Academic Emergency Medicine最新文献

{"title":"Reply to Pelaccia et al.: hold on the bathwater.","authors":"Pat Croskerry, Mike Clancy","doi":"10.1111/acem.70057","DOIUrl":"https://doi.org/10.1111/acem.70057","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075324","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":"Combined screening of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus in an emergency department: The URDEPTRIO cross-sectional study.","authors":"Chris Wong, Quentin Le Hingrat, Florian Salipante, Vincent Mackiewicz, Florence Damond, Lucile Larrouy, Christophe Choquet, Dan Pospai, Karen Champenois, Diane Descamps, Judith Leblanc, Paul Loubet, Enrique Casalino, Jade Ghosn, Donia Bouzid","doi":"10.1111/acem.70060","DOIUrl":"https://doi.org/10.1111/acem.70060","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075322","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":"Implementation of geriatric clinical decision support in the emergency department for potentially inappropriate medications.","authors":"Gina A Elder, Kevin King, Marc Willner, Matthew J Campbell, Baruch S Fertel, Saket Saxena, Stephen Meldon","doi":"10.1111/acem.70059","DOIUrl":"https://doi.org/10.1111/acem.70059","url":null,"abstract":"<p><strong>Objectives: </strong>The use of potentially inappropriate medications (PIMs) in older adults in the emergency department (ED) is associated with increased risk of readmissions and adverse drug reactions. We sought to assess the impact of electronic health record (EHR)-based geriatric clinical decision support (CDS) on adherence to geriatric recommendations for targeted PIMs prescribed to older adults while in the ED and at ED discharge.</p><p><strong>Methods: </strong>We performed a multicenter pre-post implementation cohort study comparing adherence to geriatric recommendations before and after implementation of ED geriatric CDS for patients 65 years or older for a targeted list of 12 PIMs. ED geriatric CDS consisted of custom order panels with clinical guidance for preferred alternative agents or preferred geriatric dosing if providers opted to proceed with ordering a targeted PIM; CDS was implemented for both medications ordered during the ED visit as well as outpatient prescriptions ordered at discharge. The primary outcomes were the proportions of ED orders and discharge prescriptions adherent to ED geriatric CDS recommendations.</p><p><strong>Results: </strong>A total of 6745 ED orders and 1440 discharge prescriptions were eligible for study inclusion. The proportion of targeted PIMs consistent with geriatric CDS recommendations was higher in the postimplementation group compared to preimplementation group for both ED orders (52% vs. 71%; difference 19%, 95% confidence interval [CI] 16.8%-21.3%) and discharge prescriptions (0.5% vs. 31.7%; difference 31.1%, 95% CI 27.5%-34.7%). In the postimplementation period, geriatric CDS order panel utilization for targeted PIMs was 62.1% for ED orders and 36.7% for discharge prescriptions. Among orders placed through ED geriatric CDS order panels, 90% of ED orders and 80.4% of discharge prescriptions were adherent to geriatric CDS recommendations.</p><p><strong>Conclusions: </strong>EHR-based CDS for older adults in the ED increased the proportion of ED orders and discharge prescriptions adherent to geriatric drug therapy recommendations.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960510","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":"Paper.","authors":"Jonathan D Talmud","doi":"10.1111/acem.70063","DOIUrl":"https://doi.org/10.1111/acem.70063","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959707","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":"Early versus delayed colonoscopy for acute lower gastrointestinal bleeding.","authors":"Olalekan Shobowale, Elias Youssef","doi":"10.1111/acem.70061","DOIUrl":"https://doi.org/10.1111/acem.70061","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957515","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":"Impact of telemental health on suicide prevention care in U.S. emergency departments.","authors":"Stephanie K Doupnik, Cadence F Bowden, Diana Worsley, Cameron Keating, Ashley A Foster, William Quarshie, Jungwon Min, Paul Schulz, Ilmul Jahan Tani, Zachary Meisel, Steven C Marcus","doi":"10.1111/acem.70055","DOIUrl":"https://doi.org/10.1111/acem.70055","url":null,"abstract":"<p><strong>Background: </strong>Mental health concerns are the reason for 7% of U.S. emergency department (ED) visits, and telehealth is increasingly used to provide emergency mental health care. Rural, critical-access hospitals have limited access to in-person mental health care. We sought to describe telemental health care programs in U.S. EDs and test whether access to telemental health care affects use of suicide prevention practices.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey of telemental health care and suicide prevention practices at a nationally representative sample of all U.S. EDs associated with acute care general medical hospitals. We used proportionate allocation and nonresponse weighting to generate national estimates. We used weighted adjusted logistic regression models to measure associations between an ED's access to telemental health care and use of six recommended suicide-prevention practices.</p><p><strong>Results: </strong>A total of 606 of 977 eligible EDs completed the survey (62% response rate), weighted to represent 4321 EDs nationally. Telemental health care was used in 68% of EDs, and rural, smaller-volume, and critical-access EDs were more likely to use telemental health care. Critical-access hospitals were more likely to use telemental health care 24/7 and less likely to have access to a telehealth psychiatrist or electronic health record (EHR)-based information sharing. With structural differences being adjusted for, EDs with telemental health care were more likely to assess patients' suicidal intent or plans (adjusted risk ratio [ARR] 1.07, 95% confidence interval [CI] 1.10-1.14) and access to lethal means (ARR 1.13, 95% CI 1.01-1.26). Critical-access EDs with telemental health care were also more likely to provide lethal means safety counseling (ARR 2.11, 95% CI 1.14-3.89).