Academic Emergency Medicine最新文献

{"title":"Dynamic Appraisal of Situational Aggression Score at Emergency Department Triage Is Associated With Behavioral Intervention: A Cross-Sectional Study.","authors":"Amy D Costigan, Martin A Reznek, Christopher Slocum, Maureen M Canellas, Alexandra M Sanseverino, Vincent Kan, Janell Forget, Laurel C O'Connor","doi":"10.1111/acem.70082","DOIUrl":"https://doi.org/10.1111/acem.70082","url":null,"abstract":"<p><strong>Objective: </strong>Incidents of aggression and hostility towards staff in emergency departments (EDs) have escalated in frequency and severity, posing a serious threat to the well-being of patients and healthcare providers. Research on predictive tools for identifying individuals at risk of violent behavior in the ED remains scarce. The objective of this study was to assess the association between the Dynamic Appraisal of Situational Aggression (DASA) score assigned at triage and physical restraint or medications administered for safety during an ED encounter.</p><p><strong>Methods: </strong>From January 11, 2023 to December 31, 2023, patients ≥ age 18 were assigned a DASA score during triage at five EDs. Subjects' triage DASA scores, demographic characteristics, and clinical outcomes were abstracted from the electronic health record. Subjects were risk-stratified into validated DASA risk categories for aggression (low, moderate, high, or imminent). Outcomes were measured by documented physical restraint or the administration of injected antipsychotic medication with or without a benzodiazepine. Modified Poisson regressions were used to calculate the crude and adjusted prevalence ratios (PRs) of any intervention (physical restraints and medication administration) by DASA score.</p><p><strong>Results: </strong>159,154 qualifying ED encounters were identified (mean age 51.5, 53.5% female). Increasing DASA score was associated with increasing PR of any behavioral intervention: physical restraint and/or safety medication administration. An imminent-risk DASA score was associated with an adjusted PR of 4.71 (CI 3.65-6.06, p < 0.001) for any intervention, 3.63 (CI 3.25-4.05, p < 0.001) for physical restraint, and 5.26 for any medication administration (CI 4.08-6.78, p < 0.001) compared to patients with a DASA score of 0.</p><p><strong>Conclusions: </strong>Elevated DASA scores at ED triage were associated with an increased risk of patient restraint and safety medication administration during the ED encounter. Future research should assess how proactive interventions based on DASA scores influence violence risk and investigate the predictive value of consecutive DASA evaluations throughout ED encounters.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245605","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":"Formal Education in Life.","authors":"Zhaohui Su","doi":"10.1111/acem.70078","DOIUrl":"https://doi.org/10.1111/acem.70078","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223937","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":"Standards for Point-of-care Ultrasound Research Reporting (SPUR): A modified Delphi to develop a framework for reporting point-of-care ultrasound research.","authors":"Nikolai Schnittke, Frances M Russell, Michael Gottlieb, Samuel H F Lam, David O Kessler, Lynn P Roppolo, Stephanie C Demasi, Patricia Henwood, Yiju Teresa Liu, Jennifer R Marin, Jason Nomura, Joseph R Pare","doi":"10.1111/acem.70069","DOIUrl":"https://doi.org/10.1111/acem.70069","url":null,"abstract":"<p><strong>Background: </strong>Point-of-care ultrasound (POCUS) is a bedside diagnostic modality that depends on technical, operator-specific, patient-specific, and clinical context factors. Existing research reporting guidelines do not explicitly address these considerations as they pertain to replicability and generalizability of POCUS studies. The objective of this study was to create a framework to assist investigators, reviewers, and clinicians in reporting and evaluating the quality of POCUS research.</p><p><strong>Methods: </strong>We applied a two-stage consensus-building approach. First, a steering committee reviewed available literature and existing guidelines to generate a novel list of items and explanatory subitems relevant to POCUS research. We vetted the list by soliciting public comments from individuals affiliated with POCUS-oriented professional organizations. Second, a consensus panel of experts, defined as POCUS researchers with a minimum of three first or senior author, POCUS-relevant publications completed a three-round Delphi survey. Consensus was defined as agreement by ≥80% of the panel. Items that did not reach consensus after three rounds were excluded.</p><p><strong>Results: </strong>Twenty POCUS experts participated in the study, completing all three survey rounds. The panel reached consensus to include 19/21 items and 62/119 subitems. The resulting instrument addresses variables related to technical hardware and settings (three items), specifics of the POCUS examination (two items), participant characteristics (two items), operator characteristics (five items), data analysis and interpretation (three items), and study-specific considerations (four items).</p><p><strong>Conclusions: </strong>The Standards for Point-of-Care Ultrasound Research Reporting (SPUR) can aid researchers, reviewers, and clinicians in the design, dissemination, and critical appraisal of POCUS research.