ICU Admission, Hospital Length of Stay and Mortality
Introduction: Despite widespread implementation of the Early Warning Score (EWS) in hospitals, its effect on patient outcomes remains mostly unknown. We aimed to evaluate associations between the initial EWS and in-hospital mortality, intensive care unit (ICU) admission, and hospital length of stay (LOS). Methods: We performed a retrospective cohort study of adult patients admitted to a general hospital ward between July 1, 2014 –December 31, 2017. Data were obtained from electronic health records (EHR). The primary outcome was in-hospital mortality. Secondary outcomes were ICU admission and hospital LOS. We cat...
Source: Western Journal of Emergency Medicine - September 2, 2021 Category: Emergency Medicine Source Type: research

Enroller Experience and Parental Familiarity of Disease Influence Participation in a Pediatric Trial
In this study we investigated demographic, clinical, and environmental factors associated with likelihood of parental permission for enrollment in a study of therapies for diabetic ketoacidosis (DKA) in children.Methods: We analyzed data from patients and parents who were approached for enrollment in the Pediatric Emergency Care Applied Research Network (PECARN) Fluid Therapies Under Investigation in DKA (FLUID) trial at one major participating center. We determined the influence of various factors on patient enrollment, including gender, age, distance from home to hospital, insurance status, known vs new onset of diabetes...
Source: Western Journal of Emergency Medicine - September 2, 2021 Category: Emergency Medicine Source Type: research

Balancing Efficiency and Access: Discouraging Emergency Department Boarding in a Global Budget System
Reducing cost without sacrificing quality of patient care is an important yet challenging goal for healthcare professionals and policymakers alike. This challenge is at the forefront in the United States, where per capita healthcare costs are much higher than in similar countries around the world. The state of Maryland is unique in the hospital financing landscape due to its “capitation” payment system (also known as “global budget”), in which revenue for hospital-based services is set at the beginning of the year. Although Maryland’s system has yielded many benefits, including reduced Medicar...
Source: Western Journal of Emergency Medicine - September 2, 2021 Category: Emergency Medicine Source Type: research

Cannabis in Homes with Children: A Survey on Use, Storage, and Attitudes
Introduction: 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.Methods: We administered electronic surveys to 401 adults in a pediatric emergency department in California. Parti...
Source: Western Journal of Emergency Medicine - September 2, 2021 Category: Emergency Medicine Source Type: research

Outcomes Associated with Lower Doses of Ketamine by Emergency Medical Services for Profound Agitation
We report descriptive analyses of patient-level prehospital clinical data and ED outcomes. The primary outcome was proportion of patients intubated in the ED. Results:... (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - August 31, 2021 Category: Emergency Medicine Source Type: research

Inpatient Outcomes Following a Return Visit to the Emergency Department: A Nationwide Cohort Study
Introduction: 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.Methods: This was a retrospective cohort study using the National Health Insurance Research Database in Taiwan. One-third of ED visits from 2012 –2013 were randomly selected and their subsequent hospitalizations included. We analyzed the inpati...
Source: Western Journal of Emergency Medicine - August 30, 2021 Category: Emergency Medicine Source Type: research

Positive Toxicology Results Are Not Associated with Emergency Physician ’s Opioid Prescribing Behavior
Introduction: Given the general lack of literature on opioid and naloxone prescribing guidelines for patients with substance use disorder, we aimed to explore how a physician ’s behavior and prescribing habits are altered by knowledge of the patient’s concomitant use of psychotropic compounds as evident on urine and serum toxicology screens.Methods: We conducted a retrospective chart review study at a tertiary, academic, Level I trauma center between November 2017 –October 2018 that included 358 patients who were discharged from the emergency department (ED) with a diagnosis of fracture, dislocation, or a...
Source: Western Journal of Emergency Medicine - August 30, 2021 Category: Emergency Medicine Source Type: research

