Academic Emergency Medicine最新文献

{"title":"Early Warning Score Performance at Time of Admission in the Prediction of Future Organ Support Needs.","authors":"Samuel R Chiacchia, Nicholas M Levin, Ankita Mishra, Yaowei Deng, Alexandra June Gordon, Natalie Htet, Haley Hedlin, Jennifer G Wilson","doi":"10.1111/acem.70182","DOIUrl":"10.1111/acem.70182","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":"e70182"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145375651","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":"Jargons.","authors":"Victor N Oboli","doi":"10.1111/acem.70243","DOIUrl":"https://doi.org/10.1111/acem.70243","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":"33 2","pages":"e70243"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146177403","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":"Age-Based Diagnostic Patterns of Scrotal Ultrasound in Pediatric Emergency Departments: A Multicenter Study.","authors":"Patrick S Walsh, Sri S Chinta, Amanda S Dupont, Jonathan S Ellison, Kevin P Boyd, Patrick C Drayna","doi":"10.1111/acem.70244","DOIUrl":"https://doi.org/10.1111/acem.70244","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":"33 2","pages":"e70244"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225182","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":"Beyond Personal Resilience: Confronting the Minority Tax in Health Equity Leadership in Academic Emergency Medicine.","authors":"Alejandro Aviña-Cadena, Alaina D Geary, Emily C Cleveland Manchanda","doi":"10.1111/acem.70242","DOIUrl":"https://doi.org/10.1111/acem.70242","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":"33 2","pages":"e70242"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225254","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":"B52: \"It's not just a bomber\".","authors":"Anant Shukla, Michelle Izmaylov","doi":"10.1111/acem.70249","DOIUrl":"10.1111/acem.70249","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":"33 2","pages":"e70249"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146256914","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":"A Prospective Multi-Center Implementation Study to Improve the Diagnosis and Treatment of Benign Paroxysmal Positional Vertigo.","authors":"Robert Ohle, Danielle Roy, Elger Baraku, Kashyap Patel, David W Savage, Sarah McIsaac, Ravinder Singh, Daniel Lelli, Darren Tse, Peter Johns, Krishan Yadav, Jeffrey J Perry","doi":"10.1111/acem.70177","DOIUrl":"10.1111/acem.70177","url":null,"abstract":"<p><strong>Background: </strong>Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo, yet it remains underdiagnosed and undertreated in emergency departments (EDs). Despite evidence-based guidelines recommending bedside diagnostic maneuvers (Dix-Hallpike and supine roll test) and canalith repositioning maneuvers (CRMs), these are infrequently utilized, leading to unnecessary imaging, prolonged symptoms, and increased healthcare utilization.</p><p><strong>Objective: </strong>This study aimed to implement an educational strategy to improve the diagnosis and treatment of BPPV in the ED by increasing adherence to guideline-based practices.</p><p><strong>Methods: </strong>We conducted a multicenter interrupted time series study from August 2020 to September 2023. The intervention, developed using the CAN-Implement framework, included online training, quick-reference tools, and a mobile app. Due to the COVID-19 pandemic, in-person training was canceled. The primary clinical outcome was the proportion of patients receiving the appropriate CRM based on positional test results. Implementation outcomes included fidelity, appropriateness, adoption, penetration, and system impact, reported using the Standards for Reporting Implementation Studies (StaRI) guidelines.</p><p><strong>Results: </strong>We included 1682 patients (1252 pre-intervention, 430 post-intervention). There was no significant change in the primary outcome (appropriate CRM use, OR = 1.08, 95% CI: 0.76-1.40). However, selective CT use improved (OR = 1.29, 95% CI: 1.09-1.49), supine roll testing increased from 14.2% to 23.5%, and neurology consults decreased from 7.1% to 4.0%. Documentation of diagnostic test descriptors improved, while neurological exam documentation declined.</p><p><strong>Conclusion: </strong>The intervention did not significantly increase appropriate CRM use but led to improvements in selective imaging, neurology consultation, and horizontal canal testing. Provision of educational tools alone was insufficient to overcome identified environmental barriers. To effectively improve BPPV management in the ED, future efforts should combine hands-on training with system-level supports and workflow integration.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":"e70177"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145429846","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":"Motivating Factors for Participating in the Geriatric Emergency Department Guidelines 2.0.","authors":"Grace Wang, Carolina Diniz Hooper, Satheesh Gunaga, Sangil Lee, Wendy C Coates, Ronna L Campbell, Elizabeth Goldberg, Fernanda Bellolio, Kei Ouchi, James D van Oppen, Shan W Liu","doi":"10.1111/acem.70237","DOIUrl":"10.1111/acem.70237","url":null,"abstract":"<p><strong>Background: </strong>One in five emergency department (ED) visits is by older adults aged 65+ years. Clinical practice guidelines are needed to optimize patient care by translating the best available evidence into actionable recommendations to guide person-centered management for this medically complex and growing patient population. Our objective was to understand contributors' experiences and share best practices to inform other guideline working groups.</p><p><strong>Methods: </strong>We conducted a qualitative study based on thematic analysis with an interpretivist paradigm in June-July 2025, using semi-structured interviews of Geriatric Emergency Department (GED) Guidelines 2.0 contributors to understand their experiences. Interviews were transcribed, independently reviewed by team members, and reflexively coded to identify themes.</p><p><strong>Results: </strong>We interviewed 18 participants. Four main themes emerged: (1) motivations for participation, (2) varying opportunities to be involved, (3) personal benefits, and (4) challenges for improvement. Participants contrasted the strengths of shared learning and development with the burdens of organization and coordination.</p><p><strong>Conclusion: </strong>Contributors to the GED Guidelines 2.0 reported a positive experience. They joined because they wanted to contribute to better care of older patients and to achieve personal and professional goals. Many cited that their roles aligned with their strengths and expertise. They also gained skills and knowledge on systematic reviews and benefited from networking. Future groups planning a similar process should consider having multiple levels of leadership, experts in systematic reviews, regular reminders, and creative incentives to improve the process and foster improved networking opportunities within their disciplines.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":"33 2","pages":"e70237"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146163563","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":"Frailty Alerts Reduce Waiting Time and Length of Stay in the Emergency Department.","authors":"Samia Munir Ehrlington, Jens Wretborn, Daniel Wilhelms","doi":"10.1111/acem.70239","DOIUrl":"10.1111/acem.70239","url":null,"abstract":"<p><strong>Background: </strong>Prolonged emergency department waiting times are associated with increased mortality among older patients. In January 2025, the ED of Linkoping University Hospital, Sweden, implemented a low-resource routine to expedite the workup of older patients living with frailty by prioritized physician assessment and subsequent workup.</p><p><strong>Aim: </strong>To investigate if a frailty alert using the Clinical Frailty Scale followed by prioritized clinical assessment influences ED operating metrics.</p><p><strong>Design: </strong>This was an observational before and after study of a pre-implementation group (control) and a post-implementation group (intervention) between October 2024 and February 2025.</p><p><strong>Setting/participants: </strong>Consecutive patients aged > 64 years, with a documented CFS assessment during the ED visit at the Linkoping University Hospital, Sweden, who consented to participation, were included.</p><p><strong>Method: </strong>Standard ED operating metrics, Time to physician, ED length of stay (LOS), and admission rates were compared between a pre-implementation group and a post-implementation group.</p><p><strong>Results: </strong>A total of 542 ED visits were analyzed (248 pre-implementation, 294 post-implementation). Time to physician was shorter in the post-implementation group at 31 min (IQR 15, 65) versus 44 min (IQR 20, 94) (p < 0.001). ED LOS was reduced from 352 (IQR 266, 515) to 319 (IQR 240, 458) minutes (p = 0.014). The admission rate was unchanged at 59% and 60% (p = 0.4).</p><p><strong>Conclusion: </strong>Frailty alerts based on the CFS with prioritized workup reduced ED LOS and time to physician in older patients living with frailty in this single center study and may be a low-resource intervention to reduce the risks of adverse events in the ED.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT06869148.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":"33 2","pages":"e70239"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12878553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123458","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":"Alpha-2 Agonist Adulterants Are Not Associated With Prolonged Sedation in Emergency Department Opioid Overdose.","authors":"Jennifer S Love, Rachel Culbreth, Kim Aldy, Jeffrey Brent, Paul Wax, Alex Krotulski, Barry Logan, Sharan Campleman, Stephanie Abston, Shao Li, Adrienne Hughes, Rob Hendrickson, Alexandra Amaducci, Bryan Judge, Joseph Carpenter, Michael Levine, Evan Schwarz, Diane Calello, Christopher Meaden, Jennie Buchanan, Joshua Shulman, Alex F Manini","doi":"10.1111/acem.70241","DOIUrl":"https://doi.org/10.1111/acem.70241","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":"33 2","pages":"e70241"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146163558","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":"Comment on \"Development of a Novel Frailty Trigger for Use at Triage in the Emergency Department\".","authors":"Shyam Sundar Sah, Abhishek Kumbhalwar","doi":"10.1111/acem.70188","DOIUrl":"10.1111/acem.70188","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":"e70188"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145429823","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}