Showing papers in "Annals of Emergency Medicine in 2018"

TL;DR: Meta‐analysis demonstrated that, compared with noncontrast CT, contrast‐enhanced CT was not significantly associated with either acute kidney injury or all‐cause mortality, and other patient‐ and illness‐level factors, rather than the use of contrast material, likely contribute to the development of acute kidney Injury.

TL;DR: A randomized clinical trial is designed to compare the liberal and restrictive fluids strategies, the Crystalloid Liberal or Vasopressor Early Resuscitation in Sepsis trial, to outline the rationale for the upcoming trial and review the current literature on approaches to early fluid resuscitation.

TL;DR: Efforts to improve trans ED experiences should focus on provider competency and communication training, electronic medical record modifications, and assurance of private means for gender disclosure, as well as staff and provider training about gender and trans health.

TL;DR: The diagnostic performance of positive qSOFA score for predicting 28‐day mortality was low in critically ill septic patients, particularly during the early period after emergency department (ED) presentation.

TL;DR: This clinical review article examines current strategies for identifying patients with opioid use disorder, the treatment of patients with acute opioid withdrawal syndrome, approaches to medication‐assisted therapy, and the transition of patients from the emergency department to outpatient services.

TL;DR: High‐velocity nasal insufflation is noninferior to noninvasive positive‐pressure ventilation for the treatment of undifferentiated respiratory failure in adult patients presenting to the ED.

TL;DR: The findings support the use of the Verbal Numerical Rating Scale for most children aged 6 years and older, but not for those aged 4 and 5 years, and known‐groups validity and responsivity were strong in all years of age.

TL;DR: The addition of a point‐of‐care ultrasonography protocol to standard care may not translate into a survival benefit in undifferentiated hypotensive ED patients, and any benefits for survival, length of stay, rates of CT scanning, inotrope use, or fluid administration are not found.

TL;DR: Transtracheal sonography is rapid to perform, with an acceptable degree of sensitivity and specificity for the confirmation of endotracheal intubation, and should be considered when quantitative capnography is unavailable or unreliable.

TL;DR: Between 1996 and 2012, opioid prescribing for noncancer patients in the United States significantly increased, and the majority of this growth was attributable to office visits and refills of previously prescribed opioids.

TL;DR: The prevalence of bacteremia and meningitis among febrile infants 28 days of age and younger is high and exceeds that observed in infants aged 29 to 60 days.

TL;DR: Although infrequent in this population, prescriptions greater than 225 MME were associated with higher rates of prolonged opioid use, and this is concerning because these prescriptions could still fall within 5‐ or 7‐day supply limit policies aimed at promoting safer opioid prescribing.

TL;DR: Agitated patients frequently required restraint and sedation, with significant rates of clinical events requiring intervention, and characteristics associated with a clinical event included delirium symptoms.

TL;DR: Emergency physicians, as front-line providers, without question save lives by reversing opioid overdoses, but they also have a unique opportunity to engage in prevention of a future overdose, particularly for patients whomay not have other contact with the health care system.

TL;DR: This clinical policy from the American College of Emergