Western Journal of Emergency Medicine最新文献

{"title":"Ultrasound-guided Emergency Pericardiocentesis Simulation on Human Cadavers: A Scoping Review.","authors":"Luca Ünlü, Felix Margenfeld, Adib Zendehdel, Johannes A Griese, Amélie Poilliot, Magdalena Müller-Gerbl, Christian H Nickel, Mirza Dedic","doi":"10.5811/westjem.39696","DOIUrl":"10.5811/westjem.39696","url":null,"abstract":"<p><strong>Objectives: </strong>Emergency pericardiocentesis is a critical but infrequently performed procedure in emergency medicine, necessitating effective training modalities for emergency physicians. In this scoping review we aimed to identify existing literature on simulation of ultrasound-guided pericardiocentesis in human cadavers.</p><p><strong>Methods: </strong>We carried out a scoping review based on a search on the use of sonography on human cadavers. The following databases were searched: MEDLINE; EMBASE; CENTRAL; BIOSIS Previews; and Web of Science Core Collection. Additionally, we performed a gray literature search. Title and abstract screening were done by a single reviewer, and full-text review was performed by two independent reviewers. Studies included were limited to those published in English or German, focusing specifically on ultrasound-guided pericardiocentesis training models in human cadavers, with no restrictions on publication year or outcomes.</p><p><strong>Results: </strong>Our search strategy yielded 9,821 publications and 1,440 reports were assessed for eligibility. Ultimately, four studies met the inclusion criteria. All were conducted in the USA; two used soft-embalmed cadavers, one reported using fresh frozen cadavers, and one did not specify the cadaver type used. All studies accessed the pericardial sac using large-bore catheters or peripheral lines, filling it with (colored) water for simulation.</p><p><strong>Conclusions: </strong>Evidence on ultrasound-guided emergency pericardiocentesis simulation on human cadavers remains limited, but based on the four studies we reviewed human cadavers could be used for (emergency) pericardiocentesis simulation.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"685-691"},"PeriodicalIF":1.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498172","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":"Field vs. Emergency Department Intubation: A Retrospective Review of Hospital Outcomes of Trauma Patients.","authors":"Mitchell Vorce, Sagar Galwankar, Jarrod Shuck, Amit Agrawal","doi":"10.5811/westjem.41184","DOIUrl":"10.5811/westjem.41184","url":null,"abstract":"<p><strong>Introduction: </strong>Definitive airway management is crucial for severely injured trauma patients when basic pre-hospital interventions fail to provide adequate oxygenation and ventilation. Endotracheal intubation by emergency medical service (EMS) personnel is often necessary before reaching the emergency department (ED). While some studies suggest that advanced airway protocols in the pre-hospital setting improve survival in patients with severe head injuries, others indicate potential complications and adverse outcomes associated with pre-hospital intubation. In this study we aimed to evaluate whether trauma patients who underwent intubation by EMS in the field experienced different hospital outcomes compared to those intubated by physicians in the ED. Specifically, it assessed the impact of pre-hospital intubation on the number of days requiring mechanical ventilation, intensive care unit length of stay (ICU LOS), and overall hospital LOS.</p><p><strong>Methods: </strong>We conducted a retrospective chart review at a single, level II trauma center from January 1, 2019-December 31, 2023, involving trauma patients requiring intubation. Patients were divided into two groups: 608 patients ED department (ED ETT). Primary outcomes included days on mechanical ventilation, while secondary outcomes included ICU and hospital LOS. An independent t-test was performed to compare the differences in mean ventilator days, ICU LOS, and hospital LOS between the two groups, accepting P-value of <0.10 as significant.</p><p><strong>Results: </strong>The study included 1,010 patients, with a mean age of 55.5 years in the ED group and 52.5 years in the pre-hospital group. No statistically significant differences were found in mean ventilator days (4.1 ± 4.6 days for the ED group and 4.1 ± 5.7 days for the pre-hospital group), ICU LOS (5.8 ± 6.1 days in the ED ETT group vs 5.6 ± 7.4 days in the pre-hospital ETT group), or overall hospital LOS (10.1 ± 13.6 days in the ED group vs 10.2 ± 17.5 days in the pre-hospital group).</p><p><strong>Conclusion: </strong>These findings indicate no significant differences in patient outcomes between those intubated pre-hospital and those intubated in the ED. Further research is needed to make modifications to airway management protocols in the pre-hospital setting.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"751-757"},"PeriodicalIF":1.