Pub Date : 2026-02-10DOI: 10.1016/j.annemergmed.2025.12.017
Carl Preiksaitis MD MEd, Al’ai Alvarez MD, Maia Winkel MD, Mia Karamatsu MD, Ian Brown MD MS, Neetha Sama MS, Luke Morris MSDA MHBS, Jae-yeon Lee MD, Allie Gubbels MD, Eileen Wahl MS, Anna Frye MPH, Christian Rose MD
To describe real-world adoption of an ambient artificial intelligence (AI) scribe in the emergency department (ED) and compare documentation time and note characteristics between ambient and standard encounters using electronic health record audit logs.
{"title":"Ambient Artificial Intelligence Scribe Adoption and Documentation Time in the Emergency Department","authors":"Carl Preiksaitis MD MEd, Al’ai Alvarez MD, Maia Winkel MD, Mia Karamatsu MD, Ian Brown MD MS, Neetha Sama MS, Luke Morris MSDA MHBS, Jae-yeon Lee MD, Allie Gubbels MD, Eileen Wahl MS, Anna Frye MPH, Christian Rose MD","doi":"10.1016/j.annemergmed.2025.12.017","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.12.017","url":null,"abstract":"To describe real-world adoption of an ambient artificial intelligence (AI) scribe in the emergency department (ED) and compare documentation time and note characteristics between ambient and standard encounters using electronic health record audit logs.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"24 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146146300","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 : 2026-02-10DOI: 10.1016/j.annemergmed.2026.01.003
Reuben J. Strayer MD
{"title":"Shaking Up the Cocktail: Integrating Sphenopalatine Ganglion Block Into Emergency Department Headache Care","authors":"Reuben J. Strayer MD","doi":"10.1016/j.annemergmed.2026.01.003","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2026.01.003","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"9 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146146299","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 : 2026-02-10DOI: 10.1016/j.annemergmed.2026.01.005
Stephen Gamboa MD MPH, Paul Roman Chelminski MD MPH, Christina Shenvi MD PhD MBA
Hurricane Helene struck Western North Carolina in September 2024, leaving an entire region without power, clean water, or internet connectivity for more than a week. A small, rural, community hospital and its emergency department, which normally sees 84 patients per day, suddenly became the sole source of medical care for an estimated 200,000 residents and experienced a 70% surge in patient volume. Although structural damage to the hospital was limited, the complete loss of digital connectivity rendered electronic medical records, laboratory information systems, radiology, pharmacy, and routine communication tools inoperable. Forced back into an analog system of care, clinicians rapidly redesigned workflows: in-person huddles replaced digital messaging, point-of-care testing replaced central laboratory processing, radiologists interpreted imaging in real time at the scanner, and paper charting was used. When patients dependent on powered medical devices such as oxygen concentrators and left ventricular assist devices overwhelmed emergency department space, the hospital created a staffed medical device shelter in a nearby high school. Paper medication administration records and take-home medication packs were developed to allow safe discharge despite pharmacy closures.
{"title":"Lessons Learned From Helene: The Role of a Rural Community Hospital in Disaster Response After a Major Hurricane","authors":"Stephen Gamboa MD MPH, Paul Roman Chelminski MD MPH, Christina Shenvi MD PhD MBA","doi":"10.1016/j.annemergmed.2026.01.005","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2026.01.005","url":null,"abstract":"Hurricane Helene struck Western North Carolina in September 2024, leaving an entire region without power, clean water, or internet connectivity for more than a week. A small, rural, community hospital and its emergency department, which normally sees 84 patients per day, suddenly became the sole source of medical care for an estimated 200,000 residents and experienced a 70% surge in patient volume. Although structural damage to the hospital was limited, the complete loss of digital connectivity rendered electronic medical records, laboratory information systems, radiology, pharmacy, and routine communication tools inoperable. Forced back into an analog system of care, clinicians rapidly redesigned workflows: in-person huddles replaced digital messaging, point-of-care testing replaced central laboratory processing, radiologists interpreted imaging in real time at the scanner, and paper charting was used. When patients dependent on powered medical devices such as oxygen concentrators and left ventricular assist devices overwhelmed emergency department space, the hospital created a staffed medical device shelter in a nearby high school. Paper medication administration records and take-home medication packs were developed to allow safe discharge despite pharmacy closures.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"46 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146146450","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 : 2026-02-04DOI: 10.1016/j.annemergmed.2025.12.026
Rachel Brown, Jungwon Min, Joel Fein, Mushyra Wright, Danielle Cullen
{"title":"Comparing Patient-Centered Approaches to Social Care in the Emergency Department: A Mixed-Method Randomized Controlled Trial","authors":"Rachel Brown, Jungwon Min, Joel Fein, Mushyra Wright, Danielle Cullen","doi":"10.1016/j.annemergmed.2025.12.026","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.12.026","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"15 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109973","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 : 2026-02-03DOI: 10.1016/j.annemergmed.2025.12.024
Megan A. Rech, Michael Shalaby, Kendra A. Gage, Michael Gottlieb
{"title":"Managing Cannabinoid Hyperemesis Syndrome","authors":"Megan A. Rech, Michael Shalaby, Kendra A. Gage, Michael Gottlieb","doi":"10.1016/j.annemergmed.2025.12.024","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.12.024","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"217 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109974","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 : 2026-02-02DOI: 10.1016/j.annemergmed.2025.12.025
Andrew J. Wood, Nicole Rosendale, Remle Crowe, J. Daniel Kelly, Elan L. Guterman
{"title":"Social Vulnerability and Out-of-Hospital Identification of Neurologic Emergencies","authors":"Andrew J. Wood, Nicole Rosendale, Remle Crowe, J. Daniel Kelly, Elan L. Guterman","doi":"10.1016/j.annemergmed.2025.12.025","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.12.025","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"61 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109975","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 : 2026-01-28DOI: 10.1016/j.annemergmed.2025.12.016
Sundes Kazmir,Wee-Jhong Chua
{"title":"Understanding the Nuances of Sentinel Injury Evaluation in Infants and Toddlers.","authors":"Sundes Kazmir,Wee-Jhong Chua","doi":"10.1016/j.annemergmed.2025.12.016","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.12.016","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"41 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146056879","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 : 2026-01-27DOI: 10.1016/j.annemergmed.2025.12.007
Dane McCarthy,Lester Borrayes,Elyse Hopper,Carlo L Lutz,Alan Teigman,Rebecca Siegel,Clemencia Solorzano,Eddie Irizarry,Benjamin W Friedman
STUDY OBJECTIVETo determine, when performing a sphenopalatine ganglion block (SPGB) for emergency department (ED) patients with headache, whether larger doses of bupivacaine result in greater rates of sustained headache relief than lower doses.METHODSThis was a randomized, 4-armed study conducted in 2 EDs. Eligible patients were those with a moderate or severe primary or secondary headache. We randomized patients to unilateral (UL) or bilateral (BL) transnasal SPGB with 0.5% bupivacaine and also to high dose (3 mL) or low dose (1 mL) bupivacaine. Thus, participants could have received 1 mL, 2 mL, 3 mL, or 6 mL of bupivacaine. No attempts were made to blind study participants or investigators. We did not use a sham procedure. We assessed pain using the descriptors severe, moderate, mild, or none. The primary outcome was sustained headache relief, defined as achieving a headache intensity of mild or none within 2 hours of medication administration and maintaining a level of mild or none for 48 hours after the procedure without the use of any rescue analgesic medications at any time during the 48 hours. The secondary outcome was the request to receive the same medication during a subsequent visit to the ED for headache. The minimum clinically important between-group difference was an absolute risk reduction of 15% to 20%.RESULTSIn total, 2,494 patients were screened for eligibility, and 220 were randomized. Of the 2,494 patients, 1,612 (65%) refused participation because they preferred a route of administration other than nasal. Rates of sustained headache relief were as follows: 3 mL BL, 17/54 (31%); 3 mL UL, 15/44 (34%); 1 mL BL, 23/65 (35%); and 1 mL UL, 9/48 (19%). When compared to the 1 mL UL dose, neither the 3 mL BL (95% CI for difference of 13% -4% to 29%) nor the 3 mL UL dose (95% CI for difference of 15% -2% to 33%) resulted in more sustained relief. Rates of wish to receive again were 3 mL BL, 35/53 (66%); 3 mL UL, 26/ 44 (59%); 1 mL BL, 36/62 (58%); and 1 mL UL, 33/45 (73%). There were no statistically significant differences among the groups regarding wish to receive again. The intervention was generally well tolerated, with minor procedure-related adverse events reported in ≤10% of participants in each arm.CONCLUSIONAmong ED patients with headache treated with a SPGB, larger doses of bupivacaine do not result in more sustained headache relief than smaller doses.
