Western Journal of Emergency Medicine最新文献

{"title":"Effects of Emergency Department Training on Buprenorphine Prescribing and Opioid Use Disorder-Associated ED Revisits: Retrospective Cohort Study.","authors":"Anna Torchiano, Brian Roberts, Rachel Haroz, Christopher Milburn, Kaitlan Baston, Jessica Heil, Valerie Ganetsky, Matthew Salzman","doi":"10.5811/westjem.35589","DOIUrl":"10.5811/westjem.35589","url":null,"abstract":"<p><strong>Introduction: </strong>Prescribing patients buprenorphine from the emergency department (ED) is recommended by multiple organizations. However, it is unclear how best to encourage physicians to prescribe buprenorphine from the ED. Our objectives in this study were to examine the effects of a departmental-wide training initiative for emergency physicians to prescribe buprenorphine, increase buprenorphine prescribing, and decrease ED re-utilization for opioid use disorder (OUD) complications.</p><p><strong>Methods: </strong>We performed this retrospective cohort study at an academic medical center. Beginning May 1, 2018, the ED started a buprenorphine-education initiative and tracked the proportion of clinicians who obtained buprenorphine-prescribing certification over the following 16 months. We identified adult patients referred to an addiction clinic from the ED during this period. Our primary outcome was the proportion of patients who received a buprenorphine prescription from the ED. Secondary outcomes included ED re-utilization for OUD complications and buprenorphine refills, as well as follow-up in the bridge clinic within 30 days.</p><p><strong>Results: </strong>The proportion of physicians eligible to prescribe buprenorphine increased from 37% to 88% over the study period, and 430 patients were referred to an addiction clinic. The proportion of patients referred to a bridge program who received a buprenorphine prescription increased from 50% during the first month compared to 92% during month 16 (odds ratio 1.14, 95% confidence interval 1.08-1.21 per month). There were no statistically significant changes in any secondary outcomes.</p><p><strong>Conclusion: </strong>Our intervention increased buprenorphine prescribing by emergency physicians. It did not decrease ED reutilization for complications related to opioid use disorder.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"580-587"},"PeriodicalIF":1.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Characteristics of Alcohol-Based Hand Sanitizer Ingestion in Florida before and during the Coronavirus Pandemic.","authors":"Justin Arnold, Amira Athanasios, Diep Nguyen, Rahul Mhaskar","doi":"10.5811/westjem.20814","DOIUrl":"10.5811/westjem.20814","url":null,"abstract":"<p><strong>Introduction: </strong>Hand sanitizer use and media coverage increased throughout the coronavirus-2019 pandemic. In this study our goal was to examine and compare the incidence, demographics, and clinical outcomes of exposures to alcohol-based hand sanitizers (ABHS) before and during the COVID-19 pandemic in the state of Florida.</p><p><strong>Methods: </strong>We analyzed statewide data on all ABHS exposures in adults collected by the Florida Poison Information Network from March 1, 2015-February 28, 2020 (\"pre-COVID-19\" cohort) and during the COVID-19 pandemic from March 1, 2020-May 5, 2023 (\"COVID-19\" cohort). We performed descriptive, univariable, and multivariable analyses to assess changes in sex, age, medical outcome, and intentionality of the exposure in the pre-COVID-19 vs COVID-19 study periods, and we examined the factors associated with medical outcomes.</p><p><strong>Results: </strong>We identified 876 single-substance ingestions of ABHS, 414 in the pre-COVID-19 cohort and 462 in the COVID-19 cohort. The proportions of ABHS ingestions increased significantly during the COVID-19 pandemic in all age groups except the 25-50 age group, where it decreased. Individuals 18-24 of age and those ≥51 years showed a relative increase in both intentional and unintentional ingestions during the COVID-19 period compared to the 25-50 age group. The significant risk factors associated with more severe outcomes in exposed individuals were intentional exposures and younger age.