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498134","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":"Moving Beyond \"Check A Box\": Shifting Physician Perceptions and Culture with an Antiracism and Equity Curriculum.","authors":"Hannah Barber Doucet, Timmy Lin, Taneisha Wilson","doi":"10.5811/westjem.20797","DOIUrl":"10.5811/westjem.20797","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to evaluate the impact of the Discussing Anti-Racism and Equity (DARE) curriculum on individual physician knowledge and practice, as well as on perceptions of group culture.</p><p><strong>Methods: </strong>DARE was a longitudinal multimodal curriculum targeted at pediatric and adult emergency medicine (EM) trainees and faculty, made up of 12 lectures/workshops, three simulations, five book clubs, and two movie screenings. We used a multiphase, parallel convergent mixed-methods approach. Focus groups before and after DARE explored prior education, antiracism attitudes and behaviors, perceived impact of intervention curriculum, and perceptions of departmental medical culture. We elucidated themes using thematic analysis. Surveys of trainees and attendings evaluated individual attitudes and practices related to equity and antiracism.</p><p><strong>Results: </strong>We held nine focus groups with a total of 52 participants. Half of participants were EM residents (26), and half were faculty (12 pediatric EM and 14 general EM). Four major themes emerged around antiracism education and DARE. Both trainees and faculty reported a lack of standardized or effective prior education, although trainees are beginning to report increased exposure in medical school. Participants reported an overall positive impact of DARE on individual knowledge and practice, with continued room for improvement. Focus groups particularly highlighted a perceived shift in departmental antiracist culture post-DARE. Finally, future curricular aims were elucidated. A total of 56 surveys showed significant improvement in all realms of antiracism medical- practice questions when posed as retrospective pre-post questions (P < 0.01).</p><p><strong>Conclusion: </strong>The DARE curriculum increased individual antiracism awareness and cultivated culture shift among the targeted clinician group. Focus groups provided clear next steps for ongoing and expanded education.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"441-451"},"PeriodicalIF":1.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498139","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":"Practical Status and Social Background of Current Mobile Stroke Units Worldwide: A Survey and Investigation.","authors":"Masahiko Hiroki, Mototsugu Kohno, Yutaka Kohno, Masaki Misawa","doi":"10.5811/westjem.21267","DOIUrl":"10.5811/westjem.21267","url":null,"abstract":"<p><strong>Background: </strong>We aimed to clarify the current challenges involved in introducing and operating mobile stroke units (MSU) in new regions, considering the social background of regions with MSUs.</p><p><strong>Methods: </strong>We conducted a questionnaire survey on the operational and financial status of all active MSU programs worldwide as of March 2023, and investigated the demographic, economic, and healthcare backgrounds of areas with and without active MSUs. We compared the data for the two groups at the country, state, or city level. We then correlated data gathered from the survey and the investigation.</p><p><strong>Results: </strong>Of the 33 MSU programs contacted, 19 (59%) responded. The responding programs treated a range of 52-1,663 (median 781) patients at an MSU per year. The most commonly reported hours of operation were eight hours every weekday (5, 26%). The majority had four staff on board (11, 58%). No physicians were on board in six MSUs (32%). The catchment area radius ranged from 5-250 (median 22) kilometers. The start-up costs and subsequent annual operation costs of an MSU ranged from $0.7-1.8 million (median 1.0) and $0.7-1.7 (median 1.0) million US dollars, respectively. Reimbursement was obtained by eight (47%), with full reimbursement by two (12%). A negative gross financial balance was reported in eight MSUs (53%, of 15), and a financial challenge was reported in 17 (94%, of 18). Compared to the non-MSU group at the country level, active MSU groups had a significantly higher population, nominal gross domestic product, healthcare access and quality index, and physician density. They also had significantly lower age-standardized stroke incidence rates and age-standardized stroke disability-adjusted life year rate. The MSU operation time was significantly positively correlated with age-standardized stroke incidence rate and negatively with physician density.</p><p><strong>Conclusion: </strong>Despite facing serious financial problems, mobile stroke units currently operate around the world. However, the social context of MSUs appears relatively advanced. For future implementation of MSUs, cost-saving strategies and reimbursements should be addressed, and national or regional social backgrounds should be considered.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"700-711"},"PeriodicalIF":1.