Western Journal of Emergency Medicine最新文献

{"title":"Creation and Implementation of an EMS Elective for Final-Year Medical Students: A 5-year Evaluation.","authors":"Edder Peralta, Christopher Evers, Toniann Gonell, Megan Hodges, David Cohen, Lauren M Maloney","doi":"10.5811/westjem.35419","DOIUrl":"10.5811/westjem.35419","url":null,"abstract":"<p><strong>Introduction: </strong>Emergency medical services (EMS) professionals interact with nearly every type of physician and are key stakeholders across the healthcare spectrum. However, no formal national recommendations exist for medical student education about EMS. When looking for institution-level resources to assist in writing the educational objectives and curricular content for an EMS elective for medical students, limited examples are available for guidance. We designed, implemented, and evaluated a two-week EMS elective for final-year medical students. A pragmatic description of how to create an EMS elective is detailed.</p><p><strong>Methods: </strong>The EMS elective involves an introductory session, an operational orientation, and six ambulance shifts. Self-directed activities and checklists encourage interdisciplinary learning between calls. Additionally, students deliver a case presentation including an example for improved interdisciplinary communication. Before and after the elective, a voluntary anonymous survey is distributed, in addition to a formal standard course evaluation.</p><p><strong>Results: </strong>From 2017-2022, 37 students participated in the elective. Thirty-four (92%) submitted the pre-elective survey, and 21 (57%) submitted the post-elective survey. Mann-Whitney U testing suggested an improved understanding of the capabilities of different EMS practitioner levels and of the different types of medical oversight after the elective (median pre=60%, median post=90%, U=118, P<0.001). Qualitatively, students described their experiences as \"practical,\" \"hands-on,\" and \"eye-opening.\"</p><p><strong>Conclusion: </strong>An EMS elective using andragogy and intentional interdisciplinary communication seems useful in facilitating improved understanding of the fundamentals of EMS practice for final-year medical students.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"556-563"},"PeriodicalIF":1.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Department Comprehensive Social Risk Screening and Resource Referral Program.","authors":"Kaytlena Stillman, Alex Dahut, Antonina Caudill, Katie Hren, Krystal Green, Marie Lauzon, Susan Jackman, Alexander Lawton, Tananshi Chopra, Joel Geiderman, Sam Torbati","doi":"10.5811/westjem.18578","DOIUrl":"10.5811/westjem.18578","url":null,"abstract":"<p><strong>Introduction: </strong>The emergency department (ED) is an appropriate location to screen for and address social risks among patients; however, a standardized process does not currently exist. Our objective in this study was to describe the implementation and findings of a social risk screening and resource referral program using a comprehensive screening questionnaire.</p><p><strong>Methods: </strong>We conducted a prospective, cohort study between July 2022-April 2023 at a single academic, urban ED in Los Angeles, CA. Trained staff on rotating shifts recruited ED patients between 6 am to midnight, with an average of 40 hours of coverage per week including weekends. Patients were excluded if they were <18 years of age, could not provide informed consent, or were deemed too medically unstable. Trained staff screened eligible consenting patients at ED bedside for social risks within 12 different domains of social determinants of health using a 19-question survey. Personalized resources were provided through an online platform or through direct communication with a social worker. Demographic data and patient responses were recorded in a deidentified database. We used a univariate logistic regression analysis to evaluate associations between demographic information and burden of social risk.</p><p><strong>Results: </strong>A total of 4,277 ED patients were considered for screening, and 1,677 (39.2%) were eligible: 1,473 (87.8%) patients consented to social risk screening, and 1,078 (73.2%) of them had at least one social risk as indicated by the screening questionnaire. The most commonly reported social risks were social isolation (39%) and depression (23%). Between 88.9-96.8% of patients categorized as medium social risk were successfully provided resources through the online platform. Between 80.8-100% of patients categorized into high social risk had successfully connected with a social worker while in the ED. In this sample, there were significantly higher odds of having greater than one social risk for female (odds ratio [OR] 1.30, 95% confidence interval [CI] 1.02-1.67) and Black patients (OR 1.37, 95% CI 1.02-1.85) compared to male and White patients, respectively.</p><p><strong>Conclusion: </strong>This study describes the findings from a comprehensive social risk screening and resource referral program at a large, urban, academic ED. The results will inform resource prioritization at the study institution. This model can serve as a basis for similar institutions to use, while individualizing their own approach.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"387-395"},"PeriodicalIF":1.