A Clinical Prediction Tool for MRI in Emergency Department Patients with Spinal Infection
Introduction: Patients with pyogenic spinal Infection (PSI) are often not diagnosed at their initial presentation, and diagnostic delay is associated with increased morbidity and medical-legal risk. We derived a decision tool to estimate the risk of spinal infection and inform magnetic resonance imaging (MRI) decisions.Methods: We conducted a two-part prospective observational cohort study that collected variables from spine pain patients over a six-year derivation phase. We fit a multivariable regression model with logistic coefficients rounded to the nearest integer and used them for variable weighting in the final risk ...
Source: Western Journal of Emergency Medicine - August 30, 2021 Category: Emergency Medicine Source Type: research

The Use of Dexmedetomidine in the Emergency Department: A Cohort Study
Introduction: Management of sedation, analgesia, and anxiolysis are cornerstone therapies in the emergency department (ED). Dexmedetomidine (DEX), a central alpha-2 agonist, is increasingly being used, and intensive care unit (ICU) data demonstrate improved outcomes in patients with respiratory failure. However, there is a lack of ED-based data. We therefore sought to: 1) characterize ED DEX use; 2) describe the incidence of adverse events; and 3) explore factors associated with adverse events among patients receiving DEX in the ED.Methods: This was a single-center, retrospective, cohort study of consecutive ED patients ad...
Source: Western Journal of Emergency Medicine - August 23, 2021 Category: Emergency Medicine Source Type: research

Cancer-related Emergency Department Visits: Comparing Characteristics and Outcomes
Introduction: There is increasing appreciation of the challenges of providing safe and appropriate care to cancer patients in the emergency department (ED). Our goal here was to assess which patient characteristics are associated with more frequent ED revisits.Methods: This was a retrospective cohort study of all ED visits in California during the 2016 calendar year using data from the California Office of Statewide Health Planning and Development. We defined revisits as a return visit to an ED within seven days of the index visit. For both index and return visits, we assessed various patient characteristics, including age...
Source: Western Journal of Emergency Medicine - August 22, 2021 Category: Emergency Medicine Source Type: research

Toxicologic Exposures in California Emergency Departments in 2011 and Its Risk Factors
Introduction: 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.Methods: This was a cross-sectional study. We used data from the California State Emergency Department Database (SEDD) 2011 for statistical analysis.Results: The study included 10,124,598 ED visits in California in 2011....
Source: Western Journal of Emergency Medicine - August 22, 2021 Category: Emergency Medicine Source Type: research

Comparing Physician Assistant and Nurse Practitioner Practice in U.S. Emergency Departments, 2010 –2017
Conclusion:... (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - August 21, 2021 Category: Emergency Medicine Source Type: research

National Survey of Point-of-Care Ultrasound Scholarly Tracks in Emergency Medicine Residency Programs
In this study we sought to determine the prevalence, characteristics, and outcomes of POCUS scholarly tracks in emergency medicine (EM).Methods: This was a cross-sectional survey of EM residency programs accredited by the Accreditation Council for Graduate Medical Education. Surveys were distributed between March-August 2020 using a listserv followed by targeted emails to residency and ultrasound leadership. We summarized data using descriptive statistics, and performed logistic regression to identify factors associated with a POCUS scholarly track.Results:... (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - August 21, 2021 Category: Emergency Medicine Source Type: research

Does the Medical Student Performance Evaluation Change the Decision to Invite Residency Applicants?
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. Methods: We conducted a prospective, observational study analyzing applications to three EM residency programs during the 2019-2020 match cycle. Reviewers assessed applications and rated the LTI on a five-point Likert scale where LTI was defined as follows: 1 = definitely no; 2 = probably... (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - August 21, 2021 Category: Emergency Medicine Source Type: research

A Global Survey of Emergency Department Responses to the COVID-19 Pandemic
Introduction: 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.Methods: We electronically surveyed EMERGE and non-EMERGE EDs from April 3 –June 1, 2020 on ED capacity, pandemic preparedness plans, triage methods, staffing, supplies, and communication practices. The survey was available in English, Mandari...
Source: Western Journal of Emergency Medicine - August 21, 2021 Category: Emergency Medicine Source Type: research

