Western Journal of Emergency Medicine 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.

Arterial Monitoring in Hypertensive Emergencies: Significance for the Critical Care Resuscitation Unit
Introduction: Blood pressure measurement is important for treating patients. It is known that there is a discrepancy between cuff blood pressure vs arterial blood pressure measurement. However few studies have explored the clinical signi ﬁcance of discrepancies between cuff (CPB) vs arterial blood pressure (ABP). Our study investigated whether differences in CBP and ABP led to change in management for patients with hypertensive emergencies and factors associated with this change.Methods:This prospective observational study included adult patients admitted between January 2019 –May 2021 to a resuscitation unit with hype...
Source: Western Journal of Emergency Medicine - July 17, 2023 Category: Emergency Medicine Authors: Tran, Quincy K. Source Type: research

Social Determinants of Health Screening at an Urban Emergency Department Urgent Care During COVID-19
Introduction: Social determinants of health (SDoH) impact patients ’ health outcomes, yet screening methods in emergency departments (ED) are not consistent or standardized. The SDoH-related health disparities may have widened during the coronavirus 2019 (COVID-19) pandemic, especially among patients who primarily receive their medical care in EDs. We sought to i dentify SDoH among ED urgent care patients during the COVID-19 pandemic at an urban safety-net hospital, assess the impact of the pandemic on their SDoH, study the feasibility of SDoH screening and resource referrals, and identify preferred methods of resource r...
Source: Western Journal of Emergency Medicine - July 17, 2023 Category: Emergency Medicine Authors: Hong, Haeyeon Source Type: research

Skin Tone and Gender of High-Fidelity Simulation Manikins in Emergency Medicine Residency Training and Their Use in Cultural Humility Training
Introduction: It is important for physicians to learn how to provide culturally sensitive care. Cultural humility is de ﬁned as a lifelong process with a goal of ﬁxing power imbalances and creating institutional accountability through learning about another’s culture as well as performing self-exploration about one’s own beliefs, identities, and biases. One way to teach cultural humility in medicine is simula tion. However, there are no peer-reviewed published studies that examine whether the skin tone or gender of the high-ﬁdelity simulation manikins (HFSM) used by emergency medicine (EM) residency programs re�...
Source: Western Journal of Emergency Medicine - July 12, 2023 Category: Emergency Medicine Authors: Brown, Cortlyn Source Type: research

Impact of Care Initiation Model on Emergency Department Orders and Operational Metrics: Cohort Study
The objective of this study was to quantify the impact of a Care Initiation model on resource utilization and operational metrics in the ED.Methods: We performed a retrospective analysis of ED visits at our institution during October 2021. Baseline characteristics were compared with Chi-square and quantile regression. We used t-tests to calculate unadjusted difference in outcome measures, including number of laboratory tests ordered and average time patients spent in the waiting room and the ED treatment room, and the time from arrival until ED disposition. We performed propensity score analysis using matching and inverse ...
Source: Western Journal of Emergency Medicine - July 12, 2023 Category: Emergency Medicine Authors: Lee, Andy Hung-Yi Source Type: research

A National Snapshot of Social Determinants of Health Documentation in Emergency Departments
Introduction:Documentation and measurement of social determinants of health (SDoH) are critical to clinical care and to healthcare delivery system reforms targeting health equity. The SDoH are codi ﬁed in the International Classiﬁcation of Disease 10th Rev (ICD-10) Z codes. However, Z codes are listed in only1-2% of inpatient charts. Little is known about the frequency of Z code utilization speciﬁcally among emergency department (ED) patient populations nationally.Methods:This was a repeated cross-sectional analysis of ED visit data in the United States from the Nationwide Emergency Department Sample from 2016 –201...
Source: Western Journal of Emergency Medicine - July 12, 2023 Category: Emergency Medicine Authors: Ryus, Caitlin R. Source Type: research

A Virtual National Diversity Mentoring Initiative to Promote Inclusion in Emergency Medicine
We describe the implementation of a virtual Diversity Mentoring Initiative (DMI) geared toward supporting URiM trainees interested in EM. The program development involved 1) partnering of national EM organizations to obtain funding; (2) identifying a comprehensive platform to facilitate participant communication, arti ﬁcial intelligence-enabled... (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - July 12, 2023 Category: Emergency Medicine Authors: Carrillo, Tatiana Source Type: research

Impact of Faculty Incentivization on Resident Evaluations
This study occurred over a two-year period, with an intervention between years one and two. Throughout year two of the study, faculty incentive compensation was linked to completion of end-of-shift evaluations. We compared pre- an post-implementation data using paired sample t-tests with the signi ﬁcance level P< .05 applied.Results:After implementation of the incentive metric there was an increase in the number of total evaluations by 42% (P = .001). The mean number of evaluations submitted by each faculty... (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - July 12, 2023 Category: Emergency Medicine Authors: Patel, Viral Source Type: research

Perception of Quiet Students in Emergency Medicine: An Exploration of Narratives in the Standardized Letter of Evaluation
Introduction: The Standardized Letter of Evaluation (SLOE) is designed to assist emergency medicine (EM) residency programs in differentiating applicants and in selecting those to interview. The SLOE narrative component summarizes the student ’s clinical skills as well as their non-cognitive attributes. The purpose of this qualitative investigation was to explore how students described in the SLOE as quiet are perceived by faculty and to better understand how this may impact their residency candidacy.Methods: This retrospective cohort study included all SLOEs submitted to one EM residency program during one application c...
Source: Western Journal of Emergency Medicine - July 12, 2023 Category: Emergency Medicine Authors: Quinn, John K. Source Type: research

