STUDY OBJECTIVEAs a safety net for adolescents, the emergency department (ED) is considered an opportune setting for suicide screening and response (ie, safety assessments, brief interventions, and referrals). This study explored adolescent and caregiver perspectives on the ED's response when nonacute suicide risk was identified during universal screening.METHODSThis was a qualitative study of adolescents who completed the Ask Suicide-Screening Questions (ASQ) in the ED and/or their caregiver. Our institution performs universal suicide screening with the ASQ for all ED patients aged 10 or more years. We conducted semistructured interviews with adolescents (13 to 17 years) who had a "nonacute positive" ASQ (defined as "yes" to questions 1 to 4 on the ASQ without current thoughts of suicide), and/or their caregiver. Interviews were scheduled after ED discharge and occurred from October 2023 to June 2024. Interviews were audio-recorded, transcribed, and coded in ATLAS.ti. Content analysis was used to identify salient themes. The analytic team diagrammed each participant's story to augment the analysis.RESULTSWe completed 17 interviews (8 adolescents and 9 caregivers). Three primary themes were identified: (1) responses by ED clinicians are lacking, confusing, and inconsistent; (2) ED responses should be tailored, well timed, private, and autonomous; and (3) resources provided by the ED should empower adolescents and caregivers moving forward. Participants recommended resources that overcome barriers to care and standardized ED interventions to better support patients and families.CONCLUSIONIn this study, the ED response to nonacute suicide risk was described as inadequate. Participants recommended additional resources to safely manage suicidal thoughts and navigate mental health treatment.
{"title":"A Qualitative Study Exploring Adolescent and Caregiver Perspectives of Emergency Department Response After a Positive Suicide Screen.","authors":"Rachel Cafferty,Anastasia Klott,Ashley Dafoe,Chloe Glaros,Brooke Dorsey,Maya Haasz,Bruno J Anthony,Sean T O'Leary","doi":"10.1016/j.annemergmed.2025.03.019","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.03.019","url":null,"abstract":"STUDY OBJECTIVEAs a safety net for adolescents, the emergency department (ED) is considered an opportune setting for suicide screening and response (ie, safety assessments, brief interventions, and referrals). This study explored adolescent and caregiver perspectives on the ED's response when nonacute suicide risk was identified during universal screening.METHODSThis was a qualitative study of adolescents who completed the Ask Suicide-Screening Questions (ASQ) in the ED and/or their caregiver. Our institution performs universal suicide screening with the ASQ for all ED patients aged 10 or more years. We conducted semistructured interviews with adolescents (13 to 17 years) who had a \"nonacute positive\" ASQ (defined as \"yes\" to questions 1 to 4 on the ASQ without current thoughts of suicide), and/or their caregiver. Interviews were scheduled after ED discharge and occurred from October 2023 to June 2024. Interviews were audio-recorded, transcribed, and coded in ATLAS.ti. Content analysis was used to identify salient themes. The analytic team diagrammed each participant's story to augment the analysis.RESULTSWe completed 17 interviews (8 adolescents and 9 caregivers). Three primary themes were identified: (1) responses by ED clinicians are lacking, confusing, and inconsistent; (2) ED responses should be tailored, well timed, private, and autonomous; and (3) resources provided by the ED should empower adolescents and caregivers moving forward. Participants recommended resources that overcome barriers to care and standardized ED interventions to better support patients and families.CONCLUSIONIn this study, the ED response to nonacute suicide risk was described as inadequate. Participants recommended additional resources to safely manage suicidal thoughts and navigate mental health treatment.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"23 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866987","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}
Pub Date : 2025-04-22DOI: 10.1016/j.annemergmed.2025.03.016
Daniel S Tsze,Nick Barrowman,Maala Bhatt
STUDY OBJECTIVEChildren with upper respiratory infections (URIs) have an increased risk of respiratory adverse events when undergoing operative anesthesia and in general populations of children receiving procedural sedation. It is unclear if children with URI undergoing emergency department (ED) sedation share the same increased risk. We aimed to determine if the presence of a URI in children undergoing ED sedation is associated with increased risk of respiratory adverse events and serious respiratory interventions.METHODSWe conducted a secondary analysis of a prospective cohort study of children aged 17 years or younger who received parenteral sedation for a painful procedure in 1 of 6 pediatric EDs. A multivariable regression model was used to identify potential associations between URI and respiratory adverse events, serious respiratory adverse events (ie, complete airway obstruction, apnea, laryngospasm, clinically apparent pulmonary aspiration, and death), and serious respiratory interventions (ie, bag-valve-mask ventilation and endotracheal intubation).RESULTSWe analyzed 6,292 children; 444 (7.1%) had a URI. The risk of respiratory adverse events, serious respiratory adverse events, or serious respiratory interventions was adjusted odds ratio (aOR) 1.00 (95% confidence interval [CI] 0.78 to 1.29), 0.53 (95% CI 0.18 to 1.58), and 1.08 (95% CI 0.68 to 1.71), respectively.CONCLUSIONIn this study, we found no increase in risk of any respiratory adverse events or serious respiratory interventions associated with URI in children undergoing ED sedation.
