Journal of Emergency Medicine最新文献

{"title":"Early Ultrasound-Guided Nerve Blocks for Sickle Cell Pain Crisis: A Novel Approach to Pain Management","authors":"Pranita Kaginele MD,&nbsp;Tyler Najac MD,&nbsp;Jonathan Maik DO","doi":"10.1016/j.jemermed.2025.07.026","DOIUrl":"10.1016/j.jemermed.2025.07.026","url":null,"abstract":"<div><h3>Background</h3><div>Pain management in patients with sickle cell disease (SCD) can be challenging for emergency physicians (EPs). Current emergency department (ED) recommendations for pain management in patients with SCD include rapid triage and pain control with intravenous opioids, followed by other adjunctive modes of analgesia. Regional anesthesia is recommended as a possible adjunct treatment option, but is generally performed later in the hospital course rather than in the ED.</div></div><div><h3>Case Report</h3><div>A 29-year-old man with SCD presented to the ED in a vaso-occlusive crisis in the setting of right worse than left, bilateral hip pain, and was found on x-ray study to have early avascular necrosis of the bilateral hips. He received multiple doses of intravenous hydromorphone for analgesia and was pending admission for further pain management. An ultrasound-guided pericapsular nerve group block was performed with 0.5% ropivacaine, resulting in a considerable reduction in the patient’s pain after 30 min. The patient was able to ambulate after the nerve block and was then discharged from the ED with outpatient follow-up.</div></div><div><h3>Why Should an Emergency Physician Be Aware of This</h3><div>Regional anesthesia can be used as an early method of pain management in vaso-occlusive crises, which can help reduce hospital admissions, reduce opiate use, and decrease hospital length of stay.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"77 ","pages":"Pages 66-68"},"PeriodicalIF":1.3,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144891888","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":"What is the Utility of Point-of-Care Ultrasound for Diagnosing Pulmonary Edema?","authors":"Kristine Jeffers MD ,&nbsp;Samuel M. Keim MD, MS ,&nbsp;Brit Long MD ,&nbsp;Michael Gottlieb MD ,&nbsp;Srikar R. Adhikari MD, MS","doi":"10.1016/j.jemermed.2025.07.024","DOIUrl":"10.1016/j.jemermed.2025.07.024","url":null,"abstract":"<div><h3>Background</h3><div>Dyspnea is a common symptom managed in the emergency department, which has a wide differential. Point-of-care ultrasound (POCUS) may assist in diagnosing several conditions, including pulmonary edema.</div></div><div><h3>Clinical Question</h3><div>What is the utility of POCUS for diagnosing pulmonary edema?</div></div><div><h3>Evidence Review</h3><div>Studies retrieved included seven systematic reviews and meta-analyses evaluating the use of POCUS for diagnosing pulmonary edema. These studies provide estimates of the potential utility of POCUS, with sensitivity ranging between 83% and 97%, specificity 84–98%, positive likelihood ratio 4.8–12.4, and negative likelihood ratio 0.06–0.189.</div></div><div><h3>Conclusion</h3><div>Based upon the available literature, POCUS can reliably diagnose pulmonary edema.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"77 ","pages":"Pages 21-29"},"PeriodicalIF":1.3,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879739","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":"Coronary Computed Tomography Angiography for Assessment of Suspected Acute Coronary Syndrome in the Emergency Department","authors":"Alexander S. Finch MD ,&nbsp;Samuel M. Keim MD, MS ,&nbsp;Venkatesh R. Bellamkonda MD ,&nbsp;Christopher R. Carpenter MD, MDS ,&nbsp;Amal Mattu MD","doi":"10.1016/j.jemermed.2025.07.020","DOIUrl":"10.1016/j.jemermed.2025.07.020","url":null,"abstract":"<div><h3>Background</h3><div>Chest pain is a common chief symptom in the emergency department (ED). Acute coronary syndrome (ACS) is a critical diagnosis and, when missed, is associated with adverse patient outcomes and is frequently associated with malpractice claims. Coronary computed tomography angiography (cCTA) is increasingly available to ED patients and it may aid in diagnosis of ACS.