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

{"title":"Etiology of septic arthritis in children of Qatar","authors":"Abdullah Khan MD,&nbsp;Abdelmoneem Mohammed Elsheikh MD,&nbsp;Khalid Alansari MD","doi":"10.1002/emp2.13313","DOIUrl":"https://doi.org/10.1002/emp2.13313","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Septic arthritis is an orthopedic emergency and if not evaluated and treated appropriately, it can lead to poor clinical outcomes. Previously several studies have been performed to identify the etiology of septic arthritis in the pediatric population in developed countries. The main objective of our study was to identify the etiology of septic arthritis in children in Qatar in previously healthy and fully vaccinated children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed retrospective chart analysis of children presenting to our emergency department between July 2018 and June 2024, who were diagnosed and treated with septic arthritis. The study was conducted at a level 1 pediatric trauma center and the only children's hospital in the country. We used ICD 9 and ICD 10 codes to identify such cases. After using predefined exclusion criteria, children with positive blood cultures, blood titers for Brucella and/or synovial cultures were included in the analysis. Clinical symptoms and signs, ultrasound findings, and culture results were tabulated using descriptive statistics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 45 patients were included. The median age of children was 5 years (interquartile range [IQR] 2–10 years). Majority (60%) were male. The most common clinical findings were limping/limitation of joint movement (100%), fever (80%), and swelling of joints (58%). The median C-reactive protein and erythrocyte sedimentation rate were 94 mg/L and 47 mm/h. The knee and hip were the most common joints affected. The most common causative organisms were <i>Staphylococcus aureus</i> (56%), <i>Streptococcus pyogenes</i> (13%), and Brucella (11%). Pre-intervention imaging, such as ultrasound and/or magnetic resonance imaging, was performed in 95% of patients. All patients recovered without any complications. One of the limitations of our study is that cases of <i>Kingella kingae</i> septic arthritis may be underreported as polymerase chain reaction (PCR) analysis of synovial fluid was not performed on all patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Gram-positive cocci, especially <i>S. aureus</i>, remains the most common cause of septic arthritis in vaccinated children. We also identified Gram-negative bacilli as causative organisms in our study. We suggest including empiric coverage for both Gram- and Gram-negative bacilli when treating children with suspected septic arthritis till culture results are available.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"5 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/emp2.13313","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142449180","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":"Rash in a slaughterhouse worker","authors":"Michael B. Murphy DO, MS,&nbsp;Brian F. Kelly DO","doi":"10.1002/emp2.13286","DOIUrl":"https://doi.org/10.1002/emp2.13286","url":null,"abstract":"<p>A 32-year-old man presented to the emergency department with a new rash on his left hand that has a clear discharge. He was employed at a livestock slaughterhouse and did not wear gloves when handling animals. The most common animals he was in contact with were sheep and goats. The rash was only in one location, between his third and fourth digit on his left hand (Figures 1 and 2) and worsened over the previous 4 days. The blister is approximately 1 cm × 1 cm × 1 cm and tender to touch. He denied any fevers, chills, or additional rashes. Due to the uniqueness of the patient's profession, dermatology was consulted and a shave biopsy was performed.</p><p>The patient was ultimately diagnosed with Orf virus based on clinical presentation alone. Tissue biopsy showed epidermal hyperplasia with vacuolated cytoplasm and eosinophilic inclusion bodies in upper epidermal keratinocytes, ulceration, and mixed inflammatory infiltrate, which aligned with the clinical diagnosis of Orf. Orf is caused by the <i>Parapoxvirus</i> and is often self-limiting, lasting around 4–6 weeks. It is found in people who have direct contact with animals, most commonly farms. Treatment is mainly supportive, cleaning the wound with soap and water, and keeping the wound dry and covered with a bandage. It is important to keep zoonotic diseases on the differential of rash.</p>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"5 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/emp2.13286","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142447603","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 a painful red eye","authors":"Casey Morris MD,&nbsp;Dana Lewis NP,&nbsp;Wesley Eilbert MD","doi":"10.1002/emp2.13325","DOIUrl":"https://doi.org/10.1002/emp2.13325","url":null,"abstract":"<p>A 38-year-old man presented to the emergency department (ED) with a 1-week history of left eye pain and redness (Figures 1-3). The eye pain radiated to his left forehead and was temporarily relieved by ibuprofen. He denied any associated change in his vision. On examination, his eye was diffusely injected, most prominently on the superior and lateral aspects. Instillation of 2.5% phenylephrine eye drops did not significantly change the injection.</p><p>Scleritis is a rare, vision-threatening inflammation of the sclera. It occurs most commonly in the middle-aged, with women more commonly affected.<span>¹</span> Up to 50% of cases of scleritis occur in the setting of systemic autoimmune disease, most commonly rheumatoid arthritis.