Academic Emergency Medicine最新文献

{"title":"SAEM26 Abstracts.","authors":"","doi":"10.1111/acem.70305","DOIUrl":"https://doi.org/10.1111/acem.70305","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":"33 Suppl 1 ","pages":"S8-S428"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147969474","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":"Guardian Presence in Research Conducted on Children With Blunt Abdominal Trauma in the Emergency Department.","authors":"Irma T Ugalde, Mohamed Badawy, Kevan A McCarten-Gibbs, Kenneth Yen, Paul Ishimine, Nisa S Atigapramoj, Pradip P Chaudhari, Daniel J Tancredi, Nathan Kuppermann, James F Holmes","doi":"10.1111/acem.70308","DOIUrl":"10.1111/acem.70308","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":"33 5","pages":"e70308"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832232","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":"How Often Are Emergency Patients Diagnosed With Diabetic Ketoacidosis Despite Not Meeting Laboratory Criteria?","authors":"Richard T Griffey, Nathan Haas, Ryan M Schneider, Daniel Suarez, Jeffrey A Kline, Rachel Ancona, Paulina Cruz-Bravo","doi":"10.1111/acem.70315","DOIUrl":"10.1111/acem.70315","url":null,"abstract":"<p><strong>Objectives: </strong>Emergency department (ED) patients with hyperglycemia, acidosis, and/or ketosis may have diabetic ketoacidosis (DKA) or any of several well-described conditions. Though the diagnosis of DKA is based on specific laboratory criteria, DKA often presents with mixed clinical pictures, making a strictly laboratory diagnosis problematic. When laboratories fail to meet criteria, patients may nevertheless be diagnosed with DKA. The extent of this is not reported.</p><p><strong>Methods: </strong>We conducted a retrospective observational study at an urban academic ED (01/01/2019-02/28/2023) of adult patients with point of care (POC) glucose > 300 mg/dL and POC ketone > 1.1 mmol/L and/or an ED diagnosis of DKA. We present the proportion whose initial laboratories met DKA criteria based on one of two laboratory definitions, the proportion whose initial laboratories did not meet criteria but who were nevertheless diagnosed with DKA, and the frequencies of non-DKA diagnoses potentially explaining these laboratory abnormalities. Analyses were descriptive.</p><p><strong>Results: </strong>Of 1676 patients included, 883 (53%, 95% CI: 50, 55) met lab criteria for DKA. Of 740 screening positive by POC testing whose initial labs did not meet DKA criteria, 229 (31%, 95% CI: 28, 34) were diagnosed with DKA. Primary ED diagnoses of the remaining 511 included: hyperglycemia (196, 38%), starvation ketosis (58, 11%), hyperosmotic hyperglycemic state (11, 2%), and other ketosis (9, 2%), while 67 (13%) had a primary diagnosis of infection, 1 (< 1%) metabolic acidosis and 169 (33%) an unrelated diagnosis.</p><p><strong>Conclusion: </strong>In this single center study of patients screening positive for DKA or given an ED diagnosis of DKA, 53% met laboratory criteria for DKA, and of those not meeting criteria, 31% were nevertheless diagnosed with DKA. This suggests that emergency physicians use criteria beyond laboratory values to diagnose DKA and supports the idea that DKA is ultimately a clinical rather than a purely laboratory-diagnosed condition.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":"33 5","pages":"e70315"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832151","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":"Sand.","authors":"Alexander D McGinley","doi":"10.1111/acem.70327","DOIUrl":"https://doi.org/10.1111/acem.70327","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":"33 5","pages":"e70327"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147939796","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":"Unheard Voices: A Systematic Review of the Experiences of Patients With Bipolar Disorder in the Emergency Department.","authors":"Elsy Willis, Ali Raza Gangji, Emma Morton, Eddy Lang","doi":"10.1111/acem.70324","DOIUrl":"https://doi.org/10.1111/acem.70324","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":"33 5","pages":"e70324"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147969494","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":"Hello, Person Behind the White Coat.","authors":"Ergi Duli","doi":"10.1111/acem.70323","DOIUrl":"https://doi.org/10.1111/acem.70323","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":"33 5","pages":"e70323"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832196","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 Point-of-Care Ultrasound on Patient-Family Experience and Behavioral Response in a Pediatric Emergency Department: A Randomized Control Survey Trial.","authors":"Samuel A Gutierrez, Matthew Hays, Pamela Soriano, Benjamin K Nti","doi":"10.1111/acem.70295","DOIUrl":"10.1111/acem.70295","url":null,"abstract":"<p><strong>Background: </strong>Existing literature indicates that patients respond positively to point-of-care ultrasound (POCUS) across various clinical settings. However, limited research explores how patient-families perceive its use in pediatric emergency department (ED) care. Our study aims to evaluate POCUS's impact on patient experience, stress, and anxiety in the pediatric ED.