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498144","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":"Ending Nuclear Weapons, Before They End Us.","authors":"Kamran Abbasi, Parveen Ali, Virginia Barbour, Marion Birch, Inga Blum, Peter Doherty, Andy Haines, Ira Helfand, Richard Horton, Kati Juva, Jose F Lapena, Robert Mash, Olga Mironova, Arun Mitra, Carlos Monteiro, Elena N Naumova, David Onazi, Tilman Ruff, Peush Sahni, James Tumwine, Carlos Umaña, Paul Yonga, Chris Zielinski","doi":"10.5811/westjem.47301","DOIUrl":"10.5811/westjem.47301","url":null,"abstract":"","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"378-380"},"PeriodicalIF":1.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498178","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":"Exposure to Community Violence and Adverse Childhood Experiences in the Emergency Department.","authors":"Leslie Cachola, Yanina Guevara, Sobia Ansari","doi":"10.5811/westjem.34857","DOIUrl":"10.5811/westjem.34857","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Adverse childhood experiences (ACEs) and exposure to community violence are public health issues linked to negative mental and physical health outcomes. The emergency department (ED) can play a critical role in the care of patients with a history of trauma exposure. Unfortunately, patients' experiences often go unidentified, leading to missed opportunities to address and prevent further harm.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We administered a 22-question survey of trauma exposure in ED patients to 1) identify the prevalence of exposure to community violence and ACEs and resulting post-traumatic stress disorder (PTSD) symptoms, and 2) determine perceived social service needs. This self-administered survey study was conducted on a convenience sample of 267 adult patients at one academic hospital in Chicago, IL, between July 2018-December 2019. This ED sees approximately 70,000 patients annually. These were fluent English-speaking patients who were non-critically ill or altered and chosen randomly after being assigned to an ED room, typically during regular business hours based on research associate availability. They were not offered compensation for study participation. The survey included demographic information and questions modified from the Adverse Childhood Experiences Study questionnaire, the 54-item Survey of Exposure to Community Violence, and the Primary Care PTSD screen. Participants were also asked to identify resources to address their exposure to trauma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 268 surveys, 267 were completed; 88% of participants endorsed exposure to ACEs or community violence (95% confidence interval [CI] 84.1-91.9%, p &lt; 0.001 compared to general US population rate of 61%). A total of 53.6% of respondents endorsed exposure to at least one ACE (95% CI, 47.6-59.6%), and 15.7% were exposed to ≥4 ACE (95% CI, 11.3-20.1%). The most commonly endorsed categories of ACE were \"emotional neglect\" (30.3%, 95% CI 24.8%-35.8%); \"emotional abuse\" (25.8%, 95% CI 20.6%-31.1%); and \"exposure to family substance use\" (21%, 95% CI 16.1%-25.9%). When asked about personal experience with violence in the community, 47.9% said they had been shoved, kicked or punched (95% CI 41.9%-53.9%), 8% had been stabbed (95% CI 4.8%-11.3%), and 6.7% had been shot (95% CI 3.7%-9.7%). Among the survey participants, 26.2% said they had seen someone die from violence either in their home or in their neighborhood (95% CI 20.9%-31.5%). ZIP Code analysis indicates that most patients resided in neighborhoods near our ED and were likely to utilize it for medical care. Of respondents with exposure to trauma 38% asked for resources through their primary care clinic (95% CI 32.2%-43.8%), while 77.4% asked for resources through faith-based organizations (95% CI 72.4%-82.4%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;These findings suggest that most respondents in the ED have experienced trauma, and many are interested in community and clinical r","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"406-412"},"PeriodicalIF":1.8,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498132","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":"Post-Concussion Syndrome Following Blast Injury: A Cross-Sectional Study of Beirut Blast Casualties.","authors":"Hind Anan, Moustafa Al Hariri, Eveline Hitti, Firas Kobeissy, Afif Mufarrij","doi":"10.5811/westjem.21131","DOIUrl":"10.5811/westjem.21131","url":null,"abstract":"<p><strong>Introduction: </strong>The massive 2020 blast in Beirut, Lebanon, caused by improperly stored ammonium nitrate, was one of the most powerful non-nuclear explosions in history, Following the blast, head injuries emerged as a predominant presentation to the emergency department (ED). Blast-induced head injuries can lead to mild traumatic brain injuries (mTBI) mediated via primary blast overpressure without direct head trauma. The recovery process from mTBIs can be prolonged and affected by several factors. If symptoms persist for more than three months, patients should be evaluated for post-concussion syndrome (PCS). While clinical blast-injury studies have focused on repetitive blast exposure, this study evaluates a cohort exposed to a single blast. We hypothesized that a single blast exposure is sufficient to induce PCS symptoms similar to those exposed to repetitive blasts.