<span>²</span> Scleritis may be due to infectious causes, medication-induced, or occurring after intraocular surgery, and many cases are idiopathic.<span>²</span></p><p>Patients with scleritis present with an injected, painful eye. The eye pain may radiate to the jaw, forehead or scalp, and is typically worse at night.<span>³</span> The involved eye is usually diffusely injected, though the injection may be localized and nodular in appearance.<span>⁴</span> As with this case, installation of topical vasoconstrictor agents such as phenylephrine will not cause a blanching of the injected vessels with scleritis, as it would with conjunctivitis and episcleritis. Further evaluation and treatment of scleritis in the ED should ideally be discussed with an ophthalmologist and may include investigations for rheumatologic and infectious etiologies. Oral nonsteroidal anti-inflammatory drugs and topical corticosteroids are considered first-line therapy for cases of noninfectious scleritis such as this.</p>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"5 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/emp2.13325","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142447665","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 left-sided flank pain","authors":"Yu-Xuan Jiang MD,&nbsp;Chun-Gu Cheng MD,&nbsp;Yen-Yue Lin MD","doi":"10.1002/emp2.13326","DOIUrl":"https://doi.org/10.1002/emp2.13326","url":null,"abstract":"<p>A 35-year-old man with alcohol abuse presented to the emergency department with a 7-day history of cough and left-sided flank pain. His temperature, pulse rate, and blood pressure were 38.1°C, 104 beats/min, and 134/92 mmHg, respectively. Based on physical examination, his breath sounds were smooth without crackles; whereas, the left flank region was tender to palpation. His white blood cell count, platelet count, and C-reactive protein were 17,740/µL, 1101 × 10³ mm, and 18.5 mg/dL, respectively. An emergency physician performed ultrasonography revealing heterogeneous echoic lesions in the spleen (Figure 1), and the diagnosis was confirmed by computed tomography (Figure 2).</p><p>The patient received antibiotic treatment (moxifloxacin), laparoscopic splenectomy, and pus drainage by a surgeon (Figure 3). The tissue culture of the spleen grew <i>Streptococcus constellatus</i>.</p><p>Splenic abscess is an uncommon life-threatening disease, with incidence ranging from 0.14% to 0.7%. However, the patients are at high risk of mortality if appropriate treatment is not administered. The clinical presentation of fever, left upper quadrant tenderness, and leukocytosis is not usually present. It potentially causes misdiagnosis in patients presenting with nonspecific symptoms, such as cough, abdominal pain, back pain, and malaise.<span>¹</span> Splenectomy is the gold standard treatment for splenic abscess. Percutaneous drainage can be an alternative therapy in patients with high surgical risk.<span>²</span></p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"5 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/emp2.13326","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142447662","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":"Foreign body complication","authors":"Marcos Adriano Garcia Campos MD,&nbsp;Jadson Oliveira Aguiar MD,&nbsp;Raphael Oliveira Lima Silva MD,&nbsp;Pedro Manuel Barros de Sousa MD,&nbsp;Gyl Eanes Barros Silva MD, PhD","doi":"10.1002/emp2.13288","DOIUrl":"https://doi.org/10.1002/emp2.13288","url":null,"abstract":"<p>A 50-year-old man presented at the emergency department (ED) with pain in the right iliac fossa (RIF) for 10 days associated with nausea, vomiting, fever, and dysuria. On admission examination, he was afebrile, anicteric, with negative Giordano's sign, and there was severe tenderness on deep palpation of the RIF. His vital signs were normal. Blood tests revealed elevated leukocytosis, no anemia, normal kidney function, amylase, and lipase level. A computed tomography (CT) scan of the abdomen was performed showing the presence of a foreign body (FB), a fishbone, inside cecal appendix, with the formation of an abscess (Figure 1). An open appendectomy was performed, with signs of perforation. The patient was discharged 5 days after surgery.</p><p>FB ingestion is a common condition at ED, mainly among children (80% cases).<span>^{1, 2}</span> In appendix, the FB can cause acute appendicitis, perforations, periappendiceal abscess, and peritonitis.<span>³</span> Although fishbone is one of the most ingested FB, it rarely causes perforation of the appendix.<span>⁴</span> Ingested fishbone can get impacted in any part of the digestive tract and cause serious complications (perforation, abscess, and tract obstruction). Due to poor peristaltic movement, the appendix is unable to expel the FB back to the cecum, leading progressively to inflammation with a high risk of appendix perforation.<span>⁵</span> CT scan has high sensitivity and specificity to detect fishbone showing as a linear calcified object surrounded by inflammation.<span>⁶</span> Surgical treatment is the best management in the case of fishbone-induced appendicitis.<span>⁷</span></p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"5 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/emp2.13288","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443536","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 hip pain post-trauma","authors":"Haley Sinatro MD, MBA,&nbsp;C. Reece Brockman II MD","doi":"10.1002/emp2.13328","DOIUrl":"https://doi.org/10.1002/emp2.13328","url":null,"abstract":"<p>A 22-year-old man presented to the emergency department with new left hip pain and chronic firmness after a fall. He has a history of multiple traumatic injuries and quadriplegia secondary to a motor vehicle accident 8 months prior. Examination reveals a firm, irregularly shaped left thigh with mild tenderness to the hip and thigh.