</p><p><strong>Conclusion: </strong>Unintentional ingestions of alcohol-based hand sanitizers showed a relative increase during the COVID-19 pandemic, particularly in individuals 18-25 years of age and those ≥51. Both intentional ingestions and younger age increased the likelihood of moderate or severe outcomes. Harm reduction strategies targeted toward younger individuals and those with intentional ingestions should be considered during future pandemics.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"643-649"},"PeriodicalIF":1.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Legislating Fear: How Immigration Status Mandates Threaten Public Health.","authors":"Peter Sangeyup Yun, Lindsey Williams, Janice Blanchard","doi":"10.5811/westjem.42065","DOIUrl":"10.5811/westjem.42065","url":null,"abstract":"","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"413-414"},"PeriodicalIF":1.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caught Unprepared: The Urgent Need for Reproductive Health Training in Emergency Medicine.","authors":"Peter Sangeyup Yun, Monica Saxena","doi":"10.5811/westjem.42064","DOIUrl":"10.5811/westjem.42064","url":null,"abstract":"","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"758-759"},"PeriodicalIF":1.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Factors and Nomogram for 30-Day Mortality in Heatstroke Patients: A Retrospective Cohort Study.","authors":"Anxin Li, Yuchen Zhang, Xiaoshi Zhang, Zixiao Duan, Yan Chen, Xiaoyan Jiang, Wuquan Deng","doi":"10.5811/westjem.23666","DOIUrl":"10.5811/westjem.23666","url":null,"abstract":"<p><strong>Objective: </strong>Heatstroke (HS) is a severe condition associated with significant morbidity and mortality. In this study we aimed to identify early risk factors that impacted the 30-day mortality of HS patients and establish a predictive model to assist clinicians in identifying the risk of death.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study, analyzing the clinical data of 203 HS patients between May 2016-September 2024. The patients were divided into two groups: those who had died within 30 days of symptom onset; and those who had survived. We analyzed the risk factors affecting 30-day mortality. A nomogram was drawn to visualize the clinical model. We used the receiver operating characteristic (ROC) curve and calibration curve to verify the accuracy of the nomogram. A decision curve analysis was also performed to evaluate the clinical usefulness of the nomogram.</p><p><strong>Results: </strong>Within a 30-day period, 57 patients (28.08%) died. The APACHE II score, the ratio of lactate-to-albumin (LAR), and the core temperature at 30 minutes after admission were independent risk factors for death of HS patients at 30 days. The area under the ROC curve (AUC) for predicting mortality based on the APACHE II score was 0.867, with a sensitivity of 96.5% and a specificity of 61.6%. Moreover, the AUC for predicting mortality based on the LAR was 0.874, with a sensitivity of 93.0% and a specificity of 77.4%. The AUC based on the core temperature at 30 minutes after admission was 0.774, with a sensitivity of 70.2% and a specificity of 78.8%. Finally, the AUC for predicting death due to HS using the combination of these three factors was 0.928, with a sensitivity of 82.5% and a specificity of 91.8%. The calibration curve and the decision-curve analysis showed that the new nomogram had better accuracy and potential application value in predicting the prognosis of HS patients.</p><p><strong>Conclusion: </strong>A nomogram with these three indicators in combination-APACHE II score, lactate-to-albumin ratio, and core temperature at 30 minutes after admission-can be used to predict 30-day mortality of heatstroke patients.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"657-666"},"PeriodicalIF":1.8,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National Study of Firearm Presence and Storage Practices in Homes of Rural Adolescents.","authors":"Benjamin Linden, Megan Sinik, Kristel Wetjen, Pam Hoogerwerf, Junlin Liao, Charles Jennissen","doi":"10.5811/westjem.35252","DOIUrl":"10.5811/westjem.35252","url":null,"abstract":"<p><strong>Introduction: </strong>Firearm-related unintentional and suicide death rates in adolescents are higher in rural areas. In 2020, the overall rural firearm death rate was 28% higher than the urban rate. Firearm access significantly increases the risk. The study objective was to evaluate firearm exposure and storage practices in the homes of rural adolescents.