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223938","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":"Cleared.","authors":"Brent R Carr","doi":"10.1111/acem.70077","DOIUrl":"https://doi.org/10.1111/acem.70077","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214613","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 to \"Reevaluating biomarker accuracy in alcohol-intoxicated TBI patients\" by Drs. Sathian and Al Hamad.","authors":"Frederick K Korley","doi":"10.1111/acem.70064","DOIUrl":"https://doi.org/10.1111/acem.70064","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207356","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":"Developing emergency medicine leaders: The AACEM/SAEM chair development program at 10 years.","authors":"Brian J Zink, Susan A Stern, Prashant Mahajan, Kayla Roseen, Apoorva Belle, James Cranford","doi":"10.1111/acem.70034","DOIUrl":"10.1111/acem.70034","url":null,"abstract":"<p><p>The AACEM Chair Development Program (CDP) provides emergency medicine (EM)-focused leadership training for academic chairs and those interested in becoming EM chairs. The CDP began in 2014.This report describes the CDP second 5-year cohort from 2018 to 2023. A total of 102 participants completed the program during this time period with increased enrollment of women leaders. Seventeen participants who were not chairs at entry have become EM chairs. Quantitative and qualitative data based on a survey of participants demonstrate continued highly favorable assessment of the CDP and likelihood to recommend it to others. The CDP remains a popular and successful training experience to develop leadership skills, foster a leadership network, and prepare EM leaders for academic chair positions.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":"681-687"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717722","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":"Will you help us?","authors":"Deeya Prakash, Jane Hesser, Tanya Thomas, Lauren Allister","doi":"10.1111/acem.15104","DOIUrl":"10.1111/acem.15104","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":"711-712"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051291","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 to Luthfiyah, Triwiyanto, and Ismath RE: Enhancing geriatric trauma mortality prediction: Modifying and assessing the geriatric trauma outcome score with net benefit and decision curve analysis.","authors":"Pawan Acharya, Tabitha Garwe, Sara K Vesely, Amanda Janitz, Jennifer D Peck, Alisa M Cross","doi":"10.1111/acem.70030","DOIUrl":"10.1111/acem.70030","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":"718-719"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707898","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":"Correction to \"Consent to advanced imaging in antenatal pulmonary embolism diagnostics: Prevalence, outcomes of nonconsent and opportunities to mitigate delayed diagnosis risk\".","authors":"","doi":"10.1111/acem.70073","DOIUrl":"10.1111/acem.70073","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":"723-724"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207355","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":"Optimal timing for epinephrine administration in adult patients with out-of-hospital cardiac arrest: A retrospective observational study.","authors":"Kenta Sakamoto, Hideto Yasuda, Yutaro Shinzato, Yuki Kishihara, Shunsuke Amagasa, Masahiro Kashiura, Takashi Moriya","doi":"10.1111/acem.15089","DOIUrl":"10.1111/acem.15089","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to clarify the appropriate timing for epinephrine administration in adults with out-of-hospital cardiac arrest (OHCA), particularly those cases with nonshockable rhythms, by addressing resuscitation time bias.</p><p><strong>Methods: </strong>We performed a retrospective observational study utilizing a multicenter OHCA registry involving 95 hospitals in Japan between June 2014 and December 2020. We included patients with OHCA and nonshockable rhythms who received epinephrine during resuscitation. The primary and secondary outcomes were favorable 30-day neurological status and survival, respectively. A favorable neurological outcome was defined as a cerebral performance category score of 1 or 2. The time from emergency medical service (EMS) personnel contact to epinephrine administration was categorized in 5-min intervals. We used the Fine-Gray regression to calculate the time-dependent propensity score in each group. After risk set matching, we employed a generalized estimating equation (GEE) to adjust for within-patient clustering.</p><p><strong>Results: </strong>A total of 36,756 patients were included in the analysis. When involving timing variables and GEE, epinephrine administration significantly affected favorable 30-day neurological status at 1-5 and 6-10 min, with risk ratios (RR; 95% confidence intervals [CIs]) of 9.36 (1.19-73.7) and 3.67 (1.89-7.14), respectively. Epinephrine administration significantly affected 30-day survival at 1-5, 6-10, 11-15, and 16-20 min, with RRs (95% CIs) of 2.33 (1.41-3.85), 2.09 (1.65-2.65), 1.64 (1.32-2.05), or 1.70 (1.29-2.25), respectively.</p><p><strong>Conclusions: </strong>Epinephrine administration within 10 min of EMS personnel contact may be associated with favorable neurological outcomes in patients with OHCA and nonshockable rhythms.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":"659-667"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963539","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}