American Journal of Emergency Medicine最新文献

{"title":"Naloxone knowledge, interest, and obtainment among a general emergency department patient population.","authors":"Carrie Gold, Troy Madsen, Marina Griffith, Sikoti Langi, Andrew Jones, Gerrit Seymour, Jacob Steenblik","doi":"10.1016/j.ajem.2024.08.043","DOIUrl":"https://doi.org/10.1016/j.ajem.2024.08.043","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395532","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":"Colubrid snake envenomation: Erythrolamprus bizona “false coral” snakebite - clinical aspects and importance of identifying mimics","authors":"Jose Antonio Suárez ,&nbsp;Mario Urriola ,&nbsp;Maickol Manuel Moreno-Botello ,&nbsp;Laura Naranjo-Lara ,&nbsp;Nathan Gundacker ,&nbsp;Luis C. Ascanio ,&nbsp;Christian Olivo-Freites ,&nbsp;Alberto Paniz-Mondolfi","doi":"10.1016/j.ajem.2024.09.018","DOIUrl":"10.1016/j.ajem.2024.09.018","url":null,"abstract":"<div><div>Colubrids represent a diverse group of snakes historically regarded as harmless. With over 300 genera, the Colubridae family is the largest, encompassing approximately two-thirds of extant snake species. We describe a case of an 18-year-old male who suffered a colubrid snakebite from <em>Erythrolamprus bizona</em>, commonly known as the double-stranded coral snake mimic or false coral snake, which he misidentified as Lampropeltis sp., a fangless colubrid snake. Patient experienced localized erythema and edema, which later spread to the entire left hand along with moderate pain. Laboratory tests revealed leukocytosis and elevated creatine kinase. Symptoms resolved one week later. This case highlights the public health significance of ophidian accidents due to apparently “non-venomous snakes” or low-risk snakes such as the opisthoglyphous colubrid <em>E. bizona</em>. It also underscores the need to correctly identify and differentiate these snakes from other harmless colubrids, particularly double-stranded coral snake mimics in areas of geographic overlap and avoid their manipulation if uncertain of their taxonomic status.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269161","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":"Etiology and characteristics of non-aneurysmal thunderclap headache presenting to an acute setting","authors":"Nika Zorko Garbajs MD ,&nbsp;Deena M. Nasr MD ,&nbsp;Fernanda Bellolio MD, MS ,&nbsp;Annelise S. Howick BS ,&nbsp;Derek E. Vanmeter ,&nbsp;Aidan F. Mullan MA ,&nbsp;Alejandro A. Rabinstein MD","doi":"10.1016/j.ajem.2024.09.031","DOIUrl":"10.1016/j.ajem.2024.09.031","url":null,"abstract":"<div><h3>Objectives</h3><p>To describe the characteristics and causes of non-aneurysmal thunderclap headache (TCH) and compare serious from benign underlying causes.</p></div><div><h3>Methods</h3><p>Retrospective cohort study of consecutive adult patients with TCH presenting to a tertiary care academic medical center between 2010 and 2020. Aneurysmal subarachnoid hemorrhage cases were excluded. Cases were categorized into serious or benign; serious TCH was defined as any condition in which delayed diagnosis and treatment could result in neurological disability or death. Risk factors for serious TCH were analyzed. We adhere to standardized guidelines for reporting observational studies.</p></div><div><h3>Results</h3><p>A total of 932 patients presented with TCH. After exclusion of 393 patients with aneurysmal-type subarachnoid hemorrhage, 539 were included in the analysis. One-half (<em>n</em> = 275, 51.0 %) had a serious cause. Median age was 51 years, 69.0 % were female. Most frequent diagnoses were intracranial hemorrhage (<em>n</em> = 102, 18.9 %), reversible cerebral vasoconstriction syndrome (<em>n</em> = 97, 18.0 %), and idiopathic TCH (n = 102, 38.6 %). A multivariable logistic regression model for prediction of serious TCH included age, hypertension, migraines, recurrent TCH, level of consciousness and other clinical exam findings, and achieved an AUROC of 0.732. This score had a sensitivity of 79.9 % (95 % CI 73.5–83.5 %) for the identification of serious TCH. A 0.5-point increase in the risk score was associated with a 73 % increase in the odds of serious TCH (odds ratio 1.73, 95 % CI 1.53–1.95, <em>p</em> &lt; 0.001).</p></div><div><h3>Conclusion</h3><p>Our study describes the relative frequency of presentation and etiologies among patients with TCH This score can aide clinicians in recognising patients with potentially serious cause of TCH, for whom additional imaging and neurological consultation is necessary.</p></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271734","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":"Grand theft ambulance: Media reports of stolen ambulances in the United States, 1980 to 2020","authors":"Ryan A. Sullivan DO, MS ,&nbsp;Chadd K. Kraus DO, DrPH","doi":"10.1016/j.ajem.2024.09.025","DOIUrl":"10.1016/j.ajem.2024.09.025","url":null,"abstract":"<div><h3>Background</h3><p>Ambulance thefts are frequently reported in the media, particularly over the past decade, with increasing numbers of news stories on these events. Despite these media reports, there is a paucity of peer-reviewed literature describing details and themes of these events.