Annals of emergency medicine最新文献_第2页

Winter Wheat 冬小麦

IF 5 1区医学

Annals of emergency medicine Pub Date : 2025-02-19 DOI: 10.1016/j.annemergmed.2024.09.007

Kevin McGurk MD

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Emergency Medicine Looks for an Alternative Residency Application Platform: Is This the End of the Electronic Residency Application Service (ERAS) Monopoly?

IF 5 1区医学

Annals of emergency medicine Pub Date : 2025-02-19 DOI: 10.1016/j.annemergmed.2024.12.018

Monique Brouillette (Special Contributor to Annals News & Perspective)

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Information for Readers

IF 5 1区医学

Annals of emergency medicine Pub Date : 2025-02-19 DOI: 10.1016/S0196-0644(25)00038-1

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Policy Statements

IF 5 1区医学

Annals of emergency medicine Pub Date : 2025-02-19 DOI: 10.1016/j.annemergmed.2024.12.019

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Global Research Highlights

IF 5 1区医学

Annals of emergency medicine Pub Date : 2025-02-19 DOI: 10.1016/j.annemergmed.2025.01.006

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Effectiveness of a Web-Based Training Intervention in Teaching Emergency Physicians First-Trimester Point-of-Care Ultrasound Image Interpretation.

IF 5 1区医学

Annals of emergency medicine Pub Date : 2025-02-19 DOI: 10.1016/j.annemergmed.2025.01.005

Lori Stolz, Gillian Sheppard, Jeremy Boyd, Jessica Baez, Patrick Minges, Martin Pusic, Mathew Swarm, Megan Hilbert, Marisa O'Brien, Katie Harris, Catherine Varner, Constance LeBlanc, Kathy Boutis

{"title":"Effectiveness of a Web-Based Training Intervention in Teaching Emergency Physicians First-Trimester Point-of-Care Ultrasound Image Interpretation.","authors":"Lori Stolz, Gillian Sheppard, Jeremy Boyd, Jessica Baez, Patrick Minges, Martin Pusic, Mathew Swarm, Megan Hilbert, Marisa O'Brien, Katie Harris, Catherine Varner, Constance LeBlanc, Kathy Boutis","doi":"10.1016/j.annemergmed.2025.01.005","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.01.005","url":null,"abstract":"<p><strong>Study objective: </strong>To examine the effectiveness of an education intervention on emergency physician accuracy in identifying pregnancy-related findings from first-trimester point-of-care ultrasound. Case features associated with the odds of a correct response were also determined.</p><p><strong>Methods: </strong>This was a multicenter prospective cross-sectional study in a convenience sample of emergency physicians in the United States and Canada. The unsupervised web-based education intervention included first-trimester point-of-care ultrasound cases acquired through the transabdominal (n=200 cases) or transvaginal (n=200 cases) approach. Physicians deliberately practiced identifying pregnancy-related imaging findings until they achieved a mastery standard.</p><p><strong>Results: </strong>In 204 participants, there were learning gains in accuracy (15.2%; 95% confidence interval [CI] 14.6 to 15.8), sensitivity (15.1%; 95% CI 14.3 to 15.9), and specificity (14.3%; 95% CI 13.7 to 15.0). Of these, 132 (64.7%) achieved the mastery standard in a median of 60 cases (interquartile range 58 to 83). Case features associated with an increased odds of a correct intrauterine pregnancy \"present\" diagnosis were transvaginal versus transabdominal-acquired images (odds ratio [OR]=1.5; 95% CI 1.3 to 1.8) and fetal heartbeat (OR=4.3; 95% CI 3.4 to 5.5). A decreased odds was associated with an eccentrically located intrauterine pregnancy (OR=0.2; 95% CI 0.1 to 0.2), subchorionic hemorrhage (OR=0.5; 95% CI 0.4 to 0.6), adnexal mass (OR=0.7; 95% CI 0.6 to 0.9), and endometrial collection (OR=0.1; 95% CI 0.09 to 0.2).</p><p><strong>Conclusions: </strong>This study's intervention was effective in teaching first-trimester point-of-care ultrasound image interpretation and identified the specific variables that posed the greatest diagnostic challenges. The methods and results from this work can serve to expand learning opportunities for this critical skill in emergency medicine.</p>","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Man With Acute Abdominal Pain

IF 5 1区医学

Annals of emergency medicine Pub Date : 2025-02-19 DOI: 10.1016/j.annemergmed.2024.09.015

Christina Y. Liao MD, Christopher W. Allen MD, Christy Hill RDMS, Enoch A. Obeng MD, Daniel Rebagliati MD, Timothy J. Batchelor MD

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A Man With Abdominal Pain and Vomiting

IF 5 1区医学

Annals of emergency medicine Pub Date : 2025-02-19 DOI: 10.1016/j.annemergmed.2024.10.008

Chen-Wei Lee MD , Tou-Yuan Tsai MD , Cheng-Han Chiang MD

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Prehospital Management of Adults With Traumatic Out-of-Hospital Circulatory Arrest—A Joint Position Statement 成人创伤性院外循环骤停患者的院前管理--联合立场声明

IF 5 1区医学

Annals of emergency medicine Pub Date : 2025-02-19 DOI: 10.1016/j.annemergmed.2024.12.015

