PubMed Journal Database | Academic emergency medicine : official journal of the Society for Academic Emergency Medicine RSS

13:17 EDT 19th March 2019 | BioPortfolio

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Showing PubMed Articles 1–25 of 331 from Academic emergency medicine : official journal of the Society for Academic Emergency Medicine

A comparison of scoring systems for predicting short- and long-term survival after trauma in older adults.

Early identification of geriatric patients at high risk for mortality is important to guide clinical care, medical decision-making, palliative discussions, quality assurance, and research. We sought to identify injured older adults at highest risk for 30-day mortality using an empirically derived scoring system from available data, and to compare it with current prognostic scoring systems.

Depression in Emergency Department Patients and Association with Healthcare Utilization.

Depression is one of the most common illnesses in the U.S., with increased prevalence among people with lower socioeconomic status and chronic mental illness who often seek care in the Emergency Department (ED). We sought to estimate the rate and severity of major depressive disorder (MDD) in a non-psychiatric emergency department (ED) population and its association with subsequent ED visits and hospitalizations.

Comments on Manuscript AEMJ-18-765.R1: Civil monetary penalties resulting from violations of EMTALA involving psychiatric emergencies, 2002-2018.

The authors' stated objective is to describe characteristics of EMTALA civil monetary penalties (CMPs) levied by the Office of Inspector General (OIG) between 2002 and 2018. [ 1 ] However, the description provided is just the government's version of the 'description', it leaves out the affected hospitals' side of the story; and the authors' statistical analysis of the penalties assessed overlooks known critical factors which could substantively undermine their conclusions. This article is protected by copyr...

Defining the problem - and the solutions - to our stubborn challenge of gender equity.

Now is the critical time to consider the pipeline of women in medicine: for the past two years, 51% matriculants into medical school were women (1) - a milestone - and increasing data demonstrates the value of women in terms of providing high quality healthcare, innovative leadership, bottom line financial results, and groundbreaking research. And yet, disturbingly, gender disparities in compensation (2, 3), promotion (4), and leadership (5) in medicine have been persistently observed, even after accounting...

So the doctor is burned out: What does it mean for patient care?

The current state of physician burnout has become an increasingly popular topic of discussion and concern. Depending on how it is defined and measured by researchers, the prevalence of physician burnout ranges anywhere from 0 to 80%. Emergency medicine is often cited as the specialty with some of the highest reported levels of physician burnout. Regardless of what the "true" prevalence of physician burnout may be, most of these studies suggest the presence of a crisis. The detrimental impact of burnout on p...

A Commentary on Impact of Women-Focused Professional Organization and Academic Retention and Advancement: Perceptions from a Qualitative Study.

Despite the steady increase in female medical students and female faculty in the US, there has been little change in the distribution of women across the ranks of assistant, associate, and full professor over the past 30 years. Women are substantially less likely than men to be full professors even after accounting for age, experience, specialty, and measures of research and clinical productivity. From 2009 to 2017, the percentage of female faculty in emergency medicine dropped from 3% to 1.8%, while it sta...

Re: SAEM Annual Meeting Abstracts.

Do High Sensitivity Troponin and Natriuretic Peptide Predict Death or Serious Cardiac Outcomes After Syncope?

An estimated 1.2 million annual emergency department (ED) visits for syncope/ near syncope occur in the United States. Cardiac biomarkers are frequently obtained during the ED evaluation, but the prognostic value of index high-sensitivity troponin (hscTnT) and Natriuretic Peptide (NT-proBNP) are unclear. The objective of this study was to determine if hscTnT and NT-proBNP drawn in the ED are independently associated with 30-day death/ serious cardiac outcomes in adult patients presenting with syncope.

Benefits of rhythm control and rate control in recent-onset atrial fibrillation. the hermes-af study.

Although rhythm control has failed to demonstrate long-term benefits over rate control in long-standing episodes of atrial fibrillation (AF), there is little evidence concerning recent-onset ones. We analyzed the benefits of rhythm and rate control in terms of symptoms alleviation and need for hospital admission in patients with recent-onset AF.

Prevalence of Pulmonary Embolism in Patients Presenting with Syncope.

Syncope accounts for 1-3% of emergency department (ED) visits and 1-6% of hospital admissions. There are numerous etiologies, ranging from relatively benign vasovagal syncope to dangerous dysrhythmias. The ED evaluation and management of syncope is comprised of history, examination, and typically an electrocardiogram, with further investigation dependent upon clinical decision-making and suspected conditions. Previously, pulmonary embolism (PE) was thought to account for a small minority of patients with sy...

Continuation of Gender Disparities in Pay Among Academic Emergency Medicine Physicians.

To identify the effects of gender and other predictors of change in the salary of academic emergency physicians over a four sequential time period of survey administration, across a sample of physicians within different emergency departments (EDs) and within states representing the four main geographical regions of the United States (US).

Why I Wear Red Shoes.

When I arrived to the Trauma Bay for my Emergency Department shift on November 21 , 2018, several emergency medicine residents and nurses asked why I was wearing my red shoes? My answer was sobering On, November 19 , 2018, Dr. Tamara O'Neal was murdered by her ex-fiancé. Dr. O'Neal, a physician employed at Mercy Hospital, along with a pharmacy resident and Chicago police officer were killed by the gunman who reportedly got into an argument with Dr. O'Neal before she was shot and killed. The news, emails an...

The Extended Treatment Window's Impact on Emergency Systems of Care for Acute Stroke.