</p><p><strong>Methods: </strong>This cross-sectional study explores PCS in patients presenting to the ED of a tertiary-care center following the Beirut blast. Patients were identified through medical charts, contacted by phone, and consented to participate at least three months post-blast (beginning in November 2020). We used the Rivermead Post-Concussion Questionnaire (RPQ) to assess for PCS. We analyzed the association of PCS with patients and injury characteristics.</p><p><strong>Results: </strong>Of 370 patients presenting to the ED, 145 (58.5%) completed the study questionnaire. Mean age was 39.8 ± 15.4 years, and 40% were females. Head trauma (46.9%) was the most common presentation. A total of 112 patients (77.2%) met the criteria for PCS, with a median RPQ score of 25 (interquartile range 18.75). After adjusting for injury types and distance from the blast, younger patients (adjusted odds ratio [aOR] 0.972, 95% confidence interval [CI] 0.947-0.998) and females (aOR 2.836, 95% CI 1.114-7.220) were more likely to suffer from PCS.</p><p><strong>Conclusion: </strong>Our study revealed a remarkably high prevalence of PCS among survivors of the Beirut blast, with younger individuals and females disproportionately affected. This highlights the need for age- and sex-specific rehabilitation and support programs. However, the study was limited by incomplete patients records and contact information, leading to the exclusion of a significant number of patients who initially presented to the ED. Ultimately, this study underscores the crucial role of robust public health preparedness and specialized care pathways against future large-scale catastrophes. Further assessment, including neurobiomarker evaluation, will be conducted on these survivors.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"743-750"},"PeriodicalIF":1.8,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498143","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":"Dispatch Decisions and Emergency Medical Services Response in the Prehospital Care of Status Epilepticus.","authors":"Robert P McInnis, Andrew J Wood, Courtney L Shay, Anna A Haggart, Remle P Crowe, Elan L Guterman","doi":"10.5811/westjem.21266","DOIUrl":"10.5811/westjem.21266","url":null,"abstract":"<p><strong>Objective: </strong>Emergency medical dispatch is intended to ensure that emergency medical services (EMS) allocate appropriate resources for the treatment of patients with status epilepticus (SE). However, it is unclear whether dispatch algorithms accurately identify those patients having a seizure-related medical emergency and how dispatch algorithms influence what prehospital resources are allocated for the encounter.</p><p><strong>Methods: </strong>We performed a cross-sectional analysis of prehospital encounters for SE using data from the 2019 ESO Data Collaborative. We included patients who were ≥18 years of age, had an EMS diagnostic impression of SE, and did not have a cardiac arrest. We examined the dispatch-determined complaint designated by the emergency medical dispatch (EMD) code, dispatch-determined level of acuity (A, B, C, D), ambulance response, and training level of the responding prehospital professional.</p><p><strong>Results: </strong>Of the 18,515 patient encounters for SE with an EMD code, 8,279 (44.9%) were women, and the mean age was 40.0 years (SD 19.7). There were 13,829 (75%) encounters that received a dispatch code for seizures/convulsions and 4,686 (25%) with a dispatch code for a non-seizure-related condition. Among encounters for SE identified by dispatch as seizures/convulsions, 6,412 (46.4%) were designated high acuity, 6,626 (63.6%) were designated low acuity, and the majority received emergent ambulance responses (98.1% among those designated high acuity and 81.8% among those designated low acuity) and an Advanced Life Support-trained responder (93.7% among those designated high acuity and 92.7% among those designated low acuity). Median response times were similar for all acuity levels (9.1, 8.8, 9.1, and 8.3 minutes for A-D, respectively).</p><p><strong>Conclusion: </strong>Approximately one-fourth of SE cases were categorized as a non-seizure related condition at dispatch, and fewer than half received the highest acuity determinant code. Despite this, dispatch-assigned acuity did not have a strong relationship with the ambulance response or training level of the EMS responder or response time, suggesting that use of dispatch algorithms might be further optimized and highlighting a potential area to improve quality of EMS care.