Journal of Emergency Medicine最新文献

{"title":"Diagnostic Accuracy of Point-of-Care Cranial Ultrasound for Initial Assessment of Infants Without Suspected Trauma in the Pediatric Emergency Department","authors":"Takaaki Mori MD, MRCPCH, MSc,&nbsp;Sung Shin Teng MBBS, MRCPCH, FAMS,&nbsp;Gene Yong-Kwang Ong MBBS, MRCPCH","doi":"10.1016/j.jemermed.2025.05.002","DOIUrl":"10.1016/j.jemermed.2025.05.002","url":null,"abstract":"<div><h3>Background</h3><div>Cranial point-of-care ultrasound (POCUS) has shown efficacy for traumatic intracranial hemorrhage in pediatric emergency care. However, reports of its use in patients without trauma are limited.</div></div><div><h3>Objectives</h3><div>This study aimed to assess the diagnostic accuracy of cranial POCUS for identifying intracranial pathologies in infants without a history of trauma in a pediatric emergency department (PED).</div></div><div><h3>Methods</h3><div>This retrospective, observational study was conducted in the PED of a tertiary children’s hospital between March 2020 and March 2024. Pediatric patients aged &lt;2 years without a history of trauma who underwent cranial POCUS were included in the study. Pediatric patients with suspected traumatic brain injuries who underwent cranial POCUS were excluded. The cranial POCUS was performed by trained pediatric emergency physicians. Neuroradiological imaging including computed tomography, magnetic resonance imaging, and radiology department ultrasound was used as the reference standard. If patients did not undergo neuroradiological imaging, clinical follow-up was used as a surrogate to detect the likelihood of serious intercranial pathologies.</div></div><div><h3>Results</h3><div>During the study period, 75 patients underwent cranial POCUS, and 51 were included in the analyses. The median age was 2 months, [interquartile range; 0 to 5 months]. Seizures (20/52), and apnea (8/52) were the common indications for cranial POCUS. The sensitivity and specificity of cranial POCUS were 40.0% (95% confidence interval [CI]; 13.4–56.1%) and 97.8% (95% CI; 94.9–99.6%), respectively.</div></div><div><h3>Conclusions</h3><div>Cranial POCUS performed by pediatric emergency physicians demonstrated high specificity for identifying intracranial pathologies in infants without trauma in the PED. However, the sensitivity of this method was low.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"79 ","pages":"Pages 143-150"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Adenosine versus Fixed-Dose Intravenous Bolus Diltiazem on Reversing Supraventricular Tachycardia in the Emergency Department: A Multi-Center Cohort Study”","authors":"Parth Aphale ,&nbsp;Shashank Dokania ,&nbsp;Himanshu Shekhar","doi":"10.1016/j.jemermed.2025.08.042","DOIUrl":"10.1016/j.jemermed.2025.08.042","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"79 ","pages":"Pages 661-662"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clarity on: Regional Anesthesia Techniques for the Shoulder","authors":"Raghuraman M․ Sethuraman M.D.","doi":"10.1016/j.jemermed.2025.07.056","DOIUrl":"10.1016/j.jemermed.2025.07.056","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"79 ","pages":"Pages 648-649"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Emergency Heart Failure Mortality Risk Grade and Ottawa Heart Failure Risk Score Scores in Predicting Mortality in Patients Presenting to the Emergency Department with Heart Failure","authors":"Hikmet Kilinc M.D. ,&nbsp;Huseyin Cahit Halhalli M.D. ,&nbsp;Serkan Gunay M.D. ,&nbsp;Merve Akin Ozdemir M.D. ,&nbsp;Furkan Alkan M.D. ,&nbsp;Asim Enes Ozbek M.D.","doi":"10.1016/j.jemermed.2025.08.017","DOIUrl":"10.1016/j.jemermed.2025.08.017","url":null,"abstract":"<div><h3>Background</h3><div>Patients discharged from the emergency department (ED) with acute decompensated heart failure (ADHF) face high mortality risks, which may render disposition decisions challenging. While clinical judgment is prominent, objective risk stratification tools such as the Emergency Heart Failure Mortality Risk Grade (EHMRG) and the Ottawa Heart Failure Risk Score (OHFRS) have been developed to aid physicians in these critical decisions.</div></div><div><h3>Objective</h3><div>This study compares the predictive performance of EHMRG and OHFRS scores for 30-day mortality in ADHF patients.</div></div><div><h3>Methods</h3><div>This single-center, prospective, observational study included patients presenting to a tertiary hospital ED with symptoms of dyspnea and diagnosed with ADHF according to the recent guidelines. EHMRG and OHFRS scores were calculated for all patients. The primary outcome was 30-day all-cause mortality. Secondary outcomes included hospital admission, intensive care unit (ICU) admissions, and ED revisits within 30 days. To evaluate the discriminative ability of the scores, the receiver operating characteristic (ROC) curve analysis were used.