</p><p><strong>Methods: </strong>We conducted a randomized study (1:1) of pediatric patients (≤ 17 years) presenting with a clinical indication for POCUS (lung, FAST, cardiac, or soft tissue applications). Patients were assigned to either a POCUS or non-POCUS group, excluding those who were unstable or had prior POCUS evaluations. Patient-families completed pre- and post-surveys (5-point Likert scale) at triage and ED disposition. Demographic data were obtained from the electronic medical record. Statistical analyses included Chi-Square, Fisher's Exact, Wilcoxon, and sign tests (α = 0.05) to compare group responses and assess for changes in responses over time.</p><p><strong>Results: </strong>A total of 200 patient-families were enrolled. The cohort was primarily English-speaking, non-Hispanic White males, with an average age of 5.16 years (SEM ±0.37). Common chief complaints included cough (34%), fever (15%), abdominal pain (14%), and shortness of breath (13%). No significant differences were observed in patient experience or ED length of stay. Sign tests indicated significant reductions in stress and anxiety within both groups from pre- to post-survey assessments [Anxiety: p < 0.0001 (POCUS), p = 0.0003 (non-POCUS); Stress: p < 0.0001 (POCUS), p < 0.0001 (non-POCUS)]. POCUS patient-families reported a significantly greater perceived importance of imaging and stated that POCUS directly alleviated their stress and anxiety.</p><p><strong>Conclusion: </strong>The primary outcome, magnitude of change in stress and anxiety, demonstrated significant reductions in both POCUS and non-POCUS groups. Despite similar findings within each group, families receiving POCUS reported greater perceived importance of imaging and strong support for its use, highlighting its potential to enhance patient-centered care and support further research into its optimal implementation in pediatric emergency care.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":"33 5","pages":"e70295"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148025597","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":"Characteristics and Short-Term Outcomes of Patients With Acute Pulmonary Embolism Requiring Intubation.","authors":"Isabel T Dhar, Cecilie D Baltsen, Drew A Birrenkott, Matthew F Freitas, Buse Bor, Asger Granfeldt, Asger Andersen, Mads D Lyhne, Christopher Kabrhel","doi":"10.1111/acem.70317","DOIUrl":"10.1111/acem.70317","url":null,"abstract":"<p><strong>Background: </strong>Patients with severe pulmonary embolism (PE) may experience hemodynamic instability with intubation and mechanical ventilation. However, the characteristics and outcomes of intubated PE patients have not been previously described in the literature.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients requiring activation of our hospital's Pulmonary Embolism Response Team (PERT) from 2012 to 2021 who were intubated within 24 h of their acute PE diagnosis. Our primary outcome was peri-intubation hemodynamic instability and death occurring within 30 min. Our secondary outcome was peri-intubation hemodynamic instability and death within 3 h of intubation.</p><p><strong>Results: </strong>We included 51 patients. Within 30 min of intubation, seven (14%) patients had a new or increased vasopressor requirement, four (8%) suffered cardiac arrest, and 1 (2%) required ECMO. Within 3 h, 26 (51%) patients had a new or increased vasopressor requirement, six (12%) suffered cardiac arrest, and five (10%) required ECMO. Patients with a central PE (n = 29, 57%) were more likely to experience peri-intubation hemodynamic instability (OR 3.4, 95% CI [0.95, 13], p = 0.048). Patients who had right ventricular strain on CT (OR 3.7, 95% CI [1.01, 15], p = 0.043) or echocardiogram (OR 8.0, 95% CI [1.9, 42], p = 0.0014) were also more likely to experience hemodynamic instability.</p><p><strong>Conclusion: </strong>Peri-intubation hemodynamic deterioration occurs in more than half of patients with acute PE, and severe events, like cardiac arrest, are common. Physicians should be cautious when intubating PE patients. Further research is needed to identify optimal strategies to treat PE patients who require intubation.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":"33 5","pages":"e70317"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832204","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":"Emergency Medicine Funding Within NIH Is the Least Concentrated of Any Specialty.","authors":"Nicholas M Mohr, Karen I Cyndari, Priyanka Vakkalanka, Brett Faine, Tera Shea, Manish N Shah","doi":"10.1111/acem.70316","DOIUrl":"10.1111/acem.70316","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":"33 5","pages":"e70316"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832220","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":"When Metrics Replace Values: Ethical Concerns in Healthcare Performance Measures.","authors":"Neeraj Chhabra","doi":"10.1111/acem.70330","DOIUrl":"10.1111/acem.70330","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":"33 5","pages":"e70330"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147961984","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}