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"549-555"},"PeriodicalIF":1.8,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498166","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":"Emergency Medicine Residency Website Wellness Pages: A Content Analysis.","authors":"Alexandra Sappington, Brian Milman","doi":"10.5811/westjem.34873","DOIUrl":"10.5811/westjem.34873","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic impacted the way medical students seek residency positions. In 2020, the Accreditation Council for Graduate Medical Education advocated for virtual interviews. Most emergency medicine (EM) interviews in 2023 remained virtual, and this format will persist for the foreseeable future. Since students are not evaluating programs in person in most cases, residency websites are crucial for prospective residents. Resident wellness is critical for resident training and important to prospective residents; it follows that programs must be transparent about resident wellness on websites. In this study we aimed to quantify the number of EM programs with wellness pages on their websites and identify themes portrayed on those pages.</p><p><strong>Methods: </strong>We analyzed residency website wellness pages from EM websites based on the 2022 directory of the Electronic Residency Application Service. We independently coded wellness statements through an inductive process. Codes were revised iteratively to consensus and organized into themes.</p><p><strong>Results: </strong>We identified 278 (100%) EM residency websites. Of these websites, 57 (20.5%) had a wellness page, 45 (16.2%) linked to an institutional page that discussed wellness, 169 (60.8%) discussed wellness themes on their website in areas other than a wellness page, and 69 (24.8%) had no direct mention of wellness anywhere on their website. Using this information, we identified themes including community involvement, growth and development, nutrition and health, psychological well-being, social and relaxation activities, wellness culture and environment, wellness curriculum, wellness structure and resources, and work-life integration.</p><p><strong>Conclusion: </strong>Most EM program websites do not include a wellness page. Of the programs that do, we identified important themes. The absence of dedicated wellness pages on most EM websites suggests an opportunity for programs to better communicate their wellness initiatives to applicants, helping them identify programs that align with their values.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"573-579"},"PeriodicalIF":1.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498176","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":"Trends in Studies on Transesophageal Echocardiography in Emergency Medicine: A Scoping Review.","authors":"Bor-Yuan Tseng, Chih-Jui Yang, Jen-Tang Sun, Yiju Teresa Liu, Kabir Yadav, Yu-Lin Hsieh, Sheng-En Chu, Chen-Wei Lee, Yi-Kung Lee, Tou-Yuan Tsai","doi":"10.5811/westjem.24870","DOIUrl":"10.5811/westjem.24870","url":null,"abstract":"<p><strong>Background: </strong>Transesophageal echocardiography (TEE) has been introduced in resuscitative scenarios in recent decades, with a growing number of emergency physicians learning, performing, and studying resuscitative TEE.</p><p><strong>Objective: </strong>Our goal was to characterize publishing trends regarding TEE use in emergency medicine (EM) and to investigate the increasing interest in potential applications of TEE in emergency departments (ED).</p><p><strong>Methods: </strong>We retrieved published research associated with the use of TEE in EM from the Web of Science database from inception to December 31, 2023. We analyzed trends based on the number of articles published annually. To systematically map trends related to TEE in emergency medicine (EM), we extracted data on the number of unique EM TEE practitioners, institutions performing EM TEE, study topics, and other characteristics from research articles and case reports. To better reflect research trends, we exclusively conducted subgroup analysis on the research articles. We used linear regression analysis to analyze trends and conducted checkpoints on the timelines.</p><p><strong>Results: </strong>Of the 964 titles and abstracts screened, we included 99 eligible published articles after careful review. Articles related to EM TEE increased from one article in 1991 to 20 articles in 2023, and the rate of publication has increased rapidly since 2018 (+12.4 publications per year, 95% confidence interval [CI] 9.8-15.0, P<0.001). The number of EM TEE practitioners and EM TEE-performing institutions underwent a rapid expansion with an inflection point between 2018-2020, with a rate of +91.7 practitioners per year and +36.5 institutions per year. Subgroup analysis revealed a similar trend in the published research articles. The most common indications for EM TEE were cardiac arrest (72.7%), shock (13.1%), and procedural guidance (11.1%). The United States published the majority of EM TEE-related articles (51.5%).</p><p><strong>Conclusion: </strong>The present study highlights that TEE-related articles in EM continue to accelerate. Among the indications for TEE, cardiac arrest remains the most frequently discussed. This scoping review provides insights into the expanding interest and applications of TEE in the field of EM.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"469-477"},"PeriodicalIF":1.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498171","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}