American Journal of Emergency Medicine最新文献

{"title":"\"Charting practices associated with preserved emergency ultrasound coding in the 2023 and beyond era\".","authors":"Christopher Thom, Benton Spirek, Gitansh Bhargava, Jakob Ottenhoff, James Moak","doi":"10.1016/j.ajem.2024.09.063","DOIUrl":"10.1016/j.ajem.2024.09.063","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376384","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":"Characterizing emergency department surgical airway placement in the setting of trauma - Reply.","authors":"Steven G Schauer, Amy R Krepps, Julie M Winkle, Franklin L Wright, Andrew D Fisher, Michael D April, David J Douin","doi":"10.1016/j.ajem.2024.09.067","DOIUrl":"10.1016/j.ajem.2024.09.067","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378580","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":"An update of the severe trauma scoring system using the Korean National Emergency Department Information System (NEDIS) database","authors":"Hyo Jin Kim ,&nbsp;Young Sun Ro ,&nbsp;Taehui Kim ,&nbsp;So-hyun Han ,&nbsp;Yoonsung Kim ,&nbsp;Jungeon Kim ,&nbsp;Won Pyo Hong ,&nbsp;Eunsil Ko ,&nbsp;Seong Jung Kim","doi":"10.1016/j.ajem.2024.09.056","DOIUrl":"10.1016/j.ajem.2024.09.056","url":null,"abstract":"<div><h3>Background</h3><div>Various scoring systems are utilized to assess severe trauma patients, with one of the most commonly used tools being the International Classification of Diseases Injury Severity Score (ICISS) criteria derived from the Survival Risk Ratio (SRR) calculated using diagnostic codes. This study aimed to redefine the severe trauma scoring system in Korea based on the SRR for diagnostic codes, and subsequently evaluate its performance in predicting survival outcomes for trauma patients.</div></div><div><h3>Methods</h3><div>This study included trauma patients who visited Level 1 and 2 emergency departments (EDs) between January 2016 and December 2019, utilizing the Korean National Emergency Department Information System (NEDIS) database. The primary outcome of this study was in-hospital mortality. The new SRR-2020 value was calculated for each of the 865 trauma diagnosis codes (Korean Standard Classification of Diseases [KCD-7] codes, 4-digit format), and the patient-specific ICISS-2020 value was derived by multiplying the corresponding SRR-2020 value based on patient diagnosis. We compared the predictive performance for in-hospital mortality between severe trauma patients with an ICISS &lt;0.9 based on the newly developed ICISS-2020 version and those defined by the previously used ICISS-2015 version.</div></div><div><h3>Results</h3><div>A total of 3,841,122 patients were enrolled, with an in-hospital mortality rate of 0.5 %. Severe trauma patients with ICISS-2020 &lt; 0.9 accounted for 5.3 % (204,897 cases) that was lower than ICISS-2015 &lt; 0.9 accounting for 15.3 % (587,801 cases). Among the 20,619 in-hospital mortality cases, 81.4 % had ICISS-2020 &lt; 0.9, and 88.6 % had ICISS-2015 &lt; 0.9. When comparing predictive performance for in-hospital mortality between the two ICISS versions, ICISS-2020 showed higher accuracy (0.95), specificity (0.95), positive predictive value (PPV) (0.08), positive likelihood ratio (LR+) (16.53), and area under the receiver operating characteristic curve (AUROC) (0.96) than ICISS-2015 for accuracy (0.85), sensitivity (0.88), specificity (0.85), PPV (0.03), LR+ (5.94), and AUROC (0.94). However, regarding sensitivity, ICISS-2020 &lt; 0.9 showed a lower value of 0.81 compared to ICISS-2015 &lt; 0.9, which was 0.88. The negative predictive value (NPV) was 1.00 for both versions.</div></div><div><h3>Conclusions</h3><div>The newly developed ICISS-2020, utilizing a nationwide emergency patient database, demonstrated relatively good performance (accuracy, specificity, PPV, LR+, and AUROC) in predicting survival outcomes for patients with trauma.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"86 ","pages":"Pages 62-69"},"PeriodicalIF":2.7,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373641","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":"Policing of youth in the hospital","authors":"Katherine Hoops MD, MPH ,&nbsp;Erin Hall MD, MPH ,&nbsp;Cassandra Ramdath PhD ,&nbsp;Christy Lopez JD","doi":"10.1016/j.ajem.2024.09.061","DOIUrl":"10.1016/j.ajem.2024.09.061","url":null,"abstract":"<div><h3>Background</h3><div>Each year millions of children seek care in emergency departments, many of whom are from marginalized and minoritized groups who lack access to primary and preventive care. Law enforcement personnel are also commonly present in pediatric and adult emergency departments serving in a range of roles. Therefore, pediatric emergency departments sit at the nexus of the health system and the legal system for many vulnerable youth and families.</div></div><div><h3>Objective</h3><div>Herein, we explore several common specific legal issues surrounding policing of youth in the hospital setting: patient privacy and disclosure of information, questioning and visitation restriction, autonomy and decision making, restraints and use of force, and patient property.</div></div><div><h3>Methods</h3><div>Our team of legal scholars and clinician researchers examined the literature on policing of youth in healthcare settings and patients' legal rights in healthcare settings through searches using PubMed, Westlaw, and Lexis.</div></div><div><h3>Findings</h3><div>Through rigorous analysis of the medical literature, legal scholarship, and relevant case law, several important themes were identified which present challenges to clinicians caring for vulnerable children.</div></div><div><h3>Conclusions and relevance</h3><div>Pediatric clinicians, highly trained professionals in the medical and social care of youth and children, are often unaware of legal rules and procedures that guide law enforcement interaction with youth. This lack of knowledge may result in unknowing and unwitting violations of patients' rights while also compromising the quality of health care provided. Therefore, it is imperative that clinicians are educated on their roles and their institutions' roles in safeguarding patients' privacy and autonomy while still promoting effective collaboration with law enforcement.