</div></div><div><h3>Clinical Question</h3><div>In adults presenting to the ED with suspected ACS, does cCTA during ED evaluation improve patient-centered outcomes compared with standard interventions, such as clinical gestalt, the HEART score/pathway, and nonimaging disposition strategies?</div></div><div><h3>Evidence Review</h3><div>Three studies were reviewed, including a before-and-after retrospective study, a randomized controlled trial, and a systematic review, in addition to consensus recommendations from the Society of Cardiovascular Computed Tomography, American College of Radiology, and North American Society for Cardiovascular Imaging.</div></div><div><h3>Conclusions</h3><div>Compared with current ED management strategies for suspected ACS, routinely ordering cCTA for patients with chest pain does not improve 1-year cardiac outcomes, reduce admissions, or return visits. However, among low-risk (&lt; 10% baseline risk) patients with ACS, cCTA reduces hospital length of stay and lower costs while increasing revascularization rates. Ultimately, targeting cCTA for patients at higher short-term risk for major adverse cardiovascular events and limited access to invasive cardiac catheterization laboratories may prove to be more efficacious and cost-effective.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"78 ","pages":"Pages 71-77"},"PeriodicalIF":1.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145061012","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":"Emergency Department Accuracy of Point-of-Care Ultrasound in Identifying Clinically Significant Pneumothorax in High-Severity Trauma Patients","authors":"Daniel D. Singer MD ,&nbsp;Hayley Scott MD ,&nbsp;Ali Khan MD ,&nbsp;Alexandra Donnelly DO ,&nbsp;Adam J. Singer MD ,&nbsp;Isadora Botwinick MD ,&nbsp;Randeep Jawa MD ,&nbsp;Ambika Mukhi MS ,&nbsp;Henry C. Thode MD ,&nbsp;Michael Secko MD","doi":"10.1016/j.jemermed.2025.07.009","DOIUrl":"10.1016/j.jemermed.2025.07.009","url":null,"abstract":"<div><h3>Background</h3><div>Thoracic point-of-care ultrasound (POCUS) is an improved modality for detecting pneumothorax (PTX) with high accuracy compared with supine chest x-ray (CXR) study. However, recent research has questioned the sensitivity of POCUS for diagnosis of PTX in trauma patients.</div></div><div><h3>Objective</h3><div>The authors determined the accuracy of emergency physician (EP) POCUS in identifying clinically significant PTX in high-severity trauma patients based on the red criteria of the 2021 National Expert Panel on Field Triage.</div></div><div><h3>Methods</h3><div>The authors conducted a retrospective review of high-severity trauma patients over a 3-year period at a level I trauma center. The presence or absence of PTX was determined by means of computed tomography or a clinician’s description of a “rush of air” on tube thoracostomy placement. PTX was defined as clinically significant if the patient required tube thoracostomy within 2.5 h of triage. Diagnostic test characteristics of CXR study and POCUS performed by emergency providers were calculated.</div></div><div><h3>Results</h3><div>Forty of 924 patients had clinically significant PTX. POCUS identified 26 of 38 patients who survived before computed tomography, for a sensitivity of 68% (95% CI 52–80%), specificity of 100% (95% CI 19.8–100%), positive predictive value of 100% (95% CI 84–100%), and negative predictive value of 14.3% (95% CI 2.5–43.9%). Review of POCUS by fellowship-trained EPs improved sensitivity to 32 of 38 (84%; 95% CI 70–93%), specificity remained the same, PPV was 100% (95% CI 87–100%), and NPV was 25% (95% CI 4.5–64%). Plain CXR study had an overall sensitivity of 48.1% (95% CI 34.2–62.2%) and specificity of 99% (95% CI 97.5–99.6%).</div></div><div><h3>Conclusions</h3><div>Our results suggest that POCUS is accurate in identifying clinically significant PTX, especially when supervised by fellowship-trained EPs. Less experienced EPs should exercise proper technique in image acquisition and interpretation and may require more supervision by trained EPs. These results highlight the necessity for ongoing real-time quality improvement.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"77 ","pages":"Pages 140-151"},"PeriodicalIF":1.