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Hospital Admissions Among Emergency Department Patients: From Triage to Admission.","authors":"Jemima Koh, Oh Hong Choon, Seah Zeyen, Steven Lim","doi":"10.5811/westjem.21263","DOIUrl":"10.5811/westjem.21263","url":null,"abstract":"<p><strong>Introduction: </strong>Healthcare systems typically provide multiple channels to access acute inpatient care, with the emergency department (ED) as the main route of access. The ED faces multifaceted demand and supply challenges, which implicate resource allocation and patient flow. In this study we aimed to identify factors associated with hospital admissions among ED patients in a Singapore tertiary-care hospital.</p><p><strong>Methods: </strong>Using a retrospective cohort study of all eligible visits to a Singapore ED between January 1-December 31, 2019, we conducted a multivariable, mixed-effect logistic regression model to study the factors associated with hospital admissions. The model accounted for patients' demographics; triage category; arrival mode; referral source; time of ED visit; discharge diagnosis; and ED occupancy levels.</p><p><strong>Results: </strong>In 2019, there were 141,719 visits to the ED, with 42,238 (29.8%) of these visits resulting in hospital admissions. Factors associated with increased odds of hospital admissions included increasing age, being male, ethnicity (Malay vs Chinese), higher patient acuity, non-self-referred patients (vs self-referred), patient being conveyed by ambulances (vs walk-in), and category of disease. Our model demonstrated that the highest odds of inpatient admissions were attributed to the patient's acuity (highest vs lowest acuity: odds ratio [OR] 326, 95% confidence interval [CI] 292-363), followed by patients' age (70 and above vs 30 and below: OR 13.8, 95% CI 12.8-14.8). The ORs for all other factors with significantly increased odds of admissions were modest, ranging from 1.12-4.18. Although the ED occupancy levels at the hour of the patient's disposition decision, the hour of the ED visit, and the month of the ED visit were significantly associated with hospital admissions, changes in the probabilities of hospital admissions across the possible range of values of these factors were marginal.</p><p><strong>Conclusion: </strong>Our study revealed several factors significantly associated with hospital admissions, with patient acuity and age as the most important factors. Moreover, emergency physicians' decisions to admit patients were clinically consistent and only marginally influenced by the degree of ED crowding. These findings offer invaluable insights into follow-up studies that will be crucial in shaping new policies or designing new interventions to enhance current preventive health or healthcare delivery systems to curtail the growth in inpatient-bed demand among ED patients over time.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"513-522"},"PeriodicalIF":1.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Delays Are Common, and Classic Presentations Are Rare in Spinal Epidural Abscess.","authors":"Edward J Durant, Sarabeth Copos, Bruce F Folck, Meredith Anderson, Meena S Ghiya, Erik R Hofmann, Peter Vuong, Judy Shan, Mamata Kene","doi":"10.5811/westjem.24985","DOIUrl":"10.5811/westjem.24985","url":null,"abstract":"<p><strong>Introduction: </strong>Spinal epidural abscess (SEA) is a rare surgical emergency of the spine that can result in permanent neurological injury if not diagnosed and treated in a timely manner. Because early presentation can appear similar to benign back or neck pain, delays in diagnosis may be relatively common. We sought an improved understanding of the characteristics associated with SEA and frequency of delays in SEA diagnosis.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of adult patients with new magnetic resonance imaging-confirmed SEA from January 1, 2016-December 31, 2019 in an integrated healthcare system. We applied electronic data abstraction and focused manual chart review to describe potentially SEA-related ambulatory and emergency visits in the 30 days prior to SEA diagnosis, and patient characteristics including comorbidities, potential risk factors, and presenting signs and symptoms. We described the frequency of potential delays in diagnosis and of previously described clinical characteristics and risk factors for SEA.</p><p><strong>Results: </strong>Spinal epidural abscess was diagnosed in 457 patients during the study period, 178 (39%) of whom were female, with median age 63 years (interquartile range 45-81 years). More than two-thirds of patients had at least one visit prior to diagnosis (323, 71%), and SEA location was most commonly the lumbar spine (235, 51%). Although over 90% of patients presented with back or neck pain or tenderness, the classic triad of back pain, fever, and neurologic symptoms was present in only 10% of patients. Diabetes mellitus and infection in the prior 90 days were common, while injection drug use, chronic steroid use, HIV infection, and solid organ transplant were rare.</p><p><strong>Conclusion: </strong>In an integrated healthcare system, 71% of patients with spinal epidural abscess had potentially related ambulatory care or emergency visits in the 30 days prior to diagnosis. Diagnosis of SEA remains challenging, with multiple visits common before the diagnosis is clear.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"692-699"},"PeriodicalIF":1.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Review of Sports-Related, Life-Threatening Injuries Presenting to Emergency Departments, 2009-18.","authors":"Abiye Ibiebele, Rebekah Mannix, William Meehan","doi":"10.5811/westjem.18630","DOIUrl":"10.5811/westjem.18630","url":null,"abstract":"<p><strong>Introduction: </strong>In the United States, 3.7 million people present to an emergency department (ED) annually with an injury related to sports or athletic activity. A prior study a decade ago revealed that 14% of life-threatening injuries presenting to EDs were sports related, with this percentage being higher in the pediatric population. However, with changes in sports participation and regulatory changes over the past decade, it is unclear whether the proportion of life-threatening sports-related injuries has changed.