</p></div><div><h3>Methods</h3><p>We performed a structured review of media reports published between 1980 and 2020 using publicly available databases <span><span>EMS1.com</span><svg><path></path></svg></span> and Newspaper Source Plus, with keywords “stolen” and “ambulance,” with filters for date range, “1980 to 2020,” and location, “US.” The search was limited to English language articles and duplicate reports were excluded.</p></div><div><h3>Results</h3><p>263 unique media reports of stolen ambulances were identified (<em>n</em> = 149 from <span><span>EMS1.com</span><svg><path></path></svg></span> and <em>n</em> = 114 from Newspaper Source Plus (NSP)). Texas (<em>n</em> = 19) and Pennsylvania (<em>n</em> = 15) had the most media-reported cases of stolen ambulances. Montana, North Dakota, Rhode Island, and Washington, District of Columbia (DC) had the fewest media-reported stolen ambulances. Most cases occurred at a hospital (<em>n</em> = 141), followed by theft on scene (<em>n</em> = 71). Males accounted for approximately two-thirds of alleged perpetrators (68 %, <span><span>EMS1.com</span><svg><path></path></svg></span>, 66 %, NSP).</p></div><div><h3>Conclusions</h3><p>Media reports of ambulance thefts in the US have increased in recent years, highlighting the opportunity for improved education, standard policies and procedures, and increased security countermeasures to prevent the potential injuries and economic losses associated with these events.</p></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241362","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":"Studies of hypothermic cardiac arrest outcomes without core temperature measurements are deeply flawed","authors":"Raimund Lechner ,&nbsp;Hermann Brugger ,&nbsp;Evelien Cools ,&nbsp;Tomasz Darocha ,&nbsp;Peter Paal ,&nbsp;Mathieu Pasquier ,&nbsp;Giacomo Strapazzon ,&nbsp;Bernd Wallner ,&nbsp;Beat Walpoth ,&nbsp;Ken Zafren ,&nbsp;Les Gordon","doi":"10.1016/j.ajem.2024.09.011","DOIUrl":"10.1016/j.ajem.2024.09.011","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301790","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":"High risk and low incidence diseases: Lisfranc injury","authors":"Anya McDermott MD ,&nbsp;Zachary Repanshek MD ,&nbsp;Alex Koyfman MD ,&nbsp;Brit Long MD","doi":"10.1016/j.ajem.2024.09.019","DOIUrl":"10.1016/j.ajem.2024.09.019","url":null,"abstract":"<div><h3>Introduction</h3><p>Lisfranc injuries are uncommon but frequently misdiagnosed and carry a high rate of morbidity.</p></div><div><h3>Objective</h3><p>This review highlights the pearls and pitfalls of Lisfranc injuries, including presentation, diagnosis, and management in the emergency department (ED) based on current evidence.</p></div><div><h3>Discussion</h3><p>Lisfranc injuries are caused by high- or low-energy trauma to the tarsometatarsal (TMT) joint complex. The severity of injury exists on a spectrum, ranging from minor subluxations to fractures and dislocations involving the TMT joint complex. They can be complicated by compartment syndrome, neurovascular compromise, and open fractures. Prompt diagnosis is critical in preventing chronic pain and mobility challenges, as even small subluxations can result in significant morbidity. Lisfranc injuries should be considered in all patients with a foot injury. Patients with Lisfranc injuries most commonly present with midfoot pain, swelling, or ecchymosis. Despite the importance of a timely diagnosis, Lisfranc injuries are commonly missed on plain radiographs due to their often subtle findings. When x-rays are negative but there is significant clinical suspicion, emergency clinicians should obtain advanced imaging such as computed tomography to aid in diagnosis. All Lisfranc injuries should be discussed with orthopedic surgery to determine definitive management. Patients who can be discharged should be made non-weightbearing and placed in a short-leg splint.</p></div><div><h3>Conclusion</h3><p>The consideration of Lisfranc injuries can help emergency clinicians make a timely diagnosis to prevent future complications.</p></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229427","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":"Association between multiple intubation attempts and complications during emergency department airway management: A national emergency airway registry study","authors":"Michael D. April MD, DPhil, MSc ,&nbsp;Steven G. Schauer DO, MS ,&nbsp;Dhimitri A. Nikolla DO, MS ,&nbsp;Jonathan D. Casey MD, MSCI ,&nbsp;Matthew W. Semler MD, MSCI ,&nbsp;Adit A. Ginde MD ,&nbsp;Jestin N. Carlson MD, MS, MHA ,&nbsp;Brit J. Long MD ,&nbsp;Calvin A. Brown III MD","doi":"10.1016/j.ajem.2024.09.014","DOIUrl":"10.1016/j.ajem.2024.09.014","url":null,"abstract":"<div><h3>Objective</h3><p>Peri-intubation complications are important sequelae of airway management in the emergency department (ED). Our objective was to quantify the increased risk of complications with multiple attempts at emergency airway intubation in the ED.