</div></div><div><h3>Results</h3><div>Among 1,348 evaluated patients, 346 met the inclusion criteria. For predicting 30-day mortality, both scores demonstrated moderate accuracy (area under the curve [AUC]: EHMRG 0.774, OHFRS 0.706). For predicting hospital admission, the OHFRS score showed moderate accuracy (AUC: 0.742), while the EHMRG score showed low accuracy (AUC: 0.682). The OHFRS score was superior in predicting ICU admission with moderate accuracy. Neither score was predictive of ED revisits.</div></div><div><h3>Conclusion</h3><div>EHMRG and OHFRS scores can aid in predicting mortality, ICU admission, and safe discharge decisions in ADHF patients presenting to the ED. However, their utility in predicting ED revisits remains limited.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"79 ","pages":"Pages 181-190"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145364490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical Landmark vs. Ultrasound Identification of the Femoral Vein","authors":"Theresa Sonka MD,&nbsp;Haley Musgrave MD ,&nbsp;Joshua L. Choe MD,&nbsp;Lauren Diercks MD,&nbsp;Meredith Kim MD,&nbsp;Trent C. Schneider MD,&nbsp;Steven Field DO,&nbsp;Gregory Cervenka MD,&nbsp;Joya Singh DO,&nbsp;Bhaskar Thakur PhD,&nbsp;Lynn Roppolo MD","doi":"10.1016/j.jemermed.2025.08.002","DOIUrl":"10.1016/j.jemermed.2025.08.002","url":null,"abstract":"<div><h3>Background</h3><div>Fast, accurate femoral vein identification is important for providing life-saving therapies via central venous access in the emergency department.</div></div><div><h3>Objective</h3><div>We aim to determine the accuracy of the anatomical landmark technique for finding the femoral vein vs. the ultrasound-guided technique. We hypothesize that the femoral vein location using anatomical landmarks is, on average, 10 mm or more away from the femoral vein location found using ultrasound.</div></div><div><h3>Methods</h3><div>A convenience sample was recruited from a large county emergency department and the femoral vein location was determined through both methods, with the location determined by ultrasound being considered the true location of the vein. The mean distance between the ultrasound-guided femoral vein location and the anatomical landmark estimates (defined as “delta”) was measured. Data were transformed on a natural log scale and <em>p</em>-value for mean delta &gt; hypothesized mean was reported. For exploratory subgroup analysis, <em>p</em>-value for a nonzero difference between subgroup delta means was reported.</div></div><div><h3>Results</h3><div>A total of 87 patients consented to participate. The average delta was 14.29 mm, which was significantly higher than the hypothesized mean (<em>p</em> = 0.0038). Subgroup analysis suggested that the average delta in the body mass index (BMI) &lt; 25 group was significantly lower than the average delta in the BMI ≥ 25 group (11.77 mm vs. 16.23 mm; <em>p</em> = 0.0157). Measurements made by researchers with hand length of &lt; 205 mm were significantly different from those made by researchers with hand length of ≥ 205 mm (17.42 mm vs. 11.74 mm; <em>p</em> = 0.0020). However, the average delta between the anatomical landmark estimate and ultrasound-guided location in the BMI &lt; 25 group and researcher hand length ≥ 205 mm group still exceeded 10 mm.</div></div><div><h3>Conclusion</h3><div>Therefore, the anatomical landmark technique is not accurate in identification of the femoral vein within 10 mm of the true location determined by ultrasound.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"79 ","pages":"Pages 191-197"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dental Splinting Using Wound Closure Strips and Wound Glue: A Technical Note for the Emergency Physician","authors":"Vincent Tran MD, BDS ,&nbsp;Mustafa Mian MD, BDS, MPH ,&nbsp;Anton Sklavos MD, BDS, MPHIL ,&nbsp;Amish Patel MBBS, BDS, FRACDS (OMS)","doi":"10.1016/j.jemermed.2025.05.025","DOIUrl":"10.1016/j.jemermed.2025.05.025","url":null,"abstract":"<div><h3>Background</h3><div>Traumatic dental injuries, such as tooth avulsions and luxations, are a common presentation to emergency departments (EDs) around the world. The authors outline a technique of splinting luxated and avulsed teeth using wound closure strips (e.g., Steri-Strips, 3M) and wound glue; two commonly found resources that are available in most EDs within Australia.</div></div><div><h3>Discussion</h3><div>The management of these injuries is time critical for success. EDs often lack the required costly dental armamentarium used for the management of these injuries, which involves repositioning and splinting of teeth using dental wires; light curing units; composite resin, which may be expired; and other specific dental handling instruments. This results in patients receiving delayed emergency dental care after being discharged from the ED, leading to poorer outcomes. Dissemination of this technique will hopefully provide emergency physicians with a low-resource alternative to the standard splinting technique for managing these time-sensitive injuries.