</p><p><strong>Methods: </strong>We conducted a cross-sectional study using the National Hospital Ambulatory Medical Care Survey (NHAMCS), consisting of patients from years 2009-2018. Life-threatening injuries were defined as International Classification of Diseases 9 and 10 codes for skull fracture, cervical spine fractures, intracranial hemorrhage, traumatic pneumothorax/hemothorax, liver lacerations, spleen lacerations, traumatic aortic aneurysm or rupture, gastric/duodenal rupture, heat stroke, and commotio cordis. Injuries were classified as sports related based on external cause of injury codes. We examined the relationship between demographic variables and sports-related injuries using Pearson chi-square analysis.</p><p><strong>Results: </strong>From the years 2009-2018 there were 256,564 observed ED visits. Of these, 646 were for life-threatening injuries, representing a national estimate of 3,456,166 patients over the 10-year period. Thirteen percent were sports related. Of the life-threatening injuries, 77.5% were injuries to the head and neck, and 9.1% of these were sports related. The proportion of life-threatening injuries due to sports and recreation was higher among pediatric patients than adult patients (30.4% vs 9.9%, P<0.001). The proportion of sports-related life-threatening injuries to the head and neck was also higher among pediatric patients than adult patients (23.3% vs 6.4%, P<0.001) CONCLUSION: A substantial proportion of life-threatening injuries occur during sports and recreation, especially among pediatric patients. Compared to a similar study a decade ago, there is a similar proportion of life-threatening injuries that are sports related, however; there does seem to be a decrease in the proportion of life-threatening sports-related injuries to the head and neck. Sports medicine physicians and sports organizations should continue to find effective ways to prevent life-threatening injuries in sports.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"627-631"},"PeriodicalIF":1.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validating an Electronic Health Record Algorithm for Diabetes Screening Eligibility in the Emergency Department.","authors":"Mary H Smart, Janet Y Lin, Brian T Layden, Yuval Eisenberg, Kirstie K Danielson, Ruth Pobee, Chuxian Tang, Brett Rydzon, Anjana Bairavi Maheswaran, A Simon Pickard, Lisa K Sharp, Angela Kong","doi":"10.5811/westjem.20548","DOIUrl":"10.5811/westjem.20548","url":null,"abstract":"<p><strong>Objective: </strong>While the American Diabetes Association (ADA) screening guidelines have been used widely, the way they are implemented and adapted to a particular setting can impact their practical application and usage. Our primary objective was to validate a best practice advisory (BPA) screening algorithm informed by the ADA guidelines to identify patients eligible for hemoglobin a1c (HbA1c) testing in the emergency department (ED).</p><p><strong>Methods: </strong>This cross-sectional study included adults presenting to a large urban medical center's ED in May 2021. We used sensitivity, specificity, likelihood ratios, and predictive values to estimate the algorithm's ability to correctly identify patients eligible for diabetes screening, with manual chart review as the reference standard. Eligibility criteria targeted patients at risk for diabetes who were likely unaware of their elevated HbA1c. We also calculated the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>In May 2021, 2,963 (77%) of the 3,850 adults admitted to the ED had a routine lab ordered. Among those, 796 (27%) had a BPA triggered, and of those 631 (79%) had an HbA1c test completed. The algorithm had acceptable sensitivity (0.69, 95% confidence interval [CI] 0.66-0.72), specificity (0.91, CI 0.89-0.92), positive predictive value (0.75, CI 0.72-0.78) and negative predictive value (0.88, CI 0.86-0.89). The positive likelihood ratio (7.39, CI 6.35-8.42) was adequate, and the negative likelihood ratio (0.34, CI 0.30-0.37) was informative. The AUC of 0.74 (CI 0.72-0.77) suggests that the algorithm had acceptable accuracy.</p><p><strong>Conclusion: </strong>Findings suggest that an electronic health record-based algorithm informed by the ADA guidelines is a valid tool for identifying patients presenting to the ED who are eligible for HbA1c testing and may be unaware of having prediabetes or diabetes. The ease of workflow integration and high yield of potentially undiagnosed diabetes and prediabetes makes the BPA algorithm an appealing method for diabetes screening within the ED.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"720-728"},"PeriodicalIF":1.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter to the Editor Regarding \"Bicarbonate and Serum Lab Markers as Predictors of Mortality in the Trauma Patient\".","authors":"Matthew M Talbott, Dietrich Jehle, Krishna Paul","doi":"10.5811/westjem.41519","DOIUrl":"https://doi.org/10.5811/westjem.41519","url":null,"abstract":"","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"760"},"PeriodicalIF":1.