Emergency Department Visits by Patients with Substance Use Disorder in the United States
Introduction: We aimed to characterize emergency department (ED) utilization and clinical characteristics of patients with substance use disorder (SUD) seeking emergency care for all reasons.Methods: Using 2016 –2017 ED data from the National Hospital Ambulatory Medical Care Survey, we investigated demographics, ED resource utilization, and clinical characteristics of patients with SUD vs those without SUD. Results: Of all adult ED visits (N = 27,609) in the US in 2016 –2017, 11.1% of patients had SUD. Among ED patients with SUD, they were mostly non-Hispanic White (62.5%) and were more likely to be male (...
Source: Western Journal of Emergency Medicine - August 19, 2021 Category: Emergency Medicine Source Type: research

Use of Telemedicine to Expedite and Expand Care During COVID-19
Introduction: 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.Methods: This was a retrospective study analyzing adult patients with COVID-19-related telemedicine visits performed between March 1 –June 30, 2020. COVID-19-related telemedicine visits refer to those who used the “Concern for Coronavirus&rdqu...
Source: Western Journal of Emergency Medicine - August 19, 2021 Category: Emergency Medicine Source Type: research

Efficacy of Various Facial Protective Equipment for Infection Control in a Healthcare Setting
Introduction: 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 stud...
Source: Western Journal of Emergency Medicine - August 18, 2021 Category: Emergency Medicine Source Type: research

Patient Perceptions of Drive-through Medical Treatment Facilities During the COVID-19 Pandemic
Introduction: 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 deliver y. 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. Method: Patients presenting to a drive-through COVID-19 medical treatme...
Source: Western Journal of Emergency Medicine - August 17, 2021 Category: Emergency Medicine Source Type: research

Special Issue on Firearm Violence Injury and Prevention
(Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - August 6, 2021 Category: Emergency Medicine Source Type: research

Anaphylaxis caused by swimming: A case of cold-induced urticaria in the Emergency Department
Cold-induced urticaria is a subset of physical urticaria that presents as wheals or angioedema in response to cold exposure. While most cases are idiopathic, secondary associations with infections, medications, and certain cancers have been described. We discuss the case of a 50-year-old male with recent episodes of urticaria from cold air exposure following a flu-like illness 6 months prior, who presents with symptoms of anaphylaxis upon jumping into a lake. While the majority of patients develop localized symptoms, understanding of this disease entity is imperative as up to one-third of patients can develop sev...
Source: Western Journal of Emergency Medicine - July 25, 2021 Category: Emergency Medicine Source Type: research

WestJEM Full-Text Issue
(Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - July 21, 2021 Category: Emergency Medicine Source Type: research

Utilization of Point-of-care Echocardiography in Cardiac Arrest: A Cross-sectional Pilot Study
Introduction: Point-of-care (POC) echocardiography (echo) is a useful adjunct in the management of cardiac arrest. However, the practice pattern of POC echo utilization during management of cardiac arrest cases among emergency physicians (EP) is unclear. In this pilot study we aimed to characterize the utilization of POC echo and the potential barriers to its use in the management of cardiac arrest among EPs.Methods: This was a cross-sectional survey of attending EPs who completed an electronic questionnaire composed of demographic variables (age, gender, year of residency graduation, practice setting, and ultrasound train...
Source: Western Journal of Emergency Medicine - July 20, 2021 Category: Emergency Medicine Source Type: research

Effectiveness of Mechanical Chest Compression Devices over Manual Cardiopulmonary Resuscitation: A Systematic Review with Meta-analysis and Trial Sequential Analysis
Introduction: Our goal was to systematically review contemporary literature comparing the relative effectiveness of two mechanical compression devices (LUCAS and AutoPulse) to manual compression for achieving return of spontaneous circulation (ROSC) in patients undergoing cardiopulmonary resuscitation (CPR) after an out-of-hospital cardiac arrest (OHCA). Methods: We searched medical databases systematically for randomized controlled trials (RCT) and observational studies published between January 1, 2000 –October 1, 2020 that compared mechanical chest compression (using any device) with manual chest compression ...
Source: Western Journal of Emergency Medicine - July 20, 2021 Category: Emergency Medicine Source Type: research