Community Paramedicine Intervention Reduces Hospital Readmission and Emergency Department Utilization for Patients with Cardiopulmonary Conditions
Objective: Patients discharged from the hospital with diagnoses of myocardial infarction, congestive heart failure or acute exacerbation of chronic obstructive pulmonary disease (COPD) have high rates of readmission. We sought to quantify the impact of a community paramedicine (CP) intervention on hospital readmission and emergency department (ED) and clinic utilization for patients discharged with these conditions and to calculate the difference in healthcare costs.Methods: This was a prospective, observational cohort study with a matched historical control. The groups were matched for qualifying diagnosis, age, gender, a...
Source: Western Journal of Emergency Medicine - July 11, 2023 Category: Emergency Medicine Authors: Burnett, Aaron Source Type: research

Flow Through the Emergency Department for Patients Presenting with Substance Use Disorder in Alberta, Canada
Introduction: Since 2016 the province of Alberta, Canada, has seen a significant increase in substance use disorder (SUD) presentations to the emergency department (ED) with a large surge during the COVID-19 pandemic. In this retrospective study we deconstruct the total length of stay (LOS) in the ED into stages for patients presenting with SUD and estimate the effects of covariates on the time to transition between stages.Methods:Using the Canadian Coding Standards for International Classification of Diseases, 10th Modification, codes F10.0-F19.9 and T36.0-T50.9, we extracted data from the National Ambulatory Care Reporti...
Source: Western Journal of Emergency Medicine - July 8, 2023 Category: Emergency Medicine Authors: Edmundson, Jonah Source Type: research

Applying a Smartwatch to Predict Work-related Fatigue for Emergency Healthcare Professionals: Machine Learning Method
In this study, we applied a machine learning (ML) approach based on data collected from a smartwatch to construct prediction models of work-related fatigue for emergency clinicians.Methods: We conducted this prospective study at the emergency department (ED) of a tertiary teaching hospital from March 10 –June 20, 2021, where we recruited physicians, nurses, and nurse practitioners. All participants wore a commercially available smartwatch capable of measuring various physiological data during the experiment. Participants completed the Multidimensional Fatigue Inventory (MFI) web form before and a fter each of their work ...
Source: Western Journal of Emergency Medicine - July 7, 2023 Category: Emergency Medicine Authors: Liu, Sot Shih-Hung Source Type: research

Single-step Optimization in Triaging Large Vessel Occlusion Strokes: Identifying Factors to Improve Door-to-groin Time for Endovascular Therapy
Introduction: Although acute stroke endovascular therapy (EVT) has dramatically improved outcomes in acute ischemic stroke (AIS) patients with large vessel occlusions (LVO), access to EVT-capable centers remains limited, particularly in rural areas. Therefore, it is essential to optimize triage systems for EVT-eligible patients. One strategy may be the use of a telestroke network that typically consists of multiple spoke sites that receive a consultation to determine appropriateness of patient transfer to an EVT-capable hub site. Standardization of AIS protocols may be necessary to achieve target door-to groin (DTG) times ...
Source: Western Journal of Emergency Medicine - June 30, 2023 Category: Emergency Medicine Authors: Rawson, Joshua Source Type: research

A Real-World Experience: Retrospective Review of Point-of-Care Ultrasound Utilization and Quality in Community Emergency Departments
Introduction: Point-of-care ultrasound (POCUS) is commonly used in the emergency department (ED) as a rapid diagnostic tool. Emergency medicine (EM) has been an early adopter of POCUS with indications expanding over the last 10 years. While the literature describes widespread use among academic sites, there is little data on clinical POCUS utilization at non-academic EDs. We sought to describe community emergency physician (EP) use of POCUS by quantifying the number and type of studies performed, characteristics of the performing physician, and quality metrics.Methods: Prior to the study period, all EPs underwent a standar...
Source: Western Journal of Emergency Medicine - June 30, 2023 Category: Emergency Medicine Authors: Smalley, Courtney M. Source Type: research

Utility of Supraclavicular Brachial Plexus Block for Anterior Shoulder Dislocation: Could It Be Useful?
Anterior shoulder dislocations (ASD) represent a common and painful orthopedic injury in the emergency department (ED). The management of ASD varies broadly from manual reductions via scapular manipulation with or without pain medication to procedural sedation and anesthesia (PSA), and various regional anesthesia (RA) techniques. The reduction approach often depends on the patient ’s subjective pain response, the expected difficulty of reduction, and the physician’s experience with each method. Of the anesthetic options for difficult shoulder reductions, we generally favor RA techniques over PSA. While several RA techn...
Source: Western Journal of Emergency Medicine - June 30, 2023 Category: Emergency Medicine Authors: Shalaby, Michael Source Type: research

Block Time: A Multispecialty Systematic Review of Efficacy and Safety of Ultrasound-guided Upper Extremity Nerve Blocks
Introduction:Ultrasound-guided peripheral nerve blockade is a common pain management strategy to decrease perioperative pain and opioid/general anesthetic use. In this article our goal was to systematically review publications supporting upper extremity nerve blocks distal to the brachial plexus.We assessed the efficacy and safety of median, ulnar, radial, suprascapular, and axillary nerve blocks by reviewing previous studies.Methods:We searched MEDLINE and Embase databases to capture studies investigating these nerve blocks across all specialties. We screened titles and abstracts according to agreed-upon inclusion/exclusi...
Source: Western Journal of Emergency Medicine - June 30, 2023 Category: Emergency Medicine Authors: Haley, Campbell Belisle Source Type: research