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Racial Differences in Triage for Emergency Department Patients with Subjective Chief Complaints
In this study we aimed to determine whether these effects are more pronounced for patients with subjective complaints.Methods: We performed a retrospective analysis for all adult visits between 2016-2019 at an urban academic emergency department (ED) with acuity-based pods. We determined rates of initial high-acuity triage both across all patients and among the subset located in the high-acuity pod at time of disposition (either through initial assignment or subsequent up-triage). Analysis was performed for common chief complaints categorized as subjective (chest pain, dyspnea, any pain); observed (altered mental status); ...
Source: Western Journal of Emergency Medicine - August 30, 2023 Category: Emergency Medicine Authors: Peitzman, Cassandra Source Type: research

Guidelines for reasonable and appropriate care in the emergency department 3 (GRACE-3): Acute dizziness and vertigo in the emergency department
Acad Emerg Med. 2023 May;30(5):442-486. doi: 10.1111/acem.14728.ABSTRACTThis third Guideline for Reasonable and Appropriate Care in the Emergency Department (GRACE-3) from the Society for Academic Emergency Medicine is on the topic adult patients with acute dizziness and vertigo in the emergency department (ED). A multidisciplinary guideline panel applied the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess the certainty of evidence and strength of recommendations regarding five questions for adult ED patients with acute dizziness of less than 2 weeks' duration. The intended pop...
Source: Accident and Emergency Nursing - May 11, 2023 Category: Emergency Medicine Authors: Jonathan A Edlow Christopher Carpenter Murtaza Akhter Danya Khoujah Evie Marcolini William J Meurer David Morrill James G Naples Robert Ohle Rodney Omron Sameer Sharif Matt Siket Suneel Upadhye Lucas Oliveira J E Silva Etta Sundberg Karen Tartt Simone Van Source Type: research

MRI of Cerebrovascular Injury Associated With COVID-19 and Non-COVID-19 Acute Respiratory Distress Syndrome: A Matched Case-Control Study
CONCLUSIONS: In a case-control study of selected ARDS patients with brain MRI, the frequencies of ischemic and hemorrhagic cerebrovascular injuries were similar between COVID-19 versus non-COVID-19 ARDS patients. However, the MRI pattern of disseminated hemorrhagic leukoencephalopathy was unique to the COVID-19 ARDS patients in this cohort.
Source: Critical Care Medicine - October 20, 2022 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research

Approaches in Prehospital Sepsis Screening
Discussion In the United States, sepsis is one of the leading causes of death, which requires timely identification and proper treatment (CDC, 2019; Guerra et al., 2020; Polito et al., 2015). Based upon a review of literature conducted from 2014 to 2018, the primary investigators could locate five prehospital EMS screening tools to assist EMS providers in identifying at-risk sepsis patients. The researchers explored how the modified SIRS and qSOFA scoring systems were used in hospital settings in addition to these five prehospital EMS screening tools. The Bas 90-30-90, Guerra, PRESEP, PRESS, and Robson tools have ove...
Source: JEMS Operations - January 5, 2021 Category: Emergency Medicine Authors: JEMS Staff Tags: Exclusives Patient Care EMS EMT Paramedic Prehospital Sepsis Source Type: news

Alteplase for Minor Stroke: The AAEM Clinical Practice Advisory is More Accurate Than Other National Guidelines
The American Heart Association (AHA) has recently published an update to their 2018 guidelines for the management of acute ischemic stroke. Compared with the 2018 guidelines, a new class III ( “No Benefit”) recommendation was made for “mild non-disabling stroke” in the 0–3-h time window (1). “Mild disabling stroke,” however, received a class I (“Strong”) recommendation in the 0–3-h window. These guidelines were endorsed by the Society for Academic Emergency Medicine. T he 2015 American College of Emergency Physicians clinical policy does not differentiate their recommendation for the use of alteplase ba...
Source: The Journal of Emergency Medicine - November 1, 2020 Category: Emergency Medicine Authors: Ravi Garg Tags: Letters to the Editor Source Type: research

Acute Kidney Injury in Acute Ischemic Stroke Patients in Clinical Trials
Objectives: Acute ischemic stroke patients are at risk of acute kidney injury due to volume depletion, contrast exposure, and preexisting comorbid diseases. We determined the occurrence rate and identified predictors associated with acute kidney injury in acute ischemic stroke patients. Setting: Multiple specialized ICUs within academic medical centers. Design: Post hoc analysis of pooled data from prospective randomized clinical trials. Patients: Acute ischemic stroke patients recruited within 3 hours or within 5 hours of symptom onset. Interventions: IV recombinant tissue plasminogen activator, endovascular...
Source: Critical Care Medicine - August 21, 2020 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research

Lung apical findings in coronavirus disease (COVID-19) infection on neck and cervical spine CT
ConclusionLung apical findings on cervical spine or neck CTs consistent with COVID-19 infection are common and may be encountered on neuroimaging performed for non-respiratory indications. For these patients, the emergency radiologist may be the first physician to suspect underlying COVID-19 infection.
Source: Emergency Radiology - July 20, 2020 Category: Emergency Medicine Source Type: research

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