Randomised Controlled Trial Assessing Head Down Deep Breathing Method Versus Modified Valsalva Manoeuvre for Treatment of Supraventricular Tachycardia in the Emergency Department
Introduction:Supraventricular tachycardia (SVT) is commonly encountered in the emergency department (ED). Vagal manoeuvres are internationally recommended therapy in stable patients. The head down deep breathing (HDDB) technique was previously described as an acceptable vagal manoeuvre, but there are no studies comparing its efficacy to other vagal manoeuvres. Our objective in this study was to compare the rates of successful cardioversion with HDDB and the commonly practiced, modified Valsalva manoeuvre (VM). Methods: We conducted a randomised controlled trial at an acute hospital ED. Patients presenting with SVT wer...
Source: Western Journal of Emergency Medicine - July 20, 2021 Category: Emergency Medicine Source Type: research

The Effects of Implementing a “Waterfall” Emergency Physician Attending Schedule
This study evaluates the impact of implementing the waterfall model of physician staffing on door-to-doctor time (DDOC), door-to-disposition time (DDIS), left without being seen (LWBS) rate, elopement rate, and the number of patient sign-outs. We examined 9,082 pre-intervention ED visits and 8,983 post-intervention ED visits. Results: The change in DDOC, LWBS rate, and elopement rate demonstrated statistically significant improvement from a mean of 65.1 to 35 minutes (P
Source: Western Journal of Emergency Medicine - July 20, 2021 Category: Emergency Medicine Source Type: research

Emergency Department-initiated High-flow Nasal Cannula for COVID-19 Respiratory Distress
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. Methods: We performed a retrospective, non-concurrent cohort study of patients with COVID-19 respiratory distress presenting to the ED who required HFNC or ETT in the ED or within 24 hours following ED departure. Comparisons were made between patients presenting before and after the introduction of an ED-HFNC protocol.Results: ...
Source: Western Journal of Emergency Medicine - July 20, 2021 Category: Emergency Medicine Source Type: research

Response to “Misunderstanding the Match: Do Students Create Rank Lists Based on True Preferences?”
Response to “Misunderstanding the Match: Do Students Create Rank Lists Based on True Preferences?” (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - July 20, 2021 Category: Emergency Medicine Source Type: research

Comment on “Misunderstanding the Match: Do Students Create Rank Lists Based on True Preferences?”
Comment on “Misunderstanding the Match: Do Students Create Rank Lists Based on True Preferences?” (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - July 20, 2021 Category: Emergency Medicine Source Type: research

Comparing Drugs for Out-of-hospital, Shock-refractory Cardiac Arrest: Systematic Review and Network Meta-analysis of Randomized Controlled Trials
This study aims to compare the treatment outcomes of medications for out-of-hospital, shock-refractory ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT).Methods: The inclusion criteria were randomized controlled trials of participants older than eight years old who had atraumatic, out-of-hospital, shock-refractory VF/pVT in which at least one studied group received a medication. We conducted a database search on October 28, 2019, that included PubMed, Scopus, Web of Science, CINAHL Complete, and Cochrane CENTRAL. Citations of relevant meta-analyses were also searched. We performed frequentist network...
Source: Western Journal of Emergency Medicine - July 19, 2021 Category: Emergency Medicine Source Type: research

A Novel, Low-cost, Low-fidelity Pericardiocentesis Teaching Model
Introduction: Pericardiocentesis is a high-risk/low-frequency procedure important to emergency medicine (EM). However, due to case rarity it is not often performed on a patient during residency training. Because the coronavirus disease 2019 pandemic limited cadaver-based practice, we developed a novel, low-cost, low-fidelity pericardiocentesis model using three dimensional-printing technology to provide advances on prior home-made models. Methods:Residents watched a 20-minute video about performing a pericardiocentesis and practiced both a blind and ultrasound-guided technique. We assessed model fidelity, convenience,...
Source: Western Journal of Emergency Medicine - July 19, 2021 Category: Emergency Medicine Source Type: research