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Oh, Another Overdose, for the Love of Pete\": First Responder Perspectives on Overdose Response Technology.","authors":"William Rioux, Stephanie Jones, S Monty Ghosh","doi":"10.5811/westjem.18471","DOIUrl":"10.5811/westjem.18471","url":null,"abstract":"<p><strong>Background: </strong>Overdose response applications and hotlines are novel overdose response technologies (ORT)/virtual harm reduction strategies that have recently emerged as a strategy to reduce the harms associated with the ongoing opioid epidemic. First responders are often the first point of contact for people who have overdosed and play a significant role in responses enacted by these services. In this study our aim was to explore the attitudes and perceptions of first responders on these novel technologies.</p><p><strong>Methods: </strong>We recruited 17 participants using purposive sampling through the province of Alberta between February-April 2023 including 11 paramedics, two firefighters, and five emergency communications operators. To be included in the study, participants were required to be older than 18 years of age, have the ability to communicate effectively in English, provide verbal informed consent, and work in an emergency responder role. Semi-structured interviews were conducted by two evaluators. When reviewing interview transcripts we used thematic analysis to identify key themes and subthemes.</p><p><strong>Results: </strong>Participants discussed their current operating procedures, their current perspectives on overdose response hotlines and apps, how they would best integrate them into their current workloads, and how to raise awareness of these services within first-responder communities. Participants were apprehensive about the integration of these services into their current workloads, including their potential benefits, and raised concerns about their efficacy within communities of people who use drugs. Key strategies were raised for the successful integration of these services into emergency responses including providing information to clients and the feasibility of overdose responses by the general public.</p><p><strong>Conclusion: </strong>This study's results add to the existing literature on the toll of the overdose epidemic seen within first-response communities. Furthermore, we explored the communities' diverse perspectives on these novel technologies, including support and concerns, and propose additional strategies for their integration into emergency responses.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"588-599"},"PeriodicalIF":1.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey of Firearm Storage Practices and Preferences Among Parents and Caregivers of Children.","authors":"Meredith B Haag, Catlin H Dennis, Steven McGaughey, Tess A Gilbert, Susan DeFrancesco, Adrienne R Gallardo, Benjamin D Hoffman, Kathleen F Carlson","doi":"10.5811/westjem.21205","DOIUrl":"10.5811/westjem.21205","url":null,"abstract":"<p><strong>Introduction: </strong>The American College of Emergency Physicians supports community- and hospital-based programs that intervene to prevent firearm-related injury. To this end, the distribution of firearm locks or storage devices in the emergency department (ED) may help achieve this target. To inform secure firearm storage programs for households with children and firearms, we examined firearm storage practices, device preferences, and cost tolerance among parents/caregivers of children.</p><p><strong>Methods: </strong>Between April 2018-November 2019, we conducted and analyzed an in-person survey of 294 caregivers, aged ≥18, with both children and firearms in the home. Surveys assessed reasons for firearm ownership, storage practices and device preferences among five storage-device options, and prices participants were willing to pay for devices. Practices and preferences were examined by participant characteristics. We used logistic regression to estimate odds ratios and 95% confidence intervals for associations of interest.</p><p><strong>Results: </strong>Most participants (73%) reported personal protection as a reason for owning firearms, and nearly 80% owned at least one firearm storage device. Over half (55%) owned cable locks, but only 36% of owners reported regularly using them. Rapid-access devices (electronic and biometric lockboxes) were less commonly owned (26%) but more likely to be regularly used (73%). The most highly rated storage device features were the following: the ability to store the firearm unloaded (87.3%); the ability to store the firearm loaded (79.1%); and device affordability (65%). Most participants (78%) preferred rapid-access devices over other options. Participants were willing to pay more for products that afforded rapid access to the firearm. Participants reported they would pay a median of $100 for a pushbutton rapid-access product ($80 retail), and $150 for a biometric lockbox ($210 retail).</p><p><strong>Conclusion: </strong>Understanding the storage practices and preferences among firearm-owning households with children can help inform ED injury-prevention screening and firearm safety practice implementation. Our results suggest that rapid-access devices may be the most preferable firearm storage devices for distribution by secure storage programs, and costs are likely minimal given parental/caregiver willingness to pay.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 1","pages":"142-146"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366154","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":"Preparation for Rural Practice with a Multimodal Rural Emergency Medicine Curriculum.","authors":"Ashley K Weisman, Skyler A Lentz, Julie T Vieth, Joseph M Kennedy, Richard B Bounds","doi":"10.5811/westjem.18573","DOIUrl":"10.5811/westjem.18573","url":null,"abstract":"","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 1","pages":"62-65"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366149","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}