</p><p><strong>Methods: </strong>We conducted a cross-sectional, anonymous survey of attendees at the 2021 National FFA (formerly Future Farmers of America) Convention & Exposition. Descriptive, bivariate, and multivariable logistic regression analyses were performed.</p><p><strong>Results: </strong>A total of 3,296 adolescents 13-18 years of age participated in our survey. Overall, 87% of respondents reported having rifles/shotguns, 71% had handguns, and 69% had both rifles/shotguns and handguns in their homes. The odds of those living on farms having rifles/shotguns and handguns were 7.5 and 2 times higher, respectively, as compared to those from towns. Rifles/shotguns and handguns were stored unlocked and/or loaded at least some of the time in 63% and 64% of homes, respectively. Respondents from farms had 1.5 and 1.7 times greater odds of having rifles/shotguns and handguns stored unlocked and loaded, respectively, as compared to those from town. The South, West and Midwest had odds that were 5.9, 3.2, and 2.8 times higher for rifles/shotguns and 8.1, 5.2, and 4.3 times greater for handguns to be stored loaded and unlocked, respectively, as compared to the Northeast. Only 43% of respondents reported ammunition being locked and stored separately from firearms.</p><p><strong>Conclusion: </strong>Most rural adolescents surveyed lived in homes with firearms, and a large proportion of those firearms were not stored safely. Firearm presence and storage differed by region and home setting. Unsafe storage practices could be contributing to the higher unintentional and suicide death rates seen in rural areas.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"632-642"},"PeriodicalIF":1.8,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variations in Out-of-Hospital Cardiac Arrest Resuscitation Performance and Outcomes in Ohio.","authors":"Michelle M J Nassal, Henry E Wang, Jonathan R Powell, Justin L Benoit, Ashish R Panchal","doi":"10.5811/westjem.19422","DOIUrl":"10.5811/westjem.19422","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding characteristics of top-performing emergency medical service (EMS) agencies and hospitals can be an important tool for improving community out-of-hospital cardiac arrest (OHCA) care. We compared deidentified EMS and hospital-level variations in OHCA performance and outcomes in Ohio.</p><p><strong>Methods: </strong>We analyzed adult OHCA data from the 2019 Ohio Cardiac Arrest Registry to Enhance Survival (Ohio CARES). We limited the analysis to EMS agencies and receiving hospitals with ≥10 OHCA episodes. The primary outcomes were return of spontaneous circulation (ROSC) and survival to hospital discharge. We compared OHCA outcomes between EMS agencies using linear mixed models, with EMS agency as a random effect and adjusting for Utstein variables. We repeated the analysis by receiving hospital. We compared EMS agency population demographics, response times, and resuscitation characteristics of the top 10% of agencies against remaining agencies using chi-squared tests.</p><p><strong>Results: </strong>We included 2,841 OHCA among 44 EMS agencies in our analysis. The ROSC varied three-fold; mean 27.9%, range 15.8%‒51.0%. Among 40 hospitals, survival varied two-fold; mean 12.9%, range 8.1%‒19.0%. Top-performing EMS agencies included both medium- and large-sized agencies that tended to treat younger patients (59 vs 62 years, P<0.01) in public areas (15.7% vs 12.3%, P<0.01). There were no differences in bystander-witnessed arrest, bystander cardio-pulmonary resuscitation (CPR), or EMS response time. However, top-performing EMS agencies used less mechanical CPR (61.7% vs 76.0%, P<0.01) and were more successful in advanced airway placement (89.6% vs 74.8% P<0.01).</p><p><strong>Conclusions: </strong>The ROSC and survival after out-of-hospital cardiac arrest varied across EMS agencies and hospitals in Ohio. Top-performing EMS agencies exhibited unique demographic characteristics, used less mechanical CPR, and were more successful in airway placement. These variations in OHCA care and outcomes can indicate opportunities for system improvement in Ohio.