Journal of the American College of Emergency Physicians open最新文献

{"title":"Elderly Female With Hypotension.","authors":"Lauren Diercks, Sam Chiacchia, Nicholas Hall, Patrick Lanter","doi":"10.1016/j.acepjo.2025.100162","DOIUrl":"https://doi.org/10.1016/j.acepjo.2025.100162","url":null,"abstract":"","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"6 3","pages":"100162"},"PeriodicalIF":1.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Images in Emergency Medicine: Man With Foot Pain and Indifference.","authors":"Alex Y Koo, Susan R O'Mara","doi":"10.1016/j.acepjo.2025.100164","DOIUrl":"10.1016/j.acepjo.2025.100164","url":null,"abstract":"","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"6 3","pages":"100164"},"PeriodicalIF":1.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Woman With Swelling and Crepitus.","authors":"Thomas D Wagner, Timothy J Batchelor","doi":"10.1016/j.acepjo.2025.100138","DOIUrl":"10.1016/j.acepjo.2025.100138","url":null,"abstract":"","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"6 3","pages":"100138"},"PeriodicalIF":1.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Man With Abdominal Pain and Cow's Milk Polydipsia.","authors":"Stefan Scheller, Matthias Nuernberger","doi":"10.1016/j.acepjo.2025.100163","DOIUrl":"10.1016/j.acepjo.2025.100163","url":null,"abstract":"","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"6 3","pages":"100163"},"PeriodicalIF":1.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Quality Improvement Initiative to Decrease Hospital Admission for Skin and Soft Tissue Infections From an Observation Unit.","authors":"Lauren T Southerland, Steffen R Simerlink, Zachary J Smith, Travis P Sharkey-Toppen","doi":"10.1016/j.acepjo.2025.100140","DOIUrl":"10.1016/j.acepjo.2025.100140","url":null,"abstract":"<p><strong>Objectives: </strong>We evaluated factors associated with the need for full admission (greater than 2 days) for patients with skin and soft tissue infection (SSTI) placed in an emergency department (ED) observation unit (EDOU) in order to inform a new SSTI protocol.</p><p><strong>Methods: </strong>Retrospective cohort study of adult ED patients assigned to the EDOU for treatment of a SSTI from 2017 to 2018. Data elements included demographics, vital signs, SSTI location and cause, procedures, consults, length of stay, and disposition. Significant relationships identified under univariable analysis were further examined in multivariable logistic regression.</p><p><strong>Results: </strong>Four hundred eight patient charts were included, of which 100 (24.5%) were admitted. The mean age was 47.3 ± 17.5 years (range, 18-95 years), and 58.0% were men. SSTI complicated by intravenous drug abuse (odds ratio [OR], 1.47; 95% CI, 0.58-3.72) and diabetes (OR, 1.38; 95% CI, 0.41-4.60) had the highest univariable odds of admission for types of infection. Infections treated with a procedure such as incision and drainage had lower odds of admission (OR, 0.56; 95% CI, 0.32-0.98). On multivariate logistic regression, tachycardia (OR, 1.85; 95% CI, 1.09-3.13) was associated with higher odds of admission. SSTI on the torso (OR, 0.23; 95% CI, 0.06-0.80), plan for expert consultation (OR, 0.32; 95% CI, 0.19-0.54), and having a procedure (OR, 0.42; 95% CI, 0.22-0.76) were associated with lower odds of admission. Based on this information, the EDOU protocol for patients with SSTI was updated. In the year after update, admission rate among patients with SSTI was 22.4%.</p><p><strong>Conclusion: </strong>Tachycardia in the ED may be an early sign of a more complicated SSTI that is more likely to require hospital admission. Adjusting an EDOU protocol to the local population may be helpful for improving EDOU patient selection.</p>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"6 3","pages":"100140"},"PeriodicalIF":1.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients Evaluated and Discharged From the Waiting Room Do Not Have a Higher Rate of 72-Hour Returns - A Retrospective Observational Study.","authors":"Cynthia M Gaudet, Bryan A Stenson, Peter S Antkowiak, Anne V Grossestreuer, Daniel L Shaw, David T Chiu","doi":"10.1016/j.acepjo.2025.100155","DOIUrl":"10.1016/j.acepjo.2025.100155","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the rate of return visits to the emergency department (ED) within 72 hours of discharge for patients evaluated in the waiting room. ED crowding challenges throughput, and we hypothesized that some patients may be suitable for the completion of evaluation without rooming.</p><p><strong>Methods: </strong>This was a single-center retrospective analysis of a tertiary hospital ED. The primary outcome was 72-hour returns following discharge from the ED, stratified by location of initial physician evaluation and discharge: waiting room only, waiting room followed by treatment space, and treatment space only. Categorical data were compared using a chi-squared test and continuous data using a one-way analysis of variance with Bonferroni correction. The primary outcome was analyzed using a chi-squared test adjusting for age, biologic sex, Emergency Severity Index, primary language, time of day, and day of the week using logistic regression.</p><p><strong>Results: </strong>There was a statistically significant overall difference in return visits within 72 hours of discharge based on the ED location where the evaluation occurred (<i>P</i> < .05; 5.0% in the waiting room only, 4.4% in the waiting room followed by treatment space, and 4.9% in the treatment space only). However, when comparing groups individually, there was a significantly lower rate of 72-hour return only for patients seen in the waiting room followed by a treatment space compared with treatment space only (<i>P</i> = .032). The patients evaluated and discharged from the waiting room tended to be younger, more likely to be male, with lower acuity Emergency Severity Index scores, and typically seen during an evening shift compared with the patients who were evaluated in a treatment space during their visit.</p><p><strong>Conclusion: </strong>There was no significant increase in the rate of return for those patients seen primarily in the waiting room or for those where the initial work up started in the waiting room compared with those who were placed in a treatment space prior to a physician evaluation.</p>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"6 3","pages":"100155"},"PeriodicalIF":1.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Old Man With Acute Visual Loss.","authors":"Tse-Ying Lee, Wan-Ching Lien","doi":"10.1016/j.acepjo.2025.100148","DOIUrl":"10.1016/j.acepjo.2025.100148","url":null,"abstract":"","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"6 3","pages":"100148"},"PeriodicalIF":1.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Man With Sudden Bilateral Leg Pain and Inability to Ambulate.","authors":"Carmen Estrada Huerta, Raelynn Vigue, John Purakal, Alixandra Purakal","doi":"10.1016/j.acepjo.2025.100159","DOIUrl":"10.1016/j.acepjo.2025.100159","url":null,"abstract":"","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"6 3","pages":"100159"},"PeriodicalIF":1.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Man With Exertional Dyspnea.","authors":"Jumpei Yamashita, Daisuke Mizu, Hidenori Higashi, Masataka Miyamoto","doi":"10.1016/j.acepjo.2025.100156","DOIUrl":"10.1016/j.acepjo.2025.100156","url":null,"abstract":"","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"6 3","pages":"100156"},"PeriodicalIF":1.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Boy With Dyspnea.","authors":"Zhang-Wei Song, Ling-Ling Lin","doi":"10.1016/j.acepjo.2025.100160","DOIUrl":"10.1016/j.acepjo.2025.100160","url":null,"abstract":"","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"6 3","pages":"100160"},"PeriodicalIF":1.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}