An Automated Tobacco Cessation Intervention for Emergency Department Discharged Patients
The objective of the study is to evaluate the effectiveness of an automated discharge instruction system in increasing the frequency of discharging current tobacco users with instructions for tobacco cessation.Methods: The study was done at an urban academic tertiary care center. A before and after study was used to test the hypothesis that use of an automated discharged instruction system would increase the frequency that patients who use tobacco were discharged with tobacco cessation instructions.... (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - July 19, 2021 Category: Emergency Medicine Source Type: research

The Role of Gender in Nurse-Resident Interactions: A Mixed-methods Study
Introduction:The role of gender in interprofessional interactions is poorly understood. This mixed-methods study explored perceptions of gender bias in interactions between emergency medicine (EM) residents and nurses.Methods: We analyzed qualitative interviews and focus groups with residents and nurses from two hospitals for dominant themes. An electronic survey, developed through an inductive-deductive approach informed by qualitative data, was administered to EM residents and nurses. Quantitative analyses included descriptive statistics and between-group comparisons.Results: Six nurses and 14 residents participated in i...
Source: Western Journal of Emergency Medicine - July 19, 2021 Category: Emergency Medicine Source Type: research

The Impact of COVID-19 Pandemic on Emergency Department Visits at a Canadian Academic Tertiary Care Center
Introduction: Public health response to the coronavirus 2019 (COVID-19) pandemic has emphasized social distancing and stay-at-home policies. Reports of decreased emergency department (ED) visits in non-epicenters of the outbreak have raised concerns that patients with non-COVID-19 emergencies are delaying or avoiding seeking care. We evaluated the impact of the pandemic on ED visits at an academic tertiary care center.Methods:We conducted an observational health records review between January 1 –April 22, 2020, comparing characteristics of all ED visits between pre- and post-pandemic declaration by the World Health O...
Source: Western Journal of Emergency Medicine - July 19, 2021 Category: Emergency Medicine Source Type: research

Risk Factors of Fall-Related Emergency Department Visits by Fall Location of Older Adults in the US
Introduction: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.Methods: Using the 2017 Nationwide Emergency Department Sample (NEDS) data, we conducted a multivariable analysis of fall-related emergency department (ED) visits disaggregated b...
Source: Western Journal of Emergency Medicine - July 19, 2021 Category: Emergency Medicine Source Type: research

Clinical, Operational, and Socioeconomic Analysis of EMS Bypass of the Closest Facility for Pediatric Asthma Patients
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.Methods: This was a retrospective study of pediatric asthma patients ages 2-18 years transported by  Lee County, FL EMS between March 1, 2018 – December 31, 2019. A priori, we defined bypass as greater than five minutes extra transport time. We performed geospatial analysis and mapping of EMS pediatric asthma encounters. We used the Pediatric Destination Tree (PDTree)... (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - July 16, 2021 Category: Emergency Medicine Source Type: research

Emergency Absentee Voting for Hospitalized Patients and Voting During COVID-19: A 50-State Study
Introduction: Voters facing illness or disability are disproportionately under-represented in terms of voter turnout. Earlier research has indicated that enfranchisement of these populations may reinforce the implementation of policies improving health outcomes and equity. Due to the confluence of the coronavirus 2019 (COVID-19) pandemic and the 2020 election, we aimed to assess emergency absentee voting processes, which allow voters hospitalized after regular absentee deadlines to still obtain an absentee ballot, and election changes due to COVID-19 in all 50 states.Methods: We performed a cross-sectional study collecting...
Source: Western Journal of Emergency Medicine - July 15, 2021 Category: Emergency Medicine Source Type: research

An Assessment of the Social Determinants of Health in an Urban Emergency Department
Introduction: Social determinants of health (SDOH) have significant impacts on patients who seek care in the emergency department (ED). We administered a social needs screening tool and needs assessment survey to assess SDOH and evaluate for trends in the population of patients visiting our ED.Methods: A survey was distributed via convenience sampling to adult ED patients to capture self-reported demographic information and data about social needs. We categorized the questions related to SDOH based on the International Classification of Diseases, Tenth Revision, Clinical Modification coding format and created a composite v...
Source: Western Journal of Emergency Medicine - July 15, 2021 Category: Emergency Medicine Source Type: research