Academic Emergency Medicine最新文献

{"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":"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}

{"title":"Performance of individual criteria of the Pediatric Emergency Care Applied Research Network (PECARN) intraabdominal injury prediction rule.","authors":"Cosby G Arnold, Paul Ishimine, Kevan A McCarten-Gibbs, Kenneth Yen, Nisa Atigapramoj, Mohamed Badawy, Irma T Ugalde, Pradip P Chaudhari, Jeffrey S Upperman, Nathan Kuppermann, James F Holmes","doi":"10.1111/acem.15084","DOIUrl":"10.1111/acem.15084","url":null,"abstract":"<p><strong>Objective: </strong>The Pediatric Emergency Care Applied Research Network (PECARN) derived and externally validated a clinical prediction rule to identify children with blunt torso trauma at low risk for intraabdominal injuries undergoing acute intervention (IAI^AI). Little is known about the risk for IAI^AI when only one or two prediction rule variables are positive. We sought to determine the risk for IAI^AI when either one or two PECARN intraabdominal injury rule variables are positive.</p><p><strong>Methods: </strong>We performed a planned secondary analysis of a prospective, multicenter study that included 7542 children (<18 years old) with blunt torso trauma evaluated in six emergency departments from December 2016 to August 2021. Patients with only one or two PECARN rule variables positive were included. The outcome was IAI^AI (IAI undergoing therapeutic laparotomy, angiographic embolization, blood transfusion, or two or more nights of intravenous fluids).</p><p><strong>Results: </strong>Among the 7542 children enrolled, 2986 (39.6%, 95% confidence interval [CI] 38.5%-40.7%) had one or two PECARN variables positive and were included. Of this subpopulation, 227 (7.6%, 95% CI 6.7%-8.6%) had intraabdominal injuries. In the 1639 patients with only one rule variable positive, 21 (1.3%, 95% CI 0.8%-2.0%) had IAI^AI. In the 1347 patients with two rule variables positive, 27 (2.0%, 95% CI 1.3%-2.9%) had IAI^AI. Risk for IAI^AI for each variable was highest for Glasgow Coma Scale (GCS) score <14 (16/291, 5.5%, 95% CI 3.2%-8.8%) and abdominal wall trauma (three of 321, 0.9%, 95% CI 0.2%-2.7%). Risk for IAI^AI when two variables were present was highest when decreased breath sounds (three of 44, 6.8%, 95% CI 1.4%-18.7%) and GCS <14 (10/207, 4.8%, 95% CI 2.3%-8.7%) were present with one other variable.</p><p><strong>Conclusions: </strong>Few children with blunt torso trauma and one or two PECARN predictor variables present have IAI^AI. Those with GCS score <14, however, are at highest risk for IAI^AI.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":"643-649"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969160","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":"Timing the key to meaningful survival: The importance of early epinephrine in cardiac arrest.","authors":"Michael C Perlmutter, Johanna C Moore","doi":"10.1111/acem.70009","DOIUrl":"10.1111/acem.70009","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":"708-710"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447714","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":"\"He was not listening to hear me\": Parent experiences with communication, inclusion, and marginalization in the pediatric emergency department.","authors":"Colleen K Gutman, Antionette McFarlane, Rosemarie Fernandez, K Casey Lion, Paul L Aronson, Carma L Bylund, Nancy Joseph, Maria L Mecias, Carla L Fisher","doi":"10.1111/acem.15091","DOIUrl":"10.1111/acem.15091","url":null,"abstract":"<p><strong>Objective: </strong>Inequities in pediatric emergency department (ED) care may be influenced by disparities in clinician communication. We sought to examine, from the perspective of parents from marginalized racial and ethnic backgrounds, how clinician-parent communication is characterized during pediatric ED visits.</p><p><strong>Methods: </strong>We conducted and analyzed in-depth semistructured individual interviews with parents of pediatric ED patients from marginalized racial and ethnic backgrounds. We applied a constant comparative method approach to conduct a thematic analysis informed by grounded theory. To ensure rigor, we collected and analyzed data concurrently. We used the patient-centered communication (PCC) framework and the 10 principles of Public Health Critical Race Praxis as sensitizing constructs during analysis. Two coders followed several analytical steps: (1) open coding for concept discovery, (2) grouping concepts into themes, (3) axial coding to identify thematic properties, and (4) identification of exemplar excerpts for rich description. Thematic saturation was based on repetition, recurrence, and forcefulness.</p><p><strong>Results: </strong>Nineteen parents participated. Parents described three clinician communicative behaviors that facilitated their sense of inclusion or marginalization: information exchange, empathic communication, and partnership-building. Parents also stressed the importance of their own proactive communication in facilitating their inclusion. Few participants described experiencing racism during their child's ED visit, yet many did during prior health care encounters, which they connected to their current experience. In particular, parents described how their use of proactive communication was motivated by their past experiences of racism in medical encounters.</p><p><strong>Conclusions: </strong>These narratives demonstrate ways in which experienced racism, both past and present, may inform how parents receive and respond to gaps in PCC. Communication focused interventions that adapt a race-conscious perspective may have a role in promoting health equity.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":"632-642"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254259","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}