The Journal of Emergency Medicine最新文献

{"title":"Direct comparison of the European Society of Cardiology 0/1-hour versus 0/2-hour algorithms in acute chest pain patients","authors":"Agnes Engström, A. Mokhtari, Ulf Ekelund","doi":"10.1016/j.jemermed.2024.02.004","DOIUrl":"https://doi.org/10.1016/j.jemermed.2024.02.004","url":null,"abstract":"","PeriodicalId":501218,"journal":{"name":"The Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139880282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement of Emergency Department Chest Pain Evaluation Using Hs-cTnT and a Risk Stratification Pathway","authors":"Zhengqiu Zhou, Kevin S. Hsu, Joshua Eason, Brian Kauh, Joshua Duchesne, Mikiyas Desta, William Cranford, Alison Woodworth, James D. Moore, Seth T. Stearley, Vedant A. Gupta","doi":"10.1016/j.jemermed.2024.02.008","DOIUrl":"https://doi.org/10.1016/j.jemermed.2024.02.008","url":null,"abstract":"","PeriodicalId":501218,"journal":{"name":"The Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139882182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid Prescribing Rate for Non-operative Distal Radius Fractures and Clinician Response to a Clinical Decision Support Alert","authors":"Ben Averkamp, Katherine Li, Meghan K. Wally, Tamar Roomian, Christopher Griggs, Michael Runyon, Joseph R. Hsu, Rachel B. Seymour, Michael Beuhler, Michael J. Bosse, Manuel Castro, Michael Gibbs, Steven Jarrett, Daniel Leas, Susan Odum, Ziqing Yu, James Rachal, Animita Saha, D. Matthew Sullivan, Brad Watling","doi":"10.1016/j.jemermed.2023.12.002","DOIUrl":"https://doi.org/10.1016/j.jemermed.2023.12.002","url":null,"abstract":"<h3>Background</h3><p>Opioids are commonly prescribed for the management of acute orthopedic trauma pain, including nonoperative distal radius fractures.</p><h3>Objectives</h3><p>This prospective study aimed to determine if a clinical decision support intervention influenced prescribing decisions for patients with known risk factors. We sought to quantify frequency of opioid prescriptions for acute nonoperative distal radius fractures treated.</p><h3>Methods</h3><p>We performed a prospective study at one large healthcare system. Utilizing umbrella code S52.5, we identified all distal radius fractures treated non-operatively and the encounters were merged with Prescription Reporting with Immediate Medication Mapping (PRIMUM) database to identify encounters with opioid prescriptions and patients with risk factors for opioid use disorder. We used multivariable logistic regression to determine patient characteristics associated with the prescription of an opioid. Among encounters that triggered the PRIMUM alert, we calculated the percentage of encounters where the PRIMUM alert influenced the prescribing decision.</p><h3>Results</h3><p>Of 2984 encounters, 1244 (41.7%) included an opioid prescription. Age increment is a significant factor to more likely receive opioid prescriptions (p&lt;0.0001) after adjusting for other factors. Among encounters where the physician received an alert, those that triggered the alert for early refill were more likely to influence physicians’ opioid prescribing when compared to other risk factors (p=0.0088).</p><h3>Conclusion</h3><p>Over 90% of patients (106/118) continued to receive an opioid medication despite having known risk factor for abuse. Additionally, we found older patients were more likely prescribed opioids for non-operatively managed distal radius fractures.</p>","PeriodicalId":501218,"journal":{"name":"The Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139027258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}