Amelia M. Breyre , Nicholas George , Alexander R. Nelson , Charles J. Ingram , Thomas Lardaro , Wayne Vanderkolk , John W. Lyng

{"title":"Prehospital Management of Adults With Traumatic Out-of-Hospital Circulatory Arrest—A Joint Position Statement","authors":"Amelia M. Breyre , Nicholas George , Alexander R. Nelson , Charles J. Ingram , Thomas Lardaro , Wayne Vanderkolk , John W. Lyng","doi":"10.1016/j.annemergmed.2024.12.015","DOIUrl":"10.1016/j.annemergmed.2024.12.015","url":null,"abstract":"<div><div>The National Association of Emergency Medical Services Physicians (NAEMSP), American College of Surgeons Committee on Trauma (ACS-COT), and American College of Emergency Physicians (ACEP) believe that evidence-based, pragmatic, and collaborative protocols addressing the care of patients with traumatic out-of-hospital circulatory arrest (TOHCA) are needed to optimize patient outcomes and clinician safety. When the etiology of arrest is unclear, particularly without clear signs of life-threatening trauma, standard basic and advanced cardiac life support (BCLS/ACLS) treatments for medical cardiac arrest are appropriate. Traumatic circulatory arrest may result from massive hemorrhage, airway obstruction, obstructive shock, respiratory disturbances, cardiogenic causes, or massive head trauma. While resuscitation and/or transport is appropriate for some populations, it is appropriate to withhold or discontinue resuscitation attempts for TOHCA patients for whom these efforts are nonbeneficial. This position statement and resource document were written as an update to the 2013 joint position statements.</div><div>NAEMSP, ACEP, and ACS-COT recommend:<ul><li><span>●</span><span><div>Emergency medical services (EMS) resuscitation of adults with TOHCA should:<ul><li><span>O</span><span><div>Prioritize prompt identification of patients who may benefit from transport to definitive care at trauma centers when safe and appropriate.</div></span></li><li><span>O</span><span><div>Emphasize the identification of reversible causes of traumatic circulatory arrest and timely use of clinically indicated life-saving interventions (LSIs) within the EMS clinician’s scope of practice. These include:<ul><li><span>■</span><span><div>External hemorrhage control with direct pressure, wound packing, and tourniquets.</div></span></li><li><span>■</span><span><div>Airway management using the least-invasive approach necessary to achieve and maintain airway patency, oxygenation, and adequate ventilation.</div></span></li><li><span>■</span><span><div>Chest decompression if there is clinical concern for a tension pneumothorax. Empiric bilateral decompression, however, is not indicated in the absence of suspected chest trauma.</div></span></li><li><span>■</span><span><div>External chest compressions may be considered but only secondary to other LSIs.</div></span></li><li><span>■</span><span><div>Epinephrine should not be routinely used, and if used should not be administered before other LSIs.</div></span></li></ul></div></span></li><li><span>O</span><span><div>If point-of-care ultrasound (POCUS) demonstrates no evidence of cardiac motion, this may have utility in TOHCA management for prognostication.</div></span></li><li><span>O</span><span><div>Emphasize that placement of cardiac monitors and/or use of POCUS should occur after indicated LSIs have been appropriately performed.</div></span></li><li><span></span><span><div>Conditions where resuscitation attempts should be withh","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"85 3","pages":"Pages e25-e39"},"PeriodicalIF":5.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Cannabinoid Hyperemesis Syndrome Is Associated With High Disease Burden: An Internet-Based Survey.

IF 5 1区医学

Annals of emergency medicine Pub Date : 2025-02-18 DOI: 10.1016/j.annemergmed.2025.01.008

Andrew C Meltzer, Callen Morrison, Aditya Loganathan, Soroush Shahamatdar, Alice Moon, Ryan Heidish, Michael Makutonin, Yan Ma, Runjia Li, Ziva D Cooper

{"title":"Cannabinoid Hyperemesis Syndrome Is Associated With High Disease Burden: An Internet-Based Survey.","authors":"Andrew C Meltzer, Callen Morrison, Aditya Loganathan, Soroush Shahamatdar, Alice Moon, Ryan Heidish, Michael Makutonin, Yan Ma, Runjia Li, Ziva D Cooper","doi":"10.1016/j.annemergmed.2025.01.008","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.01.008","url":null,"abstract":"<p><p>Cannabinoid hyperemesis syndrome is an underrecognized condition associated with recurrent vomiting and abdominal pain in individuals with prolonged cannabis use. This study used an internet-based survey targeting individuals with self-reported cannabinoid hyperemesis syndrome to assess the burden of disease and to examine associations between heavy cannabis use, early initiation of cannabis use, and cannabinoid hyperemesis syndrome episode frequency. A total of 1,052 participants were included, with the majority reporting frequent cannabis use and significant health care utilization, including emergency department visits and hospitalizations. This study highlights the substantial disease burden associated with cannabinoid hyperemesis syndrome in an online support group cohort and underscores the possible risks of heavy daily cannabis use and of use starting in adolescence. Future studies on heavy cannabis users are necessary to further elucidate cannabinoid hyperemesis syndrome and its link to daily cannabis use and the dangers of heavy use in adolescence.</p>","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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