Western Journal of Emergency Medicine 
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This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.Feasibility of a Multifaceted Social Emergency Medicine Curriculum for Emergency Medicine Residents
In this study we sought to address this need by implementing and evaluating a replicable, multifaceted introductory SEM curriculum for EM residents. This curriculum is designed to increase general awareness related to SEM and to increase ability to identify and intervene upon SDoH in clinical practice.Methods: A taskforce of EM clinician-educators with expertise in SEM developed a 4.5-hour educational curriculum for use during a single, half-day didactic session for EM residents.... (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - May 5, 2023 Category: Emergency Medicine Authors: Shufflebarger, Erin F Source Type: research
Emergency Department Length of Stay Is Associated with Delirium in Older Adults
In this study we further evaluated the emerging association between incident delirium with ED LOS, time in ED hallways, and number of non-clinical patient moves in the ED.Methods: We performed this retrospective cohort study at a single, urban, academic medical center. All data were extracted from the electronic health record. We included patients aged ≥65 years presenting to the ED and admitted to family or internal medicine services over a two-year period . Patients admitted to any other service, transferred from another hospital, discharged from the ED, or who underwent procedural sedation were excluded. The primary o...
Source: Western Journal of Emergency Medicine - May 4, 2023 Category: Emergency Medicine Authors: Elder, Natalie Source Type: research
Effect of a Home Health and Safety Intervention on Emergency Department Use in the Frail Elderly: A Prospective Observational Study
Introduction: Geriatric patients are often frail and may lose independence through a variety of mechanisms including cognitive decline, reduced mobility, and falls. Our goal was to measure the effect of a multidisciplinary home health program that assessed frailty and safety and then coordinated ongoing delivery of community resources on short-term, all-cause emergency department (ED) utilization across three study arms that attempted to stratify frailty by fall risk.Methods: Subjects became eligible for this prospective observational study via one of three pathways: 1) by visiting the ED after a fall (2,757 patients); 2) ...
Source: Western Journal of Emergency Medicine - May 3, 2023 Category: Emergency Medicine Authors: Bogucki MD, PhD, Sandy Source Type: research
Gaps in the Identification of Child Race and Ethnicity in a Pediatric Emergency Department
Introduction: Race and ethnicity are social constructs that are associated with meaningful health inequities. To address health disparities, it is essential to have valid, reliable race and ethnicity data. We compared child race and ethnicity as identified by the parent with that reported in the electronic health record (EHR).Methods: A convenience sample of parents of pediatric emergency department (PED) patients completed a tablet-based questionnaire (February-May 2021). Parents identified their child ’s race and ethnicity from options within a single category. We used chi-square to compare concordance between child ra...
Source: Western Journal of Emergency Medicine - May 3, 2023 Category: Emergency Medicine Authors: Gutman, Colleen Source Type: research
Large-scale Implementation of Fascia Iliaca Compartment Blocks in an Emergency Department
Introduction: A robust body of literature supports the use of fascia iliaca compartment blocks (FICB) for improving outcomes in hip fractures, especially in the geriatric population. Our objective in this project was to implement consistent pre-surgical, emergency department (ED) FICB for hip fracture patients and to address barriers to implementation.Methods: With the support of a multidisciplinary team, including orthopedic surgery and anesthesia, a core team of emergency physicians developed and implemented a departmentwide FICB training and credentialing program. The goal was to have 80% of all emergency physicians cre...
Source: Western Journal of Emergency Medicine - May 3, 2023 Category: Emergency Medicine Authors: Downs, Tony Source Type: research
Returns After Discharge From the Emergency Department Observation Unit: Who, What, When, and Why?
Introduction: The number of emergency department observation units (EDOU) and observation stays has continued to increase. Despite this, there is limited data on the characteristics of patients who return unexpectedly to the ED after EDOU discharge.Methods: We identified the charts of all patients who were admitted to the EDOU of an academic medical center between January 2018 –June 2020 and had a return to the ED within 14 days of discharge from the EDOU. Patients were excluded if they were admitted to the hospital from the EDOU, left against medical advice, or died in the EDOU. We manually extracted selected demographi...
Source: Western Journal of Emergency Medicine - May 3, 2023 Category: Emergency Medicine Authors: Berger, Daniel Julius Source Type: research
Utilization and Impact of Pharmacist-led, Urinary Culture Follow-Up After Discharge from the Emergency Department
Introduction: Urinary tract infections (UTI) are a common reason for an emergency department (ED) visit. The majority of these patients are discharged directly home without a hospital admission. After discharge, emergency physicians have traditionally managed the care of the patient if a change is warranted (as a result of urine culture results). However, in recent years clinical pharmacists in the ED have largely incorporated this task into their standard practice. In our study, we aimed to 1) describe our unique process in having a pharmacist-led, urinary culture follow-up, and 2) compare it to our previous, more t...
Source: Western Journal of Emergency Medicine - May 3, 2023 Category: Emergency Medicine Authors: Pham, Danny Hieu Source Type: research
A Cross-sectional Survey to Assess Awareness of Syndromic Surveillance by Clinicians Practicing Emergency Medicine: An Opportunity for Education and Collaboration
Introduction: Syndromic surveillance (SyS) is an important public health tool using de-identified healthcare discharge data from emergency department (ED) and urgent care settings to rapidly identify new health threats and provide insight into current community well-being. While SyS is directly fed by clinical documentation such as chief complaint or discharge diagnosis, the degree to which clinicians are aware their documentation directly influences public health investigations is unknown. The primary objective of this study was to evaluate the degree to which clinicians practicing in Kansas EDs or urgent care settings we...