研究目的：确定对急诊科（ED）头痛患者实施蝶帕丁神经节阻滞（SPGB）时，大剂量布比卡因是否比小剂量布比卡因更能导致持续头痛缓解。方法：这是一项随机的四组研究，在2例患者中进行。符合条件的患者为中度或重度原发性或继发性头痛患者。我们将患者随机分为单侧（UL）或双侧（BL）经鼻SPGB，并给予0.5%布比卡因，以及高剂量（3ml）或低剂量（1ml）布比卡因。因此，参与者可以接受1ml、2ml、3ml或6ml的布比卡因。没有试图使研究参与者或调查人员失明。我们没有使用假手术。我们使用严重、中度、轻度或无描述符评估疼痛。主要结局是持续的头痛缓解，定义为在给药2小时内达到轻微或无头痛强度，并在手术后48小时内保持轻微或无头痛水平，而无需在48小时内的任何时间使用任何救援镇痛药物。次要结果是在随后因头痛到急诊科就诊时要求接受相同的药物治疗。最小的临床重要组间差异是绝对风险降低15%至20%。结果共筛选2494例患者，随机抽取220例。在2494名患者中，1612名（65%）拒绝参与，因为他们更喜欢鼻腔以外的给药途径。持续头痛缓解率如下：3 mL BL， 17/54 (31%)；3ml UL, 15/44 (34%)；1 mL BL, 23/65 (35%)；1 mL UL, 9/48（19%）。与1ml UL剂量相比，3ml BL （95% CI差值为13% -4%至29%）和3ml UL剂量（95% CI差值为15% -2%至33%）都不能带来更持久的缓解。希望再次接受3 mL BL的比例为35/53 (66%)；3 mL UL, 26/ 44 (59%)；1 mL BL, 36/62 (58%)；1 mL UL, 33/45（73%）。在再次接受治疗的意愿方面，两组之间没有统计学上的显著差异。干预通常耐受性良好，每组中≤10%的参与者报告了轻微的手术相关不良事件。结论在接受SPGB治疗的ED头痛患者中，大剂量布比卡因并不比小剂量布比卡因更持久地缓解头痛。
{"title":"A Randomized, Dose-Finding Study of Sphenopalatine Ganglion Block With Bupivacaine for Emergency Department Patients With Headache.","authors":"Dane McCarthy,Lester Borrayes,Elyse Hopper,Carlo L Lutz,Alan Teigman,Rebecca Siegel,Clemencia Solorzano,Eddie Irizarry,Benjamin W Friedman","doi":"10.1016/j.annemergmed.2025.12.007","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.12.007","url":null,"abstract":"STUDY OBJECTIVETo determine, when performing a sphenopalatine ganglion block (SPGB) for emergency department (ED) patients with headache, whether larger doses of bupivacaine result in greater rates of sustained headache relief than lower doses.METHODSThis was a randomized, 4-armed study conducted in 2 EDs. Eligible patients were those with a moderate or severe primary or secondary headache. We randomized patients to unilateral (UL) or bilateral (BL) transnasal SPGB with 0.5% bupivacaine and also to high dose (3 mL) or low dose (1 mL) bupivacaine. Thus, participants could have received 1 mL, 2 mL, 3 mL, or 6 mL of bupivacaine. No attempts were made to blind study participants or investigators. We did not use a sham procedure. We assessed pain using the descriptors severe, moderate, mild, or none. The primary outcome was sustained headache relief, defined as achieving a headache intensity of mild or none within 2 hours of medication administration and maintaining a level of mild or none for 48 hours after the procedure without the use of any rescue analgesic medications at any time during the 48 hours. The secondary outcome was the request to receive the same medication during a subsequent visit to the ED for headache. The minimum clinically important between-group difference was an absolute risk reduction of 15% to 20%.RESULTSIn total, 2,494 patients were screened for eligibility, and 220 were randomized. Of the 2,494 patients, 1,612 (65%) refused participation because they preferred a route of administration other than nasal. Rates of sustained headache relief were as follows: 3 mL BL, 17/54 (31%); 3 mL UL, 15/44 (34%); 1 mL BL, 23/65 (35%); and 1 mL UL, 9/48 (19%). When compared to the 1 mL UL dose, neither the 3 mL BL (95% CI for difference of 13% -4% to 29%) nor the 3 mL UL dose (95% CI for difference of 15% -2% to 33%) resulted in more sustained relief. Rates of wish to receive again were 3 mL BL, 35/53 (66%); 3 mL UL, 26/ 44 (59%); 1 mL BL, 36/62 (58%); and 1 mL UL, 33/45 (73%). There were no statistically significant differences among the groups regarding wish to receive again. The intervention was generally well tolerated, with minor procedure-related adverse events reported in ≤10% of participants in each arm.CONCLUSIONAmong ED patients with headache treated with a SPGB, larger doses of bupivacaine do not result in more sustained headache relief than smaller doses.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"31 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146056888","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 : 2026-01-27DOI: 10.1016/j.annemergmed.2025.10.004