</p><p>X-ray of the left hip shows extensive bulky heterotopic ossifications, and a computed tomography scan shows myositis ossificans about the left iliopsoas bursa (Figures 1 and 2). Prior to discharge, the patient was counseled on the importance of continuing physical therapy, the use of nonsteroidal anti-inflammatory drugs (NSAIDs) for symptomatic management, and the importance for a follow-up outpatient x-ray.</p><p>Heterotopic ossificans refers to bone deposition within soft tissue, with myositis ossificans specifically referring to muscle. This can occur in up to half of spinal cord injury patients, most commonly 12 weeks after injury.<span>¹</span> Plain radiographs are of low utility early on, as calcification may take months to appear. Early ultrasound<span>²</span> or triple phase bone scan has high reliability as a diagnostic method. Treatment modalities include range of motion exercises to support joint mobility and NSAIDs. More recently, bisphosphonates have shown utility in halted progression of ossification.<span>³</span> Surgery remains an option for refractory cases, but recurrence is common.</p>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"5 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/emp2.13328","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443579","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":"Implementation of an EMS-based naloxone distribution program: A qualitative evaluation","authors":"Emily E. Ager MD, MPH,&nbsp;Ella K. Purington MD,&nbsp;Megan H. Purdy MD,&nbsp;Brian Benenati MD,&nbsp;Jessica E. Baker BS,&nbsp;Christine Jane Schellack MD,&nbsp;Graham C. Smith MD,&nbsp;Nathaniel R. Hunt MD,&nbsp;Eve D. Losman MD, MHSA","doi":"10.1002/emp2.13300","DOIUrl":"https://doi.org/10.1002/emp2.13300","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We evaluated a novel leave-behind naloxone (LBN) program that allows Emergency Medical Services (EMS) personnel to distribute naloxone after an opioid overdose. Our objective was to explore EMS engagement and experiences with the program, as well as interest in education on addiction and harm reduction. We also assessed the acceptability of LBN programs among people who use drugs (PWUD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted telephone interviews with EMS personnel and residents of substance use recovery housing between February and September 2023. EMS personnel described their direct experiences with the LBN program and perceived facilitating factors and barriers to naloxone distribution. First responder interactions and support for LBN were explored with PWUD. A rapid assessment method was used to analyze the interview data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighteen of the 23 EMS participants had distributed LBN; most agreed EMS agencies should have an LBN program. Barriers included forgetting, patient acuity, patients declining, and perceived liability. Facilitators included having a clear protocol, accessible kits, and minimal documentation burden. The majority expressed interest in harm reduction education. Eight of the 11 PWUD participants reported recent involvement in an opioid overdose. The majority supported LBN and felt comfortable receiving naloxone training from EMS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this qualitative evaluation, we found broad support for EMS-based naloxone distribution among EMS personnel and PWUD. We identified several modifiable barriers to the success of such programs, which should be the subject of future investigation. EMS and harm reduction communities should support the expansion of LBN programs across the United States.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"5 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/emp2.13300","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443537","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":"Emergency physicians spend more time caring for patients who prefer a language other than English which may not be accounted for in reimbursement structures","authors":"Martin A. Reznek MD, MBA,&nbsp;Jennifer Edwards MD, MBA,&nbsp;Sean S. Michael MD, MBA,&nbsp;Jacqueline Furbacher MD, MS,&nbsp;Alexandra Sanseverino MD, MBA,&nbsp;Payal K. Modi MD, MPH,&nbsp;Kevin A. Kotkowski MD, MBA,&nbsp;Celine Larkin PhD","doi":"10.1002/emp2.13332","DOIUrl":"https://doi.org/10.1002/emp2.13332","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Emergency departments increasingly serve patients who prefer a language other than English. Honoring patients’ language preferences is crucial for quality and cultural appropriateness of care. We sought to assess whether time spent in caring for patients who preferred a language other than English differed from patients whose language preference was English. Secondarily, we sought to assess professional reimbursement across the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed an existing dataset from a time-in-motion study that included direct observation measurements of emergency physicians’ time spent during patient encounters. Our primary outcome was physician time spent conducting patient care, comparing patients who preferred a language other than English to patients who preferred English. Secondarily, we sought to assess if relative value unit (RVU)-based compensation differed across the two groups. We calculated descriptive statistics and performed multivariable regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across 218 patient encounters, physicians spent 18.6% longer on encounters with patients whose preferred a language other than English (median = 18.5 min, interquartile range [IQR] 14.8–27.9 min) than for those who preferred English (median = 15.6 min, IQR 11.5–22.9 min; <i>p</i> = 0.04). After controlling for other factors, patients’ preferred language was not associated with increased RVUs (<i>β</i> = −0.12, <i>t</i> = −1.94, <i>p</i> = 0.055).