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996376","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":"Anterior Knee Dislocation","authors":"Andrew Lobashevsky MD,&nbsp;Joseph Portale MD, MSPH","doi":"10.1016/j.jemermed.2025.07.010","DOIUrl":"10.1016/j.jemermed.2025.07.010","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"77 ","pages":"Pages 61-62"},"PeriodicalIF":1.3,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890960","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":"Effectiveness of Standardized Pain Management Protocols for Acute Abdominal Pain in Emergency Departments: A Systematic Review and Meta-Analysis","authors":"Fahim Kanani MD ,&nbsp;Nir Messer MD ,&nbsp;Majd Khalil MD ,&nbsp;Eduard Khabarov MD ,&nbsp;Narmin Zoabi MD","doi":"10.1016/j.jemermed.2025.07.027","DOIUrl":"10.1016/j.jemermed.2025.07.027","url":null,"abstract":"<div><h3>Background</h3><div>Acute abdominal pain constitutes a substantial proportion of emergency department (ED) presentations, yet pain management remains suboptimal due to historical concerns about masking diagnoses. This systematic review comprehensively evaluates standardized pain management protocols across diverse abdominal pathologies.</div></div><div><h3>Objectives</h3><div>To assess the effectiveness of standardized pain management protocols compared to usual care in reducing time to analgesia and improving pain relief outcomes for adults presenting to EDs with acute abdominal pain of visceral, biliary, renal, or pelvic origin.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed/MEDLINE, Cochrane Library, and Web of Science from January 1, 2000, to January 31, 2025. Eligible studies included adults (≥18 years) with acute abdominal pain in ED settings, comparing standardized protocols (nurse-initiated, clinical pathways, patient-controlled analgesia, multimodal approaches) to usual care. Primary outcome was time to first analgesia. Secondary outcomes encompassed pain reduction, patient satisfaction, guideline adherence, and diagnostic accuracy. Risk of bias was assessed using Cochrane ROB-2 for randomized controlled trials and Newcastle-Ottawa Scale for observational studies. Random-effects meta-analyses were conducted with comprehensive sensitivity analyses.</div></div><div><h3>Results</h3><div>From 621 identified records, 47 studies (n = 8347 patients) met inclusion criteria. Time to analgesia meta-analysis (15 studies, n = 3241) demonstrated substantial reduction with standardized protocols: pooled effect size <em>d</em> = 0.54 (95% confidence interval [CI]: 0.41–0.67), representing 42.7% reduction (37.3 minutes absolute). Pain intensity reduction (18 studies, n = 3892) showed significant improvement: standardized mean differences (SMD) −0.76 (95% CI: −0.89 to −0.63). Patient satisfaction improved consistently (12 studies, risk ratios [RR] 1.43, 95% CI: 1.28–1.59). Diagnostic accuracy remained unaffected (8 studies, RR 0.98, 95% CI: 0.94–1.02). Subgroup analyses confirmed benefits across all pathologies, including biliary and pelvic conditions specifically.</div></div><div><h3>Conclusions</h3><div>Standardized pain management protocols demonstrate robust effectiveness in reducing time to analgesia and improving pain relief across all acute abdominal pathologies without compromising diagnostic accuracy. These findings definitively refute historical concerns and support immediate implementation in emergency departments globally.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"78 ","pages":"Pages 132-153"},"PeriodicalIF":1.3,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085487","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":"Quantitative Acid-Base: A Simplified Approach for the Emergency Physician","authors":"Rory Spiegel MD ,&nbsp;David Gordon MD ,&nbsp;Shane Kappler MD ,&nbsp;Max Hockstein MD","doi":"10.1016/j.jemermed.2025.07.021","DOIUrl":"10.1016/j.jemermed.2025.07.021","url":null,"abstract":"<div><h3>Background</h3><div>A deep understanding regarding acid-base physiology has been generally absent from what is considered the skill set of Emergency clinicians. The calculations needed to obtain a solid comprehension of acid-base are thought to be too complex and time consuming, making them impractical for the chaotic environment of the Emergency Department.