</p></div><div><h3>Methods</h3><p>This is a secondary analysis of a prospectively collected multicenter registry (National Emergency Airway Registry) consisting of attempted ED intubations among subjects aged &gt;14 years. The primary exposure variable was the number of intubation attempts. The primary outcome measure was the occurrence of peri-intubation major complications within 15 min of intubation including hypotension, hypoxemia, vomiting, dysrhythmias, cardiac arrest, esophageal intubation, and failed airway with cricothyrotomy. We constructed multivariable logistic regression models to determine the associations between complications and the number of intubation attempts while controlling for measured pre-exposure variables.</p></div><div><h3>Results</h3><p>There were 19,071 intubations in the NEAR database, of which 15,079 met inclusion for this analysis. Of these, 13,459 were successfully intubated on the first attempt, 1,268 on the second attempt, 269 on the third attempt, 61 on the fourth attempt, and 22 on the fifth or more attempt. A complication occurred in 2,137 encounters (14 %). Major complications accompanied 1,968 encounters (13 %) whereas minor complications affected 315 encounters (2 %). The most common major complication was hypoxia. In our multivariable logistic regression model, odds ratios with 95 % confidence intervals for the occurrence of major complications for multiple attempts compared to first-pass success were 4.4 (3.6–5.3), 7.4 (5.0–10.7), 13.9 (5.6–34.3), and 9.3 (2.1–41.7) for attempts 2–5+ (reference attempt 1), respectively.</p></div><div><h3>Conclusions</h3><p>We found an independent association between the number of intubation attempts among ED patients undergoing emergency airway intubation and the risk of complications.</p></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241330","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":"Prevalence of undiagnosed stage B heart failure among emergency department patients","authors":"Michael Gottlieb MD,&nbsp;Evelyn Schraft MD,&nbsp;James O'Brien MD,&nbsp;Daven Patel MD MPH,&nbsp;Gary D. Peksa PharmD, MBA","doi":"10.1016/j.ajem.2024.09.026","DOIUrl":"10.1016/j.ajem.2024.09.026","url":null,"abstract":"<div><h3>Introduction</h3><p>Heart failure (HF) is associated with significant morbidity, mortality, and health care costs. Stage B HF is defined as structural heart disease prior to developing symptomatic HF. If identified early in the disease process, preventative measures may be implemented to slow disease progression to Stage C (symptomatic) or Stage D (refractory) HF. Previous research has focused on outpatient screening for HF in the primary care setting; however, there are limited data on Stage B HF screening in the Emergency Department (ED) setting. The objective of this study was to determine the prevalence of undiagnosed Stage B HF among those with cardiovascular risk factors in the ED setting and identify which risk factors were associated with a greater risk of having Stage B HF.</p></div><div><h3>Methods</h3><p>A prospective, observational study was performed in a single, urban academic ED from 07/2023 to 05/2024. Inclusion criteria were age ≥ 45 years with hypertension, diabetes, obesity, coronary heart disease, previous cardiotoxic chemotherapy, or family history of HF. Exclusion criteria included signs or symptoms of HF, known history of HF, valvular disease, current atrial fibrillation, or primary language other than English. A focused cardiac ultrasound was performed and interpreted by ultrasound-fellowship trained emergency physicians. Sonographers assessed systolic function as ejection fraction &lt;50 % using visual assessment in at least two different views. Sonographers assessed diastolic dysfunction as an E/A ratio &lt; 0.8, or if ≥2 of the following were present: septal e' &lt; 7 cm/s or lateral e' &lt; 10 cm/s, E/e' ratio &gt; 14, or left atrial volume &gt; 34 mL/m². Descriptive statistics were performed, followed by comparative analyses and regression modeling.</p></div><div><h3>Results</h3><p>209 participants were included in the study, with a mean age of 60 years and 51.7 % women. Of these, 125 (59.8 %) had undiagnosed Stage B HF, with 13 (10.4 %) having systolic dysfunction and 112 (89.6 %) having isolated diastolic dysfunction. Among those with isolated diastolic dysfunction, 44 (39.3 %) were grade I, 66 (58.9 %) were grade II, and 2 (1.8 %) were grade III. Predictors of undiagnosed Stage B HF included age (odds ratio 1.06; 95 % CI 1.02 to 1.10) and BMI (odds ratio 1.06; 95 % CI 1.01 to 1.10).</p></div><div><h3>Conclusion</h3><p>A large majority of ED patients with cardiovascular risk factors had undiagnosed Stage B HF. Age and obesity were associated with a higher risk of Stage B HF. This provides an opportunity for early identification and intervention for patients with undiagnosed Stage B HF to reduce progression to more severe HF.