</div></div><div><h3>Conclusions</h3><div>The early splinting of traumatic dental injuries can be done successfully using wound closure strips and wound glue by emergency physicians to ensure optimal replantation success.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"79 ","pages":"Pages 246-249"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Industry-Sponsored Research Payments to Emergency Medicine Principal Investigators","authors":"Nicholas W Rizer MD ,&nbsp;Zeyad Hammadeh DDS, MS ,&nbsp;Misop Han MD, MS ,&nbsp;Peter Hill MD","doi":"10.1016/j.jemermed.2025.04.008","DOIUrl":"10.1016/j.jemermed.2025.04.008","url":null,"abstract":"<div><h3>Background</h3><div>Industry-sponsored research payments (ISRPs) to physicians through noncovered entities (NCEs) are a widespread practice in the United States. However, there has been limited literature examining this funding mechanism among emergency physicians.</div></div><div><h3>Objectives</h3><div>To describe the characteristics and trends in ISRPs to emergency physicians in the United States from 2015 to 2023.</div></div><div><h3>Methods</h3><div>We performed a retrospective analysis on data from the Open Payments database to examine ISRPs to principal investigators (PIs) identified as emergency physicians. Payments were categorized as being made directly to the physician, through a teaching hospital, or an NCE. Descriptive statistics and linear regression using a generalized estimating equation were used to analyze trends in payments.</div></div><div><h3>Results</h3><div>A total of $585.8 million ISRPs were made to emergency physician PIs between 2015 and 2023. Yearly payments increased from $64.6 million to $113.2 million from 2015 to 2023. Payments to NCEs increased from $54.7 million to $108.2 million. Males represented most PIs receiving funding through NCEs (151/189 in 2023), and among them there was a significant decrease in the number of PIs (−21%, <em>p</em> &lt; 0.01) and significant increases in the total (166%, <em>p</em> &lt; 0.05) and median value of payments (221%, <em>p</em> &lt; 0.001). The 10 largest manufacturer sponsors accounted for more than a half of the ISRPs to NCEs with emergency medicine (EM) PIs.</div></div><div><h3>Conclusion</h3><div>Between 2015 and 2023, ISRPs to NCEs with EM PIs increased to more than $100 million. A small number of sponsors accounted for the majority of ISRPs to EM PIs.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"79 ","pages":"Pages 21-30"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of the Relationship Between Shock Index, Scores in Patients with Upper Gastrointestinal Bleeding","authors":"Bahadir Taslidere,&nbsp;Julide Gurbuz,&nbsp;Elif Betul Balci,&nbsp;Emre Kalkan,&nbsp;Basar Cander","doi":"10.1016/j.jemermed.2025.10.043","DOIUrl":"10.1016/j.jemermed.2025.10.043","url":null,"abstract":"<div><h3>Background</h3><div>Upper gastrointestinal bleeding (UGIB) is a common and life-threatening emergency with a mortality rate of 2–8%. Although prognostic assessment often relies on the Glasgow-Blatchford Score (GBS) and Rockall Score (RS), their inclusion of multiple parameters limits use in acute settings. The shock index (SI), derived from heart rate and systolic blood pressure, provides a simple and rapid alternative. This study investigates the relationship between the SI and established risk scores (GBS and RS) in patients with UGIB.</div></div><div><h3>Methods</h3><div>This retrospective study included patients over 18 years of age who presented to the emergency department between January 1 and December 31, 2021. Of the 246 patients who underwent endoscopy, 106 were excluded due to variceal bleeding, pregnancy, incomplete or missing data, loss to follow-up, referral, or trauma. Clinical and laboratory information, including endoscopic findings, laboratory results, treatment details, and clinical follow-up, were collected. GBS, RS, and SI were calculated for each patient to evaluate the effectiveness of the SI in UGIB by examining its relationship with the GBS and RS.</div></div><div><h3>Result</h3><div>We enrolled 140 patients (62.9% male, n = 88; 37.1% female, n = 52). The mean age was comparable between the low and high SI groups (57.08 ± 20.20 vs. 54.75 ± 18.67 years, p = 0.482). Female patients had a significantly higher mean age than males (p &lt; 0.001). The high SI group demonstrated significantly higher GBS scores compared with the low SI group (9.26 ± 3.50 vs. 6.29 ± 3.47, p &lt; 0.001). The mean RS was significantly higher in the high SI group compared with the low SI group (4.42 ± 2.11 vs. 3.30 ± 2.20, p = 0.003).</div></div><div><h3>Conclusions</h3><div>In our study, both GBS and RS were significantly higher in patients with elevated SI, indicating that the Shock Index closely reflects bleeding severity and hemodynamic instability. Given that SI can be calculated rapidly, at no cost, and without the need for laboratory data, it may provide an early estimate of bleeding severity and prognosis before more comprehensive scoring systems such as GBS or RS are determined in the emergency department.