The window for acute ischemic stroke treatment was previously limited to 4.5 hours for intravenous tissue plasminogen activator and to 6 hours for thrombectomy. Recent studies using advanced imaging selection expand this window for select patients up to 24 hours from last known well. These studies directly affect emergency stroke management, including pre-hospital triage and emergency department management of suspected stroke patients. This narrative review summarizes the data expanding the treatment window...

Identifying predictors of under-triage in injured older adults after implementation of statewide geriatric trauma triage criteria.

Identify factors associated with transport of injured older adults meeting statewide geriatric trauma triage criteria to a trauma center.

The Calm After the Storm.

A child gets rushed into the resuscitation room - chest compressions in progress, pale and mottled, emesis and blood streaking his matted hair and ashen face. Everyone springs into action, instinctively assuming the roles we were trained to do. The respiratory therapist seamlessly takes over ventilations, the nurses simultaneously obtain access, prime lines, and connect monitors, and I stand at the foot of the bed acting as the conductor amongst the cacophony of sound and motion. This article is protected b...

Feasibility of emergency department initiated, mobile health, blood pressure intervention: an exploratory, randomized clinical trial.

We aimed to assess the feasibility of a text messaging intervention by determining the proportion of emergency department (ED) patients who responded to prompted home blood pressure (BP) self-monitoring and had persistent hypertension. We also explored the effect of the intervention on systolic blood pressure (SBP) over time.

Are Children Allowed?: A Survey of Childcare and Family Policies at Academic Medical Conferences.

Conference attendance and networking have long been a staple of career advancement in medicine. Presenting one's own research or chairing a conference panel provides academic physicians with the visibility necessary for career advancement and promotion. Unfortunately, this pathway to career advancement may be obstructed for some physicians. Women physicians bear a larger proportion of domestic responsibilities (including childcare) which may constitute a limitation to their participation in conferences. Thi...

Changes in Pain Score Associated with Clinically Meaningful Outcomes in Children with Acute Pain.

Identifying changes in pain score associated with clinically meaningful outcomes is necessary when using self-report measures to assess pain in children. We aimed to determine the changes in pain score associated with a minimum clinically significant difference (MCSD), ideal clinically significant difference (ICSD), and patient-perceived adequate analgesia (PPAA), and to evaluate for differences based on initial pain intensity and patient characteristics.

Point-of-Care Ocular Ultrasound for the Diagnosis of Retinal Detachment: A Systematic Review and Meta-Analysis.

Ocular complaints are common presentations to the Emergency Department (ED). Among these, retinal detachment can cause significant vision loss if not rapidly diagnosed and referred for appropriate treatment. Point-of-care ultrasound has been suggested to identify the diagnosis rapidly when the ocular examination is limited or the ophthalmology service is not readily available. However, prior studies were limited by small sample sizes, resulting in wide ranges of potential accuracy. The primary outcome for t...

The Birth of a Return to Work Policy for New Resident Parents in Emergency Medicine.

With the rising number of female physicians, there will be more children than ever born in residency and the current system is inadequate to handle this increase in new resident parents. Residency is stressful and rigorous in isolation, let alone when pregnant or with a new child. Policies that ease these stressful transitions are generally either insufficient or do not exist. Therefore, we created a comprehensive Return to Work Policy for resident parents and piloted its implementation. Our policy aims to:...

Gender Differences in Faculty Rank Among Academic Emergency Physicians in the United States.

The purpose of this study was to complete a comprehensive analysis of gender differences in faculty rank among United States (U.S.) emergency physicians that reflected all academic emergency physicians.

Hot off the Press: SGEM #237 Screening Tool for Child Sex Trafficking.

Child Sex Trafficking (CST) is a human rights violation and major global health issue. Many victims of CST seek medical attention during their exploitation and often present to the emergency department. The objective of this study was to apply and evaluate a screening tool for CST in an inner-city pediatric emergency department. This article is protected by copyright. All rights reserved.

Hospital Observation Upon Reversal (HOUR) With Naloxone: A Prospective Clinical Prediction Rule Validation Study.

St. Paul's Early Discharge Rule was derived to determine which patients could be safely discharged from the emergency department after a 1-hour observation period following naloxone administration for opiate overdose. The rule suggested that patients could be safely discharged if they could mobilize as usual and had a normal oxygen saturation, respiratory rate, temperature, heart rate, and Glasgow Coma Scale score. Validation of the St. Paul's Early Discharge Rule is necessary to ensure that these criteria ...

Corticosteroids for Treating Pneumonia.

Pneumonia remains a major cause of morbidity and mortality in the United States. There is both theoretical and laboratory evidence that corticosteroids may have beneficial effects in pneumonia through local pulmonary and systemic effects. The data for this evidence-based summary is derived from a Cochrane meta-analysis by Stern et al, which included 17 trials with 2264 adult and children admitted to the hospital with community-acquired pneumonia. This article is protected by copyright. All rights reserved.

Early Endovascular Thrombectomy for Large Vessel Ischemic Stroke Reduces Disability at 90 Days.

Anterior circulation large vessel occlusion (LVO) of the internal carotid or middle cerebral artery is one of the most devastating ischemic stroke subtypes. Prior to 2015, evidence supporting endovascular thrombectomy for acute ischemic stroke was limited. This was due to multiple factors, including low recanalization rates with previous generation thrombectomy devices, inadequate neuroimaging inclusion criteria (patients enrolled in trials lacked target LVO and/or had large pre-existing core infarcts), and...

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