</div></div><div><h3>Objectives</h3><div>Make acid-base more approachable and accessible for the Emergency Physician.</div></div><div><h3>Discussion</h3><div>We present a simplified approach to quantitative acid-base, allowing clinicians to gain a general understanding of even the most complex acid-base abnormalities with minimal calculations and often with only the use of a basic chemistry profile.</div></div><div><h3>Conclusions</h3><div>With the utilization of a simplified quantitative acid-base model Emergency Physicians can gain a better understanding of their patients’ acid-base physiology.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"77 ","pages":"Pages 50-60"},"PeriodicalIF":1.3,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890984","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":"The Dynamic Impacts of Serial Prevention-and-Control Policies Against COVID-19 Pandemic on Residents’ Emergency Medical Service Demands in China Pre- and Post-Reopening: An Observational Study","authors":"Jun-Jie Ye MS ,&nbsp;Min Yao BM ,&nbsp;Hui-Jie Qin MPH ,&nbsp;Zhi-Yang Mo MS ,&nbsp;Xiao-Hong Ma MS ,&nbsp;Lin Zhao MPH ,&nbsp;Xin-Xuan Hu MPH ,&nbsp;Ze-Qiang Guo BM ,&nbsp;Qiao Li MS ,&nbsp;Xian-Yan Tang PhD","doi":"10.1016/j.jemermed.2025.07.008","DOIUrl":"10.1016/j.jemermed.2025.07.008","url":null,"abstract":"<div><h3>Background</h3><div>China has implemented serial prevention-and-control policies against COVID-19 pandemic pre- and post-reopening, yet it was unclear whether these policy adjustments resulted in changes in residents’ emergency medical services (EMS) demands.</div></div><div><h3>Objectives</h3><div>We aimed to assess the impacts of gradual loosening and reopening policies against the COVID-19 pandemic on residents’ EMS demands.</div></div><div><h3>Methods</h3><div>We conducted an observational study using a data set of 42,909 EMS call records from Nanning Emergency Medical Center during November 2022 to January 2023. We used joinpoint regression to reveal the temporal trends in the daily volume of EMS calls, and interrupted time series analysis to assess the dynamic impacts of serial policies against COVID-19 on the daily volume of EMS calls.</div></div><div><h3>Results</h3><div>The daily volume of EMS calls declined by an average of 2.378 calls per day during the period of “dynamic zero-COVID” policy. During the period of “20 new rules” policy, the daily volume of EMS calls slightly increased by an average of 5.362 calls per day. During the period of “10 new measures” policy, the daily volume of EMS calls significantly increased, by an average of 32.566 calls per day. During the “Adjustment 1” policy, the daily volume of EMS calls dramatically decreased by an average of 33.411 calls per day. During the “Adjustment 2” policy, the daily volume of EMS calls significantly continued to decrease by an average of 4.381 calls per day.</div></div><div><h3>Conclusions</h3><div>Residents’ EMS demands slightly decreased during the “dynamic zero-COVID” policy, slightly increased during the “20 new rules” policy, rapidly increased during the reopening “10 new measures” policy, dramatically decreased during the “Adjustment 1” policy, and continued to decrease during the “Adjustment 2” policy.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"77 ","pages":"Pages 117-126"},"PeriodicalIF":1.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922030","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":"Evaluating Practice Patterns of Observation Periods Status Post Epinephrine Administration for Anaphylaxis","authors":"Benjamin Walters BS ,&nbsp;Hanna B. Short BS ,&nbsp;Nigel Ravida BS ,&nbsp;Maria Fabe BS ,&nbsp;Susan Boehmer MS ,&nbsp;Lilia Reyes MD","doi":"10.1016/j.jemermed.2025.07.001","DOIUrl":"10.1016/j.jemermed.2025.07.001","url":null,"abstract":"<div><h3>Background</h3><div>Anaphylaxis is a life-threatening emergency requiring use of epinephrine and subsequent observation period. The National Institute of Allergy and Infectious Disease (NIAID) suggests that patients with resolved anaphylaxis should be observed for at least 4–6 h to monitor for biphasic reactions.