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"79 ","pages":"Page 1"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145690436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreasing Rates of Opioid Administration in the Emergency Department: Trends in National Opioid Prescribing Patterns From 2016 to 2022","authors":"Aria C. Shi MD ,&nbsp;Kira L. Wang BA ,&nbsp;Christopher Zeuthen BS ,&nbsp;Christopher W. Baugh MD, MBA ,&nbsp;Scott G. Weiner MD, MPH ,&nbsp;Andrew D. Luo MD, MBA","doi":"10.1016/j.jemermed.2025.10.011","DOIUrl":"10.1016/j.jemermed.2025.10.011","url":null,"abstract":"<div><h3>Background</h3><div>Opioid prescribing in U.S. emergency departments (EDs) declined over the past decade due to policy reforms and awareness of opioids-related harm. However, the impact of the recent policies and COVID-19 on ED pain management and prescribing patterns remains unexplored.</div></div><div><h3>Objectives</h3><div>To assess national trends in ED opioid and nonopioid analgesic use and prescribing from 2016 to 2022.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS). We examined the proportion of visits where opioids were administered in the ED, prescribed at discharge, or both. Survey-weighted analyses compared 2016 with 2022 and included subgroup analyses by demographics, opioid type, and chief concern.</div></div><div><h3>Results</h3><div>Across nearly one billion weighted ED visits, opioid administration declined from 22.4% in 2016 to 13.9% in 2022 (absolute difference: −8.5%, 95% CI −10.2 to −6.8; <em>p</em> &lt; 0.001). The proportion of visits with opioids prescribed at discharge declined from 13.0% to 5.9% (absolute difference of 7.1%, 95% CI 5.6 to 8.5, <em>p</em> &lt; 0.001). Nonopioid analgesic administration remained stable overall, with modest increases in select subgroups. Declines in opioid administration were observed across all demographic and hospital characteristics, though fentanyl administration increased slightly, particularly for abdominal pain.</div></div><div><h3>Conclusion</h3><div>Opioid prescribing in U.S. EDs declined significantly from 2016 to 2022. These reductions were seen across diverse patient populations and visit types, reflecting the impact of policy interventions and adoption of multimodal pain strategies. These findings highlight ongoing shifts in ED pain management and the need for continued monitoring to ensure effective pain management.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"79 ","pages":"Pages 577-590"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Physician Management of Nontraumatic Dental Conditions: Impact of an Online Educational Module","authors":"Robert Matsui MSc ,&nbsp;Elaine O.C. Cardoso MSc ,&nbsp;Ava Khansari ,&nbsp;Howard C. Tenenbaum PhD ,&nbsp;Carilynne Yarascavitch PhD ,&nbsp;Amir Azarpazhooh PhD","doi":"10.1016/j.jemermed.2025.09.018","DOIUrl":"10.1016/j.jemermed.2025.09.018","url":null,"abstract":"<div><h3>Background</h3><div>Dental emergencies from nontraumatic dental conditions (NTDCs) cause tooth infections and pain. These cases are often seen by physicians in nondental settings. Definitive treatment is rarely possible in these settings. This often leads to prescribing antibiotics or opioid analgesics, which may conflict with stewardship principles.</div></div><div><h3>Objectives</h3><div>This study evaluated the impact of an online educational module on physicians' confidence and knowledge in managing NTDCs.</div></div><div><h3>Methods</h3><div>An educational module combining a cognitive aid and a multimodal online module with theoretical clinical cases was developed for medical students, licensed family physicians, and emergency physicians. It focused on evidence-based management of NTDCs in nondental settings. The impact was measured through pre- and postmodule self-evaluations and clinical case tests. Analyses were conducted using descriptive statistics and <em>t</em>-tests (<em>p</em> &lt; 0.05).</div></div><div><h3>Results</h3><div>A total of 39 participants completed all aspects of the intervention. Improvements in confidence and knowledge were observed, including better accuracy in emergency management, antibiotic prescription, and local anesthesia administration. There was a reduction in opioid prescriptions and antibiotic overprescriptions, with an increased tendency to delay prescriptions in favor of definitive treatment. Course evaluations showed strong agreement on the quality and usefulness of the educational module.</div></div><div><h3>Conclusions</h3><div>The online educational module effectively enhanced physician confidence and knowledge in managing tooth infections and pain. Its implementation may help address global concerns about antibiotic overuse and resistance, while also promoting a more responsible approach to the opioid crisis.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"79 ","pages":"Pages 507-516"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145505062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}