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"541-548"},"PeriodicalIF":1.8,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulation-based Training Changes Attitudes of Emergency Physicians Toward Transesophageal Echocardiography.","authors":"Michael Danta, Alyssa Y Nguyen-Phuoc, Suman Gupta, Aneri Sakhpara, Jeanette Kurbedin, Errel Khordipour, Antonios Likourezos, Lawrence Haines, Amish Aghera, Jefferson Drapkin, Judy Lin","doi":"10.5811/westjem.20788","DOIUrl":"10.5811/westjem.20788","url":null,"abstract":"<p><strong>Objective: </strong>The American College of Emergency Physicians recommends that transesophageal echocardiography (TEE) be used to \"maintain the standard of ultrasound-informed resuscitation\" in cardiac arrest. To date, no standards exist on how to train emergency physicians (EP) on TEE use in the emergency department (ED). We propose a novel educational paradigm using simulation to train EPs on the use of TEE in cardiac arrest.</p><p><strong>Methods: </strong>A total of 63 EPs at a single-center academic teaching hospital participated in a 90-minute simulation-based education session to summarize the use of TEE in cardiac resuscitation and practice related procedural skills. The session consisted of a simulated cardiac arrest scenario using both transthoracic echocardiography (TTE) and TEE and hands-on practice on a high-fidelity TEE task trainer. Participants filled out anonymous surveys before and after the training session, which evaluated their subjective attitudes toward TEE, knowledge of its role in cardiac arrest, and perceived efficacy of the curriculum in introducing the modality.</p><p><strong>Results: </strong>Survey results indicated fewer perceived barriers to performing TEE in resuscitation after completion of the course, with statistically significant decreases in the following: not understanding image acquisition (85.5% pre vs 27.4% post; P<0.001), interpretation (66.1% pre vs 25.8% post; P<0.001), indications (29.0% pre vs 0.0% post; P<0.001), contraindications (35.5% pre vs. 3.2% post; P<0.001), and the potential benefit for the patient (24.2% pre vs 3.2% post; P <0.001). Finally, 68% of EPs stated they were \"extremely likely\" to use TEE in cardiac arrest with the availability of assistance from a credentialed attending.</p><p><strong>Conclusion: </strong>The survey responses suggest that a short, simulation-based course can generate interest in the incorporation of TEE in cardiac resuscitation as well as overcome many of the perceived barriers regarding TEE. Moreover, they suggest that the participating academic EPs would be interested in using TEE in critical patients in the future when available.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"465-468"},"PeriodicalIF":1.8,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of an Emergency Department-based Food Insecurity Screening and Referral Program.","authors":"Victor Cisneros, Ian Dennis Capo Olliffe, Marco Santos Esteban, Joseph Bui, Armin Takallou, Shahram Lotfipour, Bharath Chakravarthy","doi":"10.5811/westjem.40006","DOIUrl":"10.5811/westjem.40006","url":null,"abstract":"<p><strong>Introduction: </strong>Food insecurity (FI) remains a pervasive issue in the United States, affecting over 12.8% of households. Marginalized populations, particularly those in urban areas, are disproportionately impacted. The emergency department (ED) holds potential as a vital outreach hub, given its diverse patient population and extensive service coverage. In this study we explore the feasibility of implementing an ED-based FI screening and referral program at an urban, academic teaching hospital. We aimed to assess the prevalence of FI among ED patients and evaluate the feasibility of a three- and six-week follow-up to assess patients' FI and related barriers to resource referral utilization.</p><p><strong>Methods: </strong>This single-center, observational study was conducted at an urban, academic ED from 2018-2024. Initial FI screening was performed using a validated two-question survey adapted from the Hunger Vital Sign screening tool. Participants who screened positive were enrolled and completed the 10-item US Department of Agriculture Adult Food Security survey, received a food assistance guide, and were followed up at three- and six-week intervals to assess changes in FI status.