</p></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142173759","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":"Languages other than English in a pediatric ED: Documentation, extended stays, and revisits","authors":"Mondira Ray MD ,&nbsp;Andrew Capraro MD","doi":"10.1016/j.ajem.2024.09.024","DOIUrl":"10.1016/j.ajem.2024.09.024","url":null,"abstract":"<div><h3>Objective</h3><p>Given the increasing proportion of patients and caregivers who use languages other than English (LOE) at our institution and across the U.S, we evaluated key workflow and outcome measures in our emergency department (ED) for patients and caregivers who use LOE.</p></div><div><h3>Methods</h3><p>This was a retrospective, cross-sectional study of patients and caregivers who presented to a free-standing urban pediatric facility. We used electronic health record data (EHR) and interpreter usage log data for our analysis of language documentation, length of stay, and ED revisits. We assessed ED revisits within 72-h using a multivariable logistic regression model adjusting for whether a primary care provider (PCP) was listed in the EHR, whether discharge was close to or on the weekend, and insurance status. We restricted our analysis to low-acuity patient encounters (Emergency Severity Index (ESI) scores of 4 and 5) to limit confounding factors related to higher ESI scores.</p></div><div><h3>Results</h3><p>We found that one in five patients and caregivers who use LOE had incorrect documentation of their language needs in the EHR. Using interpreter usage data to most accurately capture encounters using LOE, we found that patient encounters using LOE had a 38-min longer length of stay (LOS) and twice the odds of a 72-h ED revisit compared to encounters using English.</p></div><div><h3>Conclusion</h3><p>These results highlight the need for better language documentation and understanding of factors contributing to extended stays and increased revisits for pediatric patients and caregivers who use LOE.</p></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142173870","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":"Optimizing care pathways: A study of the urgent dispatch program and its impact on emergency department visits","authors":"Erin L. Simon DO ,&nbsp;Aditi Deshmukh MPH ,&nbsp;Cameron Marcus MD ,&nbsp;Judy Wolfe MD ,&nbsp;Jessica Krizo PhD","doi":"10.1016/j.ajem.2024.09.017","DOIUrl":"10.1016/j.ajem.2024.09.017","url":null,"abstract":"<div><h3>Introduction</h3><p>The use of acute hospital-level care at home (hospital-at-home) for patients who are chronically ill has led to decreased medical costs, amount of sedentary time, and hospital admissions. Our large integrated healthcare system identified the need to develop a mechanism through which to decrease emergency department (ED) visits in this patient population by creating a home acute care program called Urgent Dispatch. The primary objective of this study was to determine the medical condition for referral and seven and 30-day ED visit rates.</p></div><div><h3>Methods</h3><p>This was a retrospective cohort of all patients referred to the Urgent Dispatch program from April 1, 2021, through February 28, 2022. We assessed encounters for patient demographics, referral source, reason for visit, number of at home visits, total number of days in the program, and determined if the patient had an ED encounter within seven and 30 days of participation in the program. The healthcare system includes 10 hospitals (academic, community and rural), 17 emergency departments (hospital-based and freestanding) and their associated outpatient clinics.</p></div><div><h3>Results</h3><p>A total of 2218 orders were placed with 1530 (70.8 %) resulting in enrollment in the Urgent Dispatch program. The majority were elderly (75 ± 15.6), white (70 %), female (64.4 %), and had Medicare as their primary insurance (82 %). The average number of visits made by Urgent Dispatch was 1.46 (SD ± 0.95). The average number of days enrolled in the program was 2.4 (SD ± 4.1). The top three referral sources to the program were outpatient primary care (42 %), home care (28 %) and emergency medicine (20 %). The top body systems requiring a visit were cardiovascular (22 %), general (18 %), and respiratory (17.2 %). Of the 1530 urgent dispatch referrals, 19.8 % (<em>n</em> = 303) had an ED visit within seven days, 12 % (<em>n</em> = 183) had an ED visit within eight to 30 days, and 68.2 % (<em>n</em> = 1044) had no ED visit.</p></div><div><h3>Conclusion</h3><p>A home-based care model of healthcare delivery for patients with chronic medical conditions can provide effective care, with 80.2 % of patients avoiding an ED visit within seven days and 68.2 % avoiding an ED visit within 30 days.</p></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233061","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}