Academic Emergency Medicine最新文献

{"title":"Reporting of sex and gender demographics among research studies.","authors":"Michael Gottlieb, Rachel Chang, Miranda Viars, Alexandra Mannix","doi":"10.1111/acem.14866","DOIUrl":"10.1111/acem.14866","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139745778","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":"Enhancing emergency department charting: Using Generative Pre-trained Transformer-4 (GPT-4) to identify laceration repairs.","authors":"Jaskaran Karan Bains, Christopher Y K Williams, Drake Johnson, Hope Schwartz, Naina Sabbineni, Atul J Butte, Aaron E Kornblith","doi":"10.1111/acem.14995","DOIUrl":"https://doi.org/10.1111/acem.14995","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141854517","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":"Agreement between the Maslach Burnout Inventory and the Copenhagen Burnout Inventory among emergency physicians and trainees.","authors":"Henry Li, Erica Dance, Zafrina Poonja, Leandro Solis Aguilar, Isabelle Colmers-Gray","doi":"10.1111/acem.14994","DOIUrl":"https://doi.org/10.1111/acem.14994","url":null,"abstract":"<p><strong>Background: </strong>Emergency physicians have the highest rates of burnout among all specialties. Existing burnout tools include the Copenhagen Burnout Inventory (CBI) and single-item measures from the Maslach Burnout Inventory (MBI). While both were designed to measure burnout, how they conceptualize this phenomenon differs and their agreement is unclear. Given the close conceptual relationship between emotional regulation strategies such as distancing and distraction with the MBI subscale of depersonalization, we examined agreement between the two inventories and association with emotional regulation strategies as a lens to explore the conceptualization of burnout.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey of adult and pediatric emergency physicians and trainees in Canada. Survey questions were pretested using written feedback and cognitive interviews. \"Frequent use\" of an emotional regulation strategy was \"most\" or \"all\" shifts (≥4 on 5-point Likert scale). Burnout was defined as mean ≥50/100 on the CBI and scoring ≥5 (out of 7) on at least one of the single-item measures from the MBI. Associations with burnout were examined using multivariable logistic regression.</p><p><strong>Results: </strong>Of 147 respondents, 44.2% were positive for burnout on the CBI and 44.9% on the single-item measures from the MBI. Disagreement was 21.1% overall, ranging from 12.5% for older (≥55 years) physicians to 30.2% for younger (<35 years) physicians. Use of distraction and use of distancing were strongly associated with burnout on the single-item measures (adjusted odds ratio [aOR] 14.4, 95% confidence interval [CI] 3.4-60.8]) and CBI (aOR 10.1, 95% CI 2.5-39.8, respectively.</p><p><strong>Conclusions: </strong>Despite near-equal rates of burnout, agreement between the CBI and single-item measures from the MBI varies and was lower for younger emergency physicians/trainees. While emotional regulation strategies were felt to be important in supporting a career in emergency medicine, they were strongly associated with burnout. Future research is needed to better understand this phenomenon and which tools to use to measure burnout.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141854516","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":"Hot off the press: It's (un)happy hour again-Mortality in younger patients with alcohol-related ED attendances.","authors":"Kirsty Challen, Neil Dasgupta, W Ken Milne","doi":"10.1111/acem.14992","DOIUrl":"https://doi.org/10.1111/acem.14992","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791641","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":"Intravenous diltiazem infusions for rapid atrial fibrillation or flutter in the emergency department: A retrospective, exploratory analysis","authors":"Tony Zitek, Kristina Pagano, Carolina Fernandez, Sarah Zajd, Murtaza Akhter, Tarang Kheradia, Georgeta Vaidean, David A. Farcy","doi":"10.1111/acem.14989","DOIUrl":"https://doi.org/10.1111/acem.14989","url":null,"abstract":"BackgroundEmergency physicians commonly treat patients with atrial fibrillation (AF) or atrial flutter (AFL) with rapid ventricular response, and intravenous (IV) diltiazem is the most commonly used medication for rate control of such patients. We sought to compare rate control success and safety outcomes for emergency department (ED) patients with AF or AFL who, after a diltiazem bolus, received a diltiazem drip compared to those who did not receive a drip.MethodsWe performed a retrospective cohort study comparing outcomes of ED patients from a single hospital system with AF and AFL and a heart rate (HR) &gt; 100 beats/min who received a diltiazem drip after an IV diltiazem bolus to those who received no drip. The primary outcome was a HR &lt; 100 beats/min at the time of ED disposition. Secondary outcomes were hospital length of stay and safety (hypotension, electrical cardioversion, vasopressor use, and death). We compared groups using propensity score matching.ResultsBetween January 1, 2020, and November 8, 2022, there were 746 AF or AFL patients eligible for analysis. Of those, 382 (51.2%) received a diltiazem drip and 364 (48.8%) did not. In the unadjusted analysis, the last recorded ED HR was &lt;100 beats/min in 55.2% of patients in the drip group compared to 65.9% in the no‐drip group (difference 10.7%, 95% confidence interval [CI] 3.7 to 17.7). After propensity matching, diltiazem drip use was associated with lower likelihood of rate control in the ED (OR 0.69, 95% CI 0.48–0.99) and 22.5 h (95% CI 12.2–36.8) longer hospital stay.ConclusionsFor patients with AF or AFL, the use of a diltiazem drip after an IV diltiazem bolus was associated with less rate control in the ED.","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141785482","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":"SPEED