</p><p><strong>Results: </strong>Among 6,339 participants, 1,069 (16.9%) experienced FI, with the highest rates among Black non-Hispanic (24.7%) and Spanish-speaking participants (28.7%). Of the 1,069 participants who screened positive for FI, 630 (59.0%) were enrolled in the study. Of the enrolled participants, 161 (25.6%) completed the three-week follow-up phone calls, and 48 (7.6%) completed the six-week follow-up. The mean FI score for these 48 participants decreased from 6.67 (SD 2.68) at enrollment to 4.75 (SD 2.85) at the three-week follow-up (P < 0.001), and to 4.25 (SD 3.48) by the six-week follow-up (P < 0.001). Barriers to using the food resource guide, such as time constraints, transportation, and misplacement of resources, limited many participants' engagement.</p><p><strong>Conclusion: </strong>This study demonstrated the feasibility and effectiveness of an ED-based food insecurity screening and resource referral program, associated with a significant reduction in food insecurity scores among participants. However, barriers such as time constraints, transportation issues, and misplacement of referral materials limited engagement. Addressing these barriers through tailored follow-up and systematic support systems, including universal screening during ED intake and personalized assistance, can enhance the program's accessibility and impact.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"396-405"},"PeriodicalIF":1.8,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Guidelines for Emergency Department Care of Sexual Minorities: Implementable Actions to Improve Care.","authors":"Michael I Kruse, Sawyer Karabelas-Pittman, Grace Northrop, Joanna Stuart, Suneel Upadhye, Blair L Bigham","doi":"10.5811/westjem.20355","DOIUrl":"10.5811/westjem.20355","url":null,"abstract":"<p><strong>Introduction: </strong>Sexual minorities, including lesbian, gay, bisexual, asexual, pansexual, and others make up 4.0-5.4% of the North American population. Stigmatization and minority stress can lead to poorer health status in sexual minorities, and a previous scoping review showed gaps in the emergency medicine (EM) literature for care of sexual minorities. In this review we sought to examine existing guidelines for the care of sexual minorities that made recommendations relevant to care in the emergency department (ED).</p><p><strong>Methods: </strong>Using the PRISMA criteria, we performed a systematic search of OVID Medline, EMBASE, CINAHL, and the grey literature for clinical practice guidelines (CPG) and best practice statements (BPS) published until July 31, 2022. Articles were included if they were in English, included medical care of sexual minority populations of any age, in any setting, region, or nation, and were of national or international scope. Exclusion criteria included primary research studies, systematic or narrative reviews or otherwise non-CPG or BPS statements, editorials or letters to the editor, articles of regional or individual hospital scope, non-medical articles, or if a more recent version of the CPG or BPS existed. We identified, recorded, and assessed for quality all recommendations relevant to using the AGREE-II and AGREE-REX tools. Inter-rater reliability was assessed using the interclass correlation coefficient. We coded recommendations for the relevant point of care while in the ED (triage, registration, rooming, investigations, etc).</p><p><strong>Results: </strong>We excluded 2,413 of 2,534 unique articles. Only nine articles contributed 11 ED-relevant recommendations. Seven of the nine articles were found to be of moderate to high quality; 6 of 11 recommendations were identified as high quality and adaptable. They included recommendations for screening, testing, and care of HIV+ sexual minority populations, and general or trauma care for men who have sex with men and sexual minority populations in general.</p><p><strong>Conclusion: </strong>This is the most comprehensive review of guidance documents for care of sexual minority populations to date. It identifies 11 actionable recommendations for the ED and identifies opportunities for community-led development of comprehensive clinical practice guidelines for care of sexual minority populations in the ED.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"431-440"},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}