</div></div><div><h3>Study Objectives</h3><div>The primary objective was to investigate practice patterns in observation time in the emergency department (ED) for anaphylaxis after epinephrine administration. Secondary objectives included the adjunct medical management, allergens, and frequency of biphasic reactions.</div></div><div><h3>Methods</h3><div>A retrospective chart review from January 2017 to September 2022. Patients ≥ 18 years of age who presented with anaphylaxis requiring epinephrine administration and a documented observation period after, qualified. There were 1751 male and female patients identified; only 488 met criteria. There were 1263 patients excluded for no epinephrine administration.</div></div><div><h3>Results</h3><div>The median number of minutes observed in the ED after epinephrine administration for all patients was 235 min (95% confidence interval [CI] 251.50–285.16, SD = 187.28); 21 patients (4.29%) experienced a biphasic reaction. Patients with biphasic reactions were observed for a median of 451.38 min (95% CI 320.29–582.47, SD = 297.99). Patients without a biphasic reaction were observed for a median of 262.13 min (95% CI 245.43–278.83, SD = 181.47, <em>p</em> &lt; 0.05). No statistically significant relationship was found between the timing of epinephrine administration after symptom onset and frequency of biphasic reaction (<em>p</em> = 0.57).</div></div><div><h3>Conclusions</h3><div>Observation time after epinephrine administration on the index ED visit was comparable with the NIAID-suggested 4 to 6 h. Patients with biphasic reactions were observed longer than those without a biphasic reaction.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"77 ","pages":"Pages 69-76"},"PeriodicalIF":1.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893883","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":"Residue and Resilience: Understanding and Addressing Post-Traumatic Stress Disorder, Compassion Fatigue, Moral Injury, and Burnout in Emergency Medicine","authors":"Joshua Lowe MD,&nbsp;Sean Griffiths DO","doi":"10.1016/j.jemermed.2025.07.017","DOIUrl":"10.1016/j.jemermed.2025.07.017","url":null,"abstract":"<div><h3>Background</h3><div>Emergency medicine providers frequently experience psychological distress, often labeled as “burnout.” However, this term is frequently used as a catch-all, obscuring key differences between burnout, compassion fatigue, moral injury, and post-traumatic stress disorder (PTSD). These distinct conditions arise from different causes—ranging from individual trauma to organizational dysfunction—and require targeted interventions. Mislabeling them can lead to ineffective or even counterproductive solutions.</div></div><div><h3>Discussion</h3><div>PTSD is an acute condition stemming from identifiable traumatic events and is best addressed through individualized, evidence-based therapies. Compassion fatigue arises from chronic empathy-based stress and benefits from resilience training and self-compassion practices. Moral injury, by contrast, results from acute violations of one’s moral or ethical framework—often triggered by leadership or systemic failures—and requires organizational accountability and repair. Burnout is a chronic consequence of motivational incongruence between provider values and systemic pressures and cannot be resolved through individual-focused strategies alone. Addressing burnout and moral injury effectively requires leadership-driven changes, including ethical consistency, staffing support, and realignment of institutional priorities with provider values.</div></div><div><h3>Conclusions</h3><div>Properly naming and framing psychological distress is essential to developing appropriate, effective interventions. Interventions must align with the underlying causes of each condition. By distinguishing between these overlapping but distinct forms of distress, emergency medicine can move beyond one-size-fits-all wellness approaches and implement sustainable, compassionate, and systemic solutions that support provider well-being and improve patient care.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"77 ","pages":"Pages 14-20"},"PeriodicalIF":1.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866513","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}