Source: Western Journal of Emergency Medicine - May 3, 2023 Category: Emergency Medicine Authors: Haas MPH, Gabriel Ann Source Type: research
Improving Accessibility in the Emergency Department for Patients with Disabilities: A Qualitative Study
In this study we investigate the ED experience from the perspective of patients living with physical and cognitive disability, as well as visual impairment and blindness, to better understand the barriers to accessibility in the ED for these populations.Methods: Twelve individuals with either physical or cognitive disabilities, visual impairments or blindness were interviewed regarding their ED experiences, particularly related to accessibility. Interviews were transcribed and coded for qualitative analysis with generation of significant themes relating to accessibility in the ED.Results: Major themes from coded analysis w...
Source: Western Journal of Emergency Medicine - May 3, 2023 Category: Emergency Medicine Authors: Carmichael, John Harrison Source Type: research
Use of Hotels as a Disposition Alternative to Hospital Admission for Undomiciled Patients Undergoing SARS-CoV-2 Testing
Introduction: The coronavirus 2019 (COVID-19) pandemic has presented various unprecedented challenges to healthcare systems globally, prompting society to adopt new preventative strategies to curb spread of the disease. Those experiencing homelessness have been particularly impacted because of barriers to practicing social distancing, inability to isolate, and poor access to care. Project Roomkey was established in California as a statewide measure to provide non-congregate shelter options for individuals experiencing homelessness to properly quarantine. On goal in this study was to analyze the effectiveness of hotel rooms...
Source: Western Journal of Emergency Medicine - May 3, 2023 Category: Emergency Medicine Authors: Lin, Lucia Christiana Source Type: research
Safe Discharge Needs Following Emergency Care for Intimate Partner Violence, Sexual Assault, and Sex Trafficking
Conclusion: Safe disposition following experience or... (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - May 2, 2023 Category: Emergency Medicine Authors: Clery, Michael J Source Type: research
Nonfatal Injuries Sustained in Mass Shootings in the US, 2012-2019: Injury Diagnosis Matrix, Incident Context, and Public Health Considerations
Introduction: The epidemic of gun violence in the United States (US) is exacerbated by frequent mass shootings. In 2021, there were 698 mass shootings in the US, resulting in 705 deaths and 2,830 injuries. This is a companion paper to a publication in JAMA Network Open, in which the nonfatal outcomes of victims of mass shootings have been only partially described.Methods: We gathered clinical and logistic information from 31 hospitals in the US about 403 survivors of 13 mass shootings, each event involving greater than 10 injuries, from 2012-19. Local champions in emergency medicine and trauma surgery provided clinical dat...
Source: Western Journal of Emergency Medicine - May 2, 2023 Category: Emergency Medicine Authors: Czaja, Matthew Source Type: research
Effects of Non-physician Practitioners on Emergency Medicine Physician Resident Education
Introduction: The effects of non-physician practitioners (NPP) such as physician assistants and nurse practitioners on the education of emergency medicine (EM) residents have not previously been specifically evaluated. Emergency medicine societies have made policy statements regarding NPP presence in EM residencies without the benefit of empiric studies.Methods: A cross-sectional, mixed methods questionnaire with strong validity evidence was distributed to current EM residents who were members of a large national society, the American Academy of Emergency Medicine Resident and Student Association (AAEM/RSA), between June 4...
Source: Western Journal of Emergency Medicine - April 28, 2023 Category: Emergency Medicine Authors: Phillips, Andrew W Source Type: research
Association of Early Serum Phosphate Levels and Mortality in Patients with Sepsis
Background: Metabolic derangements in sepsis influence phosphate levels, which may predict mortality outcomes. We investigated the association between initial phosphate levels and 28-day mortality in patients with sepsis.Methods: We conducted a retrospective analysis of patients with sepsis. Initial (first 24 hours) phosphate levels were divided into phosphate quartile groups for comparisons. We used repeated-measures mixed-models to assess differences in 28-day mortality across the phosphate groups, adjusting for other predictors identified by the Least Absolute Shrinkage and Selection Operator variable selection techniqu...
Source: Western Journal of Emergency Medicine - April 28, 2023 Category: Emergency Medicine Authors: Black, Lauren Page Source Type: research
Socioeconomic Risk Factors for Pediatric Out-of-Hospital Cardiac Arrest: A Statewide Analysis.
IntroductionEconomic hardship is a major threat to children ’s health, implying that pediatric out-of-hospital cardiac arrest (pOHCA) might be promoted by lower incomes and child poverty. To target resources, it is helpful to identify geographical hotspots. Rhode Island is area-wise the smallest state in the United States of America. It has one million inh abitants and is comparable to many larger cities worldwide. We aimed to investigate possible associations of pOHCA with economic factors and the COVID-19 pandemic. We tried to identify high-risk areas and evaluated whether the COVID-19 pandemic had an influence on dela...
Source: Western Journal of Emergency Medicine - April 28, 2023 Category: Emergency Medicine Authors: Kienbacher, Calvin Lukas Source Type: research
