Academic Emergency Medicine最新文献

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Commentary on "The Use of TENS for the Treatment of Back Pain in the Emergency Department: A Randomized Controlled Trial". 评论“在急诊科使用TENS治疗背部疼痛:一项随机对照试验”。
IF 3.2 3区 医学
Academic Emergency Medicine Pub Date : 2025-07-29 DOI: 10.1111/acem.70112
Tatsuya Tanaka, Akira Matsuno
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引用次数: 0
Exploring Patients' Perceptions of an Advance Care Planning Intervention in the Emergency Department: A Qualitative Study. 探索急诊科患者对预先护理计划干预的看法:一项定性研究。
IF 3.2 3区 医学
Academic Emergency Medicine Pub Date : 2025-07-29 DOI: 10.1111/acem.70109
Youkie Shiozawa, Saaya Morton, Nanako Shirai, Hannah Oelschlager, Lucy Kiernat, Anita N Chary, Anna C Revette, Adrian Haimovich, Smit Desai, Kai-Wei Chang, Shan W Liu, Maura Kennedy, Mara A Schonberg, Kei Ouchi
{"title":"Exploring Patients' Perceptions of an Advance Care Planning Intervention in the Emergency Department: A Qualitative Study.","authors":"Youkie Shiozawa, Saaya Morton, Nanako Shirai, Hannah Oelschlager, Lucy Kiernat, Anita N Chary, Anna C Revette, Adrian Haimovich, Smit Desai, Kai-Wei Chang, Shan W Liu, Maura Kennedy, Mara A Schonberg, Kei Ouchi","doi":"10.1111/acem.70109","DOIUrl":"https://doi.org/10.1111/acem.70109","url":null,"abstract":"<p><strong>Objectives: </strong>Emergency department (ED) visits offer opportunities for seriously ill patients to formulate future medical care goals, yet ED clinicians lack practical strategies for these conversations. ED GOAL, a behavioral intervention, engages seriously ill yet clinically stable older adults in the ED to address advance care planning (ACP) with their outpatient clinicians. In a randomized trial, goals-of-care documentation was significantly higher in the intervention group compared to controls after three (24.3% vs. 9.9%, p = 0.03) and 6 months (31.4% vs. 12.7%, p < 0.01). This study is a sub-analysis to learn about intervention arm participants' perceived benefits and obstacles of the intervention.</p><p><strong>Methods: </strong>We conducted semi-structured interviews between October 2022 and August 2024 (N = 52) with intervention-arm patients aged 50+ years at three hospitals in Boston, Massachusetts. Using rapid qualitative analyses, we identified themes in intervention-arm participants' comments to open-ended questions about the intervention's benefits and obstacles to continue ACP outside the ED.</p><p><strong>Results: </strong>Of 70 intervention-arm participants, 52 completed interviews, of which two were surrogates. ED GOAL motivated most patients to initiate ACP with outpatient clinicians and loved ones and improved the quality of conversations by clarifying patients' wishes and improving patient-clinician relations. Barriers to continuing ACP were the lack of clinician availability and patient/surrogate readiness. Those with clear care goals found the intervention less useful yet harmless.</p><p><strong>Conclusions: </strong>The intervention provided participants with insights into actionable ACP steps. To address the lack of clinician availability, these conversations may be completed by non-physician clinicians or through non-personnel resources. Better tailored ACP interventions may improve patients' readiness.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT05209880.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740820","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}
引用次数: 0
Balanced Crystalloids for Pediatric Sepsis and Septic Shock. 小儿败血症和感染性休克的平衡晶体。
IF 3.2 3区 医学
Academic Emergency Medicine Pub Date : 2025-07-28 DOI: 10.1111/acem.70115
Brit Long, Michael Gottlieb
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引用次数: 0
Letter to the Editor on "Prevalence of Violence Against Health Care Workers Among Agitated Patients in an Urban Emergency Department". 致编辑的信,题目是“城市急诊科焦虑病人对医护人员的暴力行为普遍存在”。
IF 3.4 3区 医学
Academic Emergency Medicine Pub Date : 2025-07-23 DOI: 10.1111/acem.70103
Tatsuya Tanaka, Akira Matsuno
{"title":"Letter to the Editor on \"Prevalence of Violence Against Health Care Workers Among Agitated Patients in an Urban Emergency Department\".","authors":"Tatsuya Tanaka, Akira Matsuno","doi":"10.1111/acem.70103","DOIUrl":"https://doi.org/10.1111/acem.70103","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688587","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}
引用次数: 0
Inconsistencies in the Impact of Electronic Health Record-Based Clinical Decision Support on Reducing Potentially Inappropriate Medications in Older Adults. 基于电子健康记录的临床决策支持对减少老年人潜在不适当用药影响的不一致性
IF 3.4 3区 医学
Academic Emergency Medicine Pub Date : 2025-07-21 DOI: 10.1111/acem.70107
Brijesh Sathian, Hanadi Al Hamad, Israel Júnior Borges do Nascimento
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引用次数: 0
La Sagrada.