</p><p><strong>Conclusions: </strong>Telemental health care is widely used across all types of EDs, and EDs with telemental health care are more likely to use suicide prevention practices. Critical-access hospitals rely on telemental health care to a great extent and need better access to telehealth psychiatry and EHR information sharing.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957821","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":"Neighborhood-level variation in prehospital care of patients with suspected stroke in Rhode Island.","authors":"Rebecca Karb, Tina Burton, Timmy Lin, Janette Baird, Maheen Rana, Tracy E Madsen","doi":"10.1111/acem.70046","DOIUrl":"https://doi.org/10.1111/acem.70046","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to identify neighborhood-level inequities in prehospital stroke care, including EMS utilization and last known well (LKW) to ED presentation, in a small state with one large comprehensive stroke center.</p><p><strong>Methods: </strong>This was a retrospective observational study using 2 years of data (2020-2022) from Get With The Guidelines combined with data collected by a large hospital system in Rhode Island that includes a comprehensive stroke center (CSC), the Rhode Island emergency management system database, and 2020 census data.</p><p><strong>Results: </strong>Census tract disadvantage was significantly associated with LKW to ED arrival times, with individuals from more disadvantaged neighborhoods presenting almost a full hour later than individuals from the least disadvantaged neighborhoods (56.9 min, 95% confidence interval 14.9-90.3 min). EMS use was the strongest predictor of LKW to ED arrival times, and the Latinx population was significantly less likely to utilize EMS compared to the White population.</p><p><strong>Conclusions: </strong>Understanding geographical inequities in stroke recognition and prehospital stroke care can help mitigate important socioeconomic and racial/ethnic disparities. In addition, geospatial analysis provides useful information for targeting intervention strategies to neighborhoods with the longest LKW to ED arrival times and lowest use of EMS.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959935","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.","authors":"Layla Parast, Megan Mathews, Marc N Elliott","doi":"10.1111/acem.15069","DOIUrl":"10.1111/acem.15069","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":"590"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833413","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":"Assessment of sous vide water baths in the acute rewarming of frostbitten extremities: A multicenter study.","authors":"Nicholas J Daniel, Johndavid M Storn, Nicholas E Weinberg, William A Galvin, Hillary R Irons, Aaron N Barksdale, Megan L Rischall, Sean M Bilodeau, Jasmine Y Gale, Katherine G Willet, Amalya Wilson, Kara Keiper, Jessica Chevalier","doi":"10.1111/acem.15061","DOIUrl":"10.1111/acem.15061","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":"574-577"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142798950","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":"Measuring the efficacy of community consultation in a pediatric exception from informed consent trial.","authors":"Ann R Johnson, Naomi O Riches, John M VanBuren, Ana E Corona, Kammy Jacobsen, Shu Yang, Manish I Shah","doi":"10.1111/acem.15073","DOIUrl":"10.1111/acem.15073","url":null,"abstract":"<p><strong>Background: </strong>Community consultation activities are required by the Food and Drug Administration prior to conducting research using exception from informed consent (EFIC) for emergency research and aim to provide additional participant protections. However, it is difficult for institutional review boards (IRBs) to assess the efficacy of such activities. In this study, our primary aim was to evaluate the efficacy of the PediDOSE trial's consultation activities by answering key questions about whether consultation efforts reached a relevant community and if the perspectives of the consulted community coincided with those of parents actually enrolled in the study.</p><p><strong>Methods: </strong>Qualitative findings of semistructured interview data collected during community consultation efforts were compared with interview responses from parents of children enrolled in the PediDOSE trial to identify common themes.</p><p><strong>Results: </strong>Most themes were identified in both groups, but additional themes emerged with parents of enrolled participants that may be important for future study teams and IRBs to consider. Even with an overrepresentation of White and non-Hispanic/Latino participants in the community consultations compared to those who were enrolled in the EFIC study there was common overlap of themes.</p><p><strong>Conclusions: </strong>Parent interviews added to our understanding beyond the themes identified in the consultation interviews. The theme of therapeutic misconception was not found in the consultation interviews, possibly due to the child's emergency medical care being theoretical. With modest accommodations, collection of additional demographic and follow-up interview data can successfully assess key elements of community consultation efficacy for EFIC trials.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":"32 5","pages":"506-515"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958952","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}