{"title":"Upper Respiratory Infections and Respiratory Adverse Events and Interventions in Emergency Department Sedation of Children.","authors":"Daniel S Tsze,Nick Barrowman,Maala Bhatt","doi":"10.1016/j.annemergmed.2025.03.016","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.03.016","url":null,"abstract":"STUDY OBJECTIVEChildren with upper respiratory infections (URIs) have an increased risk of respiratory adverse events when undergoing operative anesthesia and in general populations of children receiving procedural sedation. It is unclear if children with URI undergoing emergency department (ED) sedation share the same increased risk. We aimed to determine if the presence of a URI in children undergoing ED sedation is associated with increased risk of respiratory adverse events and serious respiratory interventions.METHODSWe conducted a secondary analysis of a prospective cohort study of children aged 17 years or younger who received parenteral sedation for a painful procedure in 1 of 6 pediatric EDs. A multivariable regression model was used to identify potential associations between URI and respiratory adverse events, serious respiratory adverse events (ie, complete airway obstruction, apnea, laryngospasm, clinically apparent pulmonary aspiration, and death), and serious respiratory interventions (ie, bag-valve-mask ventilation and endotracheal intubation).RESULTSWe analyzed 6,292 children; 444 (7.1%) had a URI. The risk of respiratory adverse events, serious respiratory adverse events, or serious respiratory interventions was adjusted odds ratio (aOR) 1.00 (95% confidence interval [CI] 0.78 to 1.29), 0.53 (95% CI 0.18 to 1.58), and 1.08 (95% CI 0.68 to 1.71), respectively.CONCLUSIONIn this study, we found no increase in risk of any respiratory adverse events or serious respiratory interventions associated with URI in children undergoing ED sedation.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"11 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866778","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}
Pub Date : 2025-04-18DOI: 10.1016/j.annemergmed.2024.11.015
Joo Shiang Ang MBBS
{"title":"Woman With Abdominal Pain","authors":"Joo Shiang Ang MBBS","doi":"10.1016/j.annemergmed.2024.11.015","DOIUrl":"10.1016/j.annemergmed.2024.11.015","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"85 5","pages":"Pages 451-452"},"PeriodicalIF":5.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843770","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}
Pub Date : 2025-04-18DOI: 10.1016/j.annemergmed.2024.09.020
Megan A. Rech PharmD, MS, Michael Gottlieb MD
{"title":"Amiodarone Should Be the First-Line Antiarrhythmic Treatment for Pulseless Ventricular Tachycardia and Ventricular Fibrillation","authors":"Megan A. Rech PharmD, MS, Michael Gottlieb MD","doi":"10.1016/j.annemergmed.2024.09.020","DOIUrl":"10.1016/j.annemergmed.2024.09.020","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"85 5","pages":"Pages 447-448"},"PeriodicalIF":5.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843768","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}
Pub Date : 2025-04-18DOI: 10.1016/S0196-0644(25)00165-9
{"title":"Information for Readers","authors":"","doi":"10.1016/S0196-0644(25)00165-9","DOIUrl":"10.1016/S0196-0644(25)00165-9","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"85 5","pages":"Page A11"},"PeriodicalIF":5.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843857","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}
Pub Date : 2025-04-18DOI: 10.1016/j.annemergmed.2025.03.014
Ryan P. Radecki MD, MS (Guest Contributor)
{"title":"I Fought the Decision-Support Law – and No One Won","authors":"Ryan P. Radecki MD, MS (Guest Contributor)","doi":"10.1016/j.annemergmed.2025.03.014","DOIUrl":"10.1016/j.annemergmed.2025.03.014","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"85 5","pages":"Pages 458-459"},"PeriodicalIF":5.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843865","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}
Pub Date : 2025-04-18DOI: 10.1016/j.annemergmed.2024.11.018
Lance Ray PharmD, BCEMP, Laura E. Celmins PharmD, BCEMP
{"title":"Lidocaine as First-Line Treatment for Pulseless Ventricular Tachycardia and Ventricular Fibrillation","authors":"Lance Ray PharmD, BCEMP, Laura E. Celmins PharmD, BCEMP","doi":"10.1016/j.annemergmed.2024.11.018","DOIUrl":"10.1016/j.annemergmed.2024.11.018","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"85 5","pages":"Pages 445-447"},"PeriodicalIF":5.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843767","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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