IF 3.4 3区 医学
Academic Emergency Medicine Pub Date : 2025-07-21 DOI: 10.1111/acem.70111
Rama A Salhi
{"title":"La Sagrada.","authors":"Rama A Salhi","doi":"10.1111/acem.70111","DOIUrl":"https://doi.org/10.1111/acem.70111","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681742","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}
引用次数: 0
Reply: Inconsistencies in the Impact of Electronic Health Record-Based Clinical Decision Support on Reducing Potentially Inappropriate Medications in Older Adults. 回复:基于电子健康记录的临床决策支持在减少老年人潜在不适当药物方面的影响不一致。
IF 3.4 3区 医学
Academic Emergency Medicine Pub Date : 2025-07-21 DOI: 10.1111/acem.70106
Gina A Elder, Kevin King, Marc Willner, Matthew J Campbell, Baruch S Fertel, Saket Saxena, Stephen Meldon
{"title":"Reply: Inconsistencies in the Impact of Electronic Health Record-Based Clinical Decision Support on Reducing Potentially Inappropriate Medications in Older Adults.","authors":"Gina A Elder, Kevin King, Marc Willner, Matthew J Campbell, Baruch S Fertel, Saket Saxena, Stephen Meldon","doi":"10.1111/acem.70106","DOIUrl":"https://doi.org/10.1111/acem.70106","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673695","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}
引用次数: 0
Benzodiazepine Co-Exposure Among Patients Presenting to the Emergency Department With a Confirmed Opioid Overdose. 在急诊科确诊阿片类药物过量的患者中苯二氮卓类药物共同暴露
IF 3.4 3区 医学
Academic Emergency Medicine Pub Date : 2025-07-15 DOI: 10.1111/acem.70104
Adrienne Hughes, Hannah Spungen, Rachel Culbreth, Kim Aldy, Alex Krotulski, Robert G Hendrickson, Alexandra Amaducci, Bryan Judge, Christopher Meaden, Diane P Calello, Jennie Buchanan, Joseph Carpenter, Joshua Shulman, Jeffrey Brent, Paul Wax, Sharan Campleman, Michael Levine, Evan Schwarz, Alex F Manini
{"title":"Benzodiazepine Co-Exposure Among Patients Presenting to the Emergency Department With a Confirmed Opioid Overdose.","authors":"Adrienne Hughes, Hannah Spungen, Rachel Culbreth, Kim Aldy, Alex Krotulski, Robert G Hendrickson, Alexandra Amaducci, Bryan Judge, Christopher Meaden, Diane P Calello, Jennie Buchanan, Joseph Carpenter, Joshua Shulman, Jeffrey Brent, Paul Wax, Sharan Campleman, Michael Levine, Evan Schwarz, Alex F Manini","doi":"10.1111/acem.70104","DOIUrl":"https://doi.org/10.1111/acem.70104","url":null,"abstract":"<p><strong>Background: </strong>Simultaneous exposure to both benzodiazepines and opioids can lead to synergistic respiratory depression, complicating overdose management. Our objective was to report on the detection of prescription and novel benzodiazepine co-exposures among patients treated in emergency departments (EDs) with suspected opioid overdoses. We aimed to describe novel benzodiazepine exposures in this population and to compare the clinical severity of co-exposure to benzodiazepines and opioids versus opioids alone.</p><p><strong>Methods: </strong>This study utilized data from the Toxicology Investigators Consortium (ToxIC) Fentalog Study, an observational study at 10 ED sites (Sept 2020-Dec 2023). Waste serum samples were analyzed using liquid chromatography quadrupole time-of-flight mass spectrometry (LC-QTOF-MS) for the presence of over 1200 novel psychoactive substances (NPS), drugs, therapeutics, and metabolites. Analyses included demographics, clinical severity, and outcomes among those with prescription benzodiazepines, novel benzodiazepines, or no benzodiazepines.</p><p><strong>Results: </strong>Among the patients with opioids present (n = 1427), 29.0% of patients had detectable benzodiazepines. 20.5% of patients had detectable prescription benzodiazepines, and 8.5% of patients had detectable novel benzodiazepines. The most commonly detected prescription benzodiazepine was alprazolam (39.3%); the most common novel benzodiazepine was bromazolam (46.3% of novel benzodiazepines). The median age of those with novel benzodiazepines was 34, which was younger than those without benzodiazepines (40) and those with prescription benzodiazepines (41; p = 0.001). Patients without benzodiazepines received naloxone more frequently (p = 0.02), while novel benzodiazepine co-exposure was associated with higher naloxone nonresponse rates (p = 0.03). Patients with novel benzodiazepines (compared to the opioid-only group) had increased odds of requiring mechanical ventilation (aOR: 2.14; 95% CI: 1.07, 4.05) after adjusting for age, gender, race and ethnicity, and the presence of prescription benzodiazepines and/or fentanyl.</p><p><strong>Conclusions: </strong>Nearly a third of patients with confirmed opioid overdose presenting to the ED also had concomitant benzodiazepine exposures. Those with novel benzodiazepines had significantly higher odds of intubation, suggesting greater severity of overdose.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635924","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}