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"86 ","pages":"Pages 74-77"},"PeriodicalIF":2.7,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378584","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":"A case of Marchiafava Bignami disease presenting as a cerebrovascular accident.","authors":"Sundip Patel, Kelly Lambert","doi":"10.1016/j.ajem.2024.09.058","DOIUrl":"10.1016/j.ajem.2024.09.058","url":null,"abstract":"<p><p>Marchiafava Bignami Disease (MBD) is a reversible neurological disorder with can be difficult to diagnose initially due to variable neurological presentations that can be seen in patients. Physicians need to consider this diagnosis as the readily available treatment of thiamine can help reverse symptoms and prevent long lasting effects. We present the case of a 52-year-old man with a history of alcohol use disorder who presented with concerns for a cerebrovascular accident. The patient had neurological signs that were vague and included intermittent confusion, subtle droop to the lower lip, and ataxia in their limbs. MRI revealed restricted diffusion in the corpus callosum which helped confirm the diagnosis of MBD. Treatment with thiamine helped the patient get back to their usual state of health with no new neurological deficits. This case emphasizes that MBD is a rare neurological disorder that must be considered in patients with alcohol use disorder who present with varying neurological symptoms as early thiamine treatment can reverse symptoms.</p>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376385","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":"In response to \"Gabapentinoid prescribing patterns and predictors utilizing neural networks: Comment\".","authors":"Christine Ramdin, Emily Chen, Lewis S Nelson, Maryann Mazer-Amirshahi","doi":"10.1016/j.ajem.2024.09.065","DOIUrl":"https://doi.org/10.1016/j.ajem.2024.09.065","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367646","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":"Emergency Department Utilization of Physical Restraints: A Study of Documentation Compliance and Adverse Events.","authors":"Lauren Klein, Samuel Hoffman, Eric F Decena, Patricia Eckardt, Theresa Tomkin, Denise DeVoe, Lisa Gaeta, Christopher C Raio","doi":"10.1016/j.ajem.2024.09.068","DOIUrl":"https://doi.org/10.1016/j.ajem.2024.09.068","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378582","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":"Droperidol use in emergency patients with abdominal pain, nausea, and vomiting requires further analysis.","authors":"Damian Swieczkowski, Michal Pruc, Lukasz Szarpak","doi":"10.1016/j.ajem.2024.09.053","DOIUrl":"https://doi.org/10.1016/j.ajem.2024.09.053","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378581","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":"The preponderance of opioid overdoses among middle-aged individuals in the US: Analysis of 911 dispatch data — Q1 2018 to Q3 2023","authors":"Andrew J. McCabe PhD, MPH,&nbsp;Nae Y. Won PhD, MPH,&nbsp;Linda B. Cottler PhD, MPH, FACE","doi":"10.1016/j.ajem.2024.09.057","DOIUrl":"10.1016/j.ajem.2024.09.057","url":null,"abstract":"<div><h3>Background</h3><div>Opioid overdoses have increased at a concerning rate in recent years. Middle-aged individuals have been reported as an age group of high concern for opioid overdoses. The purpose of this study was to assess trends in opioid overdose 911 dispatches between Q1 2018 and Q3 2023 among different age groups. It was hypothesized that the steepest increase in dispatches would be among middle-aged individuals.</div></div><div><h3>Methods</h3><div>We assessed age-related trends in opioid-related 911 dispatches using emergency medical service (EMS) data collected by biosptial, io. Data encompassed all 50 states and were broken into yearly quarters between Q1 2018 and Q3 2023. Age groups included younger- (10 to 29), middle- (30 to 49), and older-aged (50 to 69) individuals. Joinpoint regression was utilized to examine these trends.</div></div><div><h3>Results</h3><div>There were a total of 1,420,298 opioid-related 911 dispatches reported. Most were reported among middle-aged individuals, accounting for 48.9 % (<em>n</em> = 682,132) of all dispatches. Significant increases in dispatches were identified overall between Q1 2018 and Q2 2021 (β = 0.096, SE = 0.006, <em>P</em> ≤ 0.001). The steepest increase was identified among middle-aged individuals between Q1 2018 and Q2 2021 (β = 0.104, SE = 0.007, <em>P</em> ≤ 0.001). There was a significant decrease in dispatches among younger-aged individuals between Q2 2021 and Q3 2023 (β = −0.024, SE = 0.011, <em>P</em> = .036).</div></div><div><h3>Conclusion</h3><div>Middle-aged individuals experienced significant increases in opioid-related 911 dispatches between Q1 2018 and Q2 2021, and had the steepest increase compared to the other age groups. Conversely, younger-aged individuals have experienced a recent decrease in dispatches. These findings support previous indications that middle-aged individuals are at significant risk for opioid overdose. Additional research is necessary to identify geographic and demographic factors that may affect these trends.</div></div>","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":"86 ","pages":"Pages 94-97"},"PeriodicalIF":2.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407249","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":"Corrigendum to \"Clinical outcomes of challenging out-of-hospital hypothermia management: A retrospective assessment of DOKEI protocol\" [The American Journal of Emergency Medicine, Volume 85, November 2024, Pages 71-79].","authors":"Kazue Oshiro, Takashi Matsumoto, Takeshi Nawa, Takayuki Sakuta, Tomikazu Murakami","doi":"10.1016/j.ajem.2024.09.048","DOIUrl":"10.1016/j.ajem.2024.09.048","url":null,"abstract":"","PeriodicalId":55536,"journal":{"name":"American Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333042","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}