protocol","authors":"Giles N. Cattermole, Ian M. Stell","doi":"10.1111/acem.14984","DOIUrl":"https://doi.org/10.1111/acem.14984","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141776294","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":"Assessment of an organizational effort to increase emergency medicine faculty on National Institutes of Health study sections.","authors":"Christian D Pulcini, David J Barton, Michael Cassara, Joshua J Davis, Stephanie C DeMasi, Edward J Durant, Nidhi Garg, Colin Greineder, Melissa McMillian, James H Paxton, Michael A Puskarich, Jody A Vogel, Ambrose H Wong, Willard W Sharp","doi":"10.1111/acem.14993","DOIUrl":"10.1111/acem.14993","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756533","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":"Interventions to improve equity in emergency departments for Indigenous people: A scoping review.","authors":"Davis MacLean, Kimberley D Curtin, Cheryl Barnabe, Lea Bill, Bonnie Healy, Brian R Holroyd, Jaspreet K Khangura, Patrick McLane","doi":"10.1111/acem.14987","DOIUrl":"https://doi.org/10.1111/acem.14987","url":null,"abstract":"<p><strong>Background: </strong>Disparities in health outcomes, including increased chronic disease prevalence and decreased life expectancy for Indigenous people, have been shown across settings affected by white settler colonialism including Canada, the United States, Australia, and New Zealand. Emergency departments (EDs) represent a unique setting in which urgent patient need and provider strain interact to amplify inequities within society. The aim of this scoping review was to map the ED-based interventions aimed at improving equity in care for Indigenous patients in EDs.</p><p><strong>Methods: </strong>This scoping review was conducted using the procedures outlined by Arksey and O'Malley and guidance on conducting scoping reviews from the Joanna Briggs Institute. A systematic search of MEDLINE, CINAHL, SCOPUS, and EMBASE was conducted.</p><p><strong>Results: </strong>A total of 3636 articles were screened by title and abstract, of which 32 were screened in full-text review and nine articles describing seven interventions were included in this review. Three intervention approaches were identified: the introduction of novel clinical roles, implementation of chronic disease screening programs in EDs, and systems/organizational-level interventions.</p><p><strong>Conclusions: </strong>Relatively few interventions for improving equity in care were identified. We found that a minority of interventions are aimed at creating organizational-level change and suggest that future interventions could benefit from targeting system-level changes as opposed to or in addition to incorporating new roles in EDs.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756534","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":"End stage.","authors":"Christopher Kim","doi":"10.1111/acem.14991","DOIUrl":"https://doi.org/10.1111/acem.14991","url":null,"abstract":"","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750775","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":"Identification of children with a nondiagnostic ultrasound at a low appendicitis risk using a pediatric Appendicitis Risk Calculator.","authors":"Michael Bravo, Gili Palnizky-Soffer, Carina Man, Rahim Moineddin, Dana Singer-Harel, Augusto Zani, Andrea S Doria, Suzanne Schuh","doi":"10.1111/acem.14990","DOIUrl":"https://doi.org/10.1111/acem.14990","url":null,"abstract":"<p><strong>Objectives: </strong>Up to 50% of ultrasounds (USs) for suspected pediatric appendicitis are nondiagnostic. While the validated low-risk clinical pediatric Appendicitis Risk Calculator (pARC) score < 15% and the low-risk US with nonvisualized appendix and no periappendiceal inflammation carry relatively low appendicitis risks, the contribution of the combination of both characteristics to this risk has never been assessed. The primary objective was to determine the proportion of children with the low-risk US-low-risk pARC combination with appendicitis. We hypothesized that this proportion would be 2.5% (upper 95% CI ≤ 5%).</p><p><strong>Methods: </strong>A retrospective cohort study of 448 previously healthy children 4-17 years old at a pediatric ED with suspected appendicitis, nondiagnostic US, and persistent clinical concern about appendicitis. Two investigators abstracted demographic, clinical, and imaging data. Based on published criteria, USs were classified as low-risk or high-risk. The pARC includes seven demographic, clinical, and laboratory variables and is quantified according to the published formula. The primary outcome was appendicitis, based on the histological evidence. All nonoperated patients underwent a 1-month-follow-up to exclude delayed appendicitis diagnoses.</p><p><strong>Results: </strong>Sixty of the 448 (13.4%) patients had appendicitis; 269 (60%) had low-risk US, 262 (58.4%) had low-risk pARC, and 163 (36.4%) had both characteristics. The appendicitis rates with low-risk pARC alone and low-risk US alone were 14/262 (5.4%) and 21/269 (7.8%), respectively. A total of 2/163 children (1.2%) with low-risk pARC and low-risk US had appendicitis (95% CI 0%-4.4%). Higher-risk US increased the appendicitis odds 5 (95% CI 1.54-20.55) to 11 times (95% CI 2.41-51.10) across pARC levels. The low-risk combination had sensitivity of 96.7% (95% CI 88.5%-99.6%), specificity of 41.5%, positive predictive value of 20.4%, and negative predictive value of 98.8% (95% CI 95.6%-99.9%).</p><p><strong>Conclusions: </strong>The children with low-risk pARC and low-risk US combination are unlikely to have appendicitis and can be discharged home. The presence of higher-risk US-pARC score combinations substantially increases the appendicitis risk and warrants reassessment or interval imaging.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733167","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}