Clare L Atzema,Jafna L Cox,Christopher C Cheung,Blanca Coll-Vinent,Emelia J Benjamin,Cynthia A Jackevicius,David R Vinson
The European Society of Cardiology and the American College of Cardiology/American Heart Association/American College of Clinical Pharmacy/Heart Rhythm Society both recently updated their guidelines on the management of atrial fibrillation, whereas the Canadian Cardiovascular Society/Canadian Heart Rhythm Society published their most recent guidelines in 2020. Compared with previous iterations, all three guidelines are more specific in their recommendations with respect to emergency department (ED) care. Although the principles that underpin each group's recommendations are similar, some of the details vary, which could lead to clinician confusion. In addition, no publication has compared all 3 on the care that is specific to emergency medicine, nor contextualized them with the recommendations made by 2 national emergency medicine groups. In this Concepts paper, we compare and contrast the different guidelines as they apply to the practice of emergency medicine, highlighting differences as well as the underlying rationale provided by each group. We also provide practical insights for implementation in the ED setting.
{"title":"Comparing Guidelines for Atrial Fibrillation: Focus on Emergency Medicine.","authors":"Clare L Atzema,Jafna L Cox,Christopher C Cheung,Blanca Coll-Vinent,Emelia J Benjamin,Cynthia A Jackevicius,David R Vinson","doi":"10.1016/j.annemergmed.2025.10.004","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.10.004","url":null,"abstract":"The European Society of Cardiology and the American College of Cardiology/American Heart Association/American College of Clinical Pharmacy/Heart Rhythm Society both recently updated their guidelines on the management of atrial fibrillation, whereas the Canadian Cardiovascular Society/Canadian Heart Rhythm Society published their most recent guidelines in 2020. Compared with previous iterations, all three guidelines are more specific in their recommendations with respect to emergency department (ED) care. Although the principles that underpin each group's recommendations are similar, some of the details vary, which could lead to clinician confusion. In addition, no publication has compared all 3 on the care that is specific to emergency medicine, nor contextualized them with the recommendations made by 2 national emergency medicine groups. In this Concepts paper, we compare and contrast the different guidelines as they apply to the practice of emergency medicine, highlighting differences as well as the underlying rationale provided by each group. We also provide practical insights for implementation in the ED setting.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"31 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146056880","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 : 2026-01-22DOI: 10.1016/j.annemergmed.2025.12.006
Alexandra H Baker,Joyce Li,Katherine E Douglas,Michael C Monuteaux,Sarita Chung
STUDY OBJECTIVEPediatric data on health care utilization following disasters are limited, with most studies focused on adults. This study evaluated changes in pediatric emergency department (ED) volumes, hospital admissions, and diagnoses following Major Disaster Declarations by the Federal Emergency Management Agency.METHODSThis was a retrospective observational analysis of patients aged ≤18 years presenting to a Pediatric Health Information System-participating ED between 2010 and 2023. We paired each Pediatric Health Information System ED with any major disaster that occurred within 50 miles of the ED. For each ED-disaster pair, we analyzed changes in weekly ED visits, admissions, and diagnoses for weeks 1 to 4 after the disaster. We report