引用次数: 0
The Geriatric Emergency Care Applied Research Standardization Study (GEARSS): An Observational Study of Older Emergency Department Patients. 老年急诊应用研究标准化研究(GEARSS):一项老年急诊科患者的观察性研究。
IF 3.4 3区 医学
Academic Emergency Medicine Pub Date : 2025-07-12 DOI: 10.1111/acem.70101
Ula Hwang, Natalia Sifnugel, Inessa Cohen, Ling Han, Katy Araujo, Luann M Bianco, Cynthia A Brandt, Sandra Capelli, Christopher R Carpenter, Daniel S Cruz, Scott M Dresden, Ivy L Fishman, Katrina Gipson, S Nicole Hastings, William W Hung, Raymond Kang, Mechelle Lockhart, Daniella Meeker, Ugochi Ohuabunwa, Sierra Ottilie-Kovelman, Caitlin Partridge, Timothy F Platts-Mills, Jacqueline Sandoval, Zachary Taylor, Debra F Tomasino, Camille P Vaughan
{"title":"The Geriatric Emergency Care Applied Research Standardization Study (GEARSS): An Observational Study of Older Emergency Department Patients.","authors":"Ula Hwang, Natalia Sifnugel, Inessa Cohen, Ling Han, Katy Araujo, Luann M Bianco, Cynthia A Brandt, Sandra Capelli, Christopher R Carpenter, Daniel S Cruz, Scott M Dresden, Ivy L Fishman, Katrina Gipson, S Nicole Hastings, William W Hung, Raymond Kang, Mechelle Lockhart, Daniella Meeker, Ugochi Ohuabunwa, Sierra Ottilie-Kovelman, Caitlin Partridge, Timothy F Platts-Mills, Jacqueline Sandoval, Zachary Taylor, Debra F Tomasino, Camille P Vaughan","doi":"10.1111/acem.70101","DOIUrl":"10.1111/acem.70101","url":null,"abstract":"<p><strong>Objectives: </strong>Multicenter research of geriatric emergency department (GED) care remains limited. Our objectives were to: 1. Prospectively collect data prioritized by the Geriatric Emergency care Applied Research (GEAR) network, a transdisciplinary taskforce for GED care, and create a multicenter GED research repository of prospective and electronic health record (EHR) data, 2. Assess concordance between prospective and EHR data.</p><p><strong>Methods: </strong>The GEAR Standardization Study (GEARSS) is a multicenter, prospective study of older emergency department (ED) patients (65+) focusing on the 4Ms of age-friendly care (mobility, medication safety, mentation, what matters) and elder mistreatment. Demographic and clinical data were collected via interviews by trained research assistants (RA) on Days 0, 4, 30, and 90 and linked to EHR. Prevalence of chronic comorbidities and incident delirium were measured and reported using descriptive statistics. Prospective and EHR data concordance was assessed with Cohen's Kappa.</p><p><strong>Results: </strong>999 participants were recruited from 5 EDs (3/25/2021-6/30/2022) across 3 institutions: Grady Health System, Northwestern Memorial Hospital, and Yale New Haven Health. The cohort was 57.0% female, 55.2% White, 39.1% Black, and 3.4% Hispanic, and the mean age was 75.1 years. For rheumatologic disease, peptic ulcer disease, diabetes, renal disease, and cancer, prevalence differed between prospective and EHR data by > 10%. About two-thirds of participants were at risk for falls. Concordance between prospective and EHR data was good for ethnicity (K = 0.73); excellent for sex (K = 1.00), age (K = 1.00), and race (K = 0.98); fair for disposition (K = 0.53); slight for ED observation status (K = 0.33) and dementia diagnosis (K = 0.24); poor for delirium presence (K = 0.07).</p><p><strong>Conclusion: </strong>In GEARSS, demographic variables aligned strongly between prospective and EHR data, while diagnosis, disposition, and mentation factors did not. This multicenter data source provides preliminary findings for common geriatric syndromes and conditions. Choice of measures using these data should be driven by GED research questions.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615782","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}
引用次数: 0
Telling Women to "Lean in" Isn't Going to Cut It. 告诉女人“向前一步”是行不通的。
IF 3.4 3区 医学
Academic Emergency Medicine Pub Date : 2025-07-12 DOI: 10.1111/acem.70105
Laura E Walker, Moon O Lee, Andrea Fang, Tala Elia, Elizabeth M Schoenfeld
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引用次数: 0
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