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Emergency physicians appear to spend more time caring for patients who prefer a language other than English. This additional effort during the care of this potentially vulnerable population may not be reflected in past and current reimbursement structures. Additional research is prudent as we seek to better address social determinants of health in care delivery and reimbursement systems.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"5 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/emp2.13332","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443584","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 following blunt trauma","authors":"Katarina Trajkovic MD,&nbsp;Sanela Hasanagic MD,&nbsp;Dragan Vasin MD","doi":"10.1002/emp2.13335","DOIUrl":"https://doi.org/10.1002/emp2.13335","url":null,"abstract":"<p>A 73-year-old patient presented to the emergency department after a fall from a 3-m height, complaining of headache and light pain in the abdomen. Upon examination his vital signs were stable, his abdomen tender, and a small hematoma was observed in the left hemiabdomen. Laboratory results showed a normal bleeding profile and leukocytosis. Ultrasound examination demonstrated hyperechoic mesenteric fat. Head computed tomography (CT) showed no signs of trauma. Contrast-enhanced CT of the abdomen revealed the Janus sign (Figure 1), the complete cutoff sign (Figures 2 and 3), free fluid, and small gas particles.</p><p>The patient underwent immediate surgery: jejunal resection and sigmoid resection with terminal colostomy were performed. He recovered well and was discharged in good condition. Closing of the colostomy is planned for the end of the year.</p><p>Bowel injury is rare in blunt abdominal trauma, often presenting with few signs and symptoms.<span>¹</span> CT is the primary imaging modality for evaluating these patients.<span>²</span> Bowel transection is the most severe form of bowel trauma, and the findings include the Janus sign—specific for small bowel transection, representing a hyper enhancing loop continuous with a loop that shows no or decreased enhancement, as well as the complete cutoff sign—the circular disruption of the bowel wall, specific of both small and large bowel transection.<span>³</span> Knowledge and prompt observance of these signs, as well as of nonspecific findings, such as pneumoperitoneum or free fluid, is the key to the correct diagnosis and timely surgical treatment.</p><p>The authors declare they have no conflicts of interest.</p>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"5 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/emp2.13335","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443583","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":"Emergency physicians perspectives of state continuing medical education requirements for medical licensure","authors":"Marianne Gausche-Hill MD,&nbsp;Yachana Bhakta MPH,&nbsp;Michael C. Bond MD,&nbsp;Sandra M. Schneider MD,&nbsp;Jeffrey Druck MD,&nbsp;Colleen E. Livingston BS,&nbsp;Lisa Moreno-Walton MD,&nbsp;Jonathan S. Jones MD,&nbsp;Melissa A. Barton MD","doi":"10.1002/emp2.13314","DOIUrl":"10.1002/emp2.13314","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aims to better understand the perspectives of emergency medicine physicians’ on the role that state-mandated, topic-specific continuing medical education (CME) plays in addressing knowledge gaps, its relevance to current emergency practice, its reported burden and costs of CME activities to emergency physicians, and its perceived improvement in patient care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional survey was designed by the Coalition of Board-Certified Emergency Physicians (COBCEP) and distributed in February 2023 to all American Board of Emergency Medicine (ABEM)-certified physicians. Statistical tests of significance (Pearson's chi-square and Fisher's exact test) assessed the cost and time spent on CME as well as the perceived value placed on CME by ABEM-certified physicians to improve patient care. Data were summarized using descriptive statistics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 5562 (13.0%) responses from the 43656 physicians who received the survey—5506 responses were included for analysis. Over half of the physicians (53.0%) had more than 15 years of post-residency practice experience. Most physicians (57.3%) spent less than $5,000 per year on obtaining CME. Most physicians practicing in states with state-mandated, topic-specific CME requirements believed that participation in ABEM continuing certification could be used to reduce the need for state-mandated, topic-specific CME requirements (83.6%) and state-mandated, topic-specific requirements were believed to be unlikely to improve patient care (70.8%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although well-intended, state CME requirements may lack relevancy and can, at times, place an undue burden on emergency physicians. Tailoring CME requirements to increase relevance to their patient populations and reduce barriers to completing CME could enhance knowledge translation and improve patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":"5 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395757","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}