mean counts (SD) and percent changes (95% confidence interval), stratified by the 5 disaster types (severe storm/flood, snow/ice storm, fire, tornado, and earthquake).RESULTSAcross 288 Major Disaster Declarations over 14 years, there were 409 ED-disaster pairs. For all disaster types, ED visits and admissions showed modest week 1 declines followed by a return to baseline levels. Tornadoes were associated with consistent decreases in ED visits over all 4 weeks, whereas snow/ice storms, severe storms/floods, and earthquakes demonstrated early decreases followed by recovery. Fires were associated with sustained increases, particularly for respiratory diagnoses. Admissions declined after tornadoes, with smaller decreases after snow/ice storms and earthquakes, whereas remaining stable after severe storms/floods and fires.CONCLUSIONPediatric ED utilization generally declined modestly after most disasters but increased following fires, driven by respiratory presentations. Declines likely reflect disruptions in access and care seeking, whereas fire-related surges highlight distinct respiratory effects. Preparedness efforts should incorporate event and diagnosis-specific trends to support continuity of operations and capacity for brief surges when they occur.
{"title":"Characterizing Emergency Department Visits to Pediatric Hospitals After Local Disaster Declarations.","authors":"Alexandra H Baker,Joyce Li,Katherine E Douglas,Michael C Monuteaux,Sarita Chung","doi":"10.1016/j.annemergmed.2025.12.006","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.12.006","url":null,"abstract":"STUDY OBJECTIVEPediatric data on health care utilization following disasters are limited, with most studies focused on adults. This study evaluated changes in pediatric emergency department (ED) volumes, hospital admissions, and diagnoses following Major Disaster Declarations by the Federal Emergency Management Agency.METHODSThis was a retrospective observational analysis of patients aged ≤18 years presenting to a Pediatric Health Information System-participating ED between 2010 and 2023. We paired each Pediatric Health Information System ED with any major disaster that occurred within 50 miles of the ED. For each ED-disaster pair, we analyzed changes in weekly ED visits, admissions, and diagnoses for weeks 1 to 4 after the disaster. We report mean counts (SD) and percent changes (95% confidence interval), stratified by the 5 disaster types (severe storm/flood, snow/ice storm, fire, tornado, and earthquake).RESULTSAcross 288 Major Disaster Declarations over 14 years, there were 409 ED-disaster pairs. For all disaster types, ED visits and admissions showed modest week 1 declines followed by a return to baseline levels. Tornadoes were associated with consistent decreases in ED visits over all 4 weeks, whereas snow/ice storms, severe storms/floods, and earthquakes demonstrated early decreases followed by recovery. Fires were associated with sustained increases, particularly for respiratory diagnoses. Admissions declined after tornadoes, with smaller decreases after snow/ice storms and earthquakes, whereas remaining stable after severe storms/floods and fires.CONCLUSIONPediatric ED utilization generally declined modestly after most disasters but increased following fires, driven by respiratory presentations. Declines likely reflect disruptions in access and care seeking, whereas fire-related surges highlight distinct respiratory effects. Preparedness efforts should incorporate event and diagnosis-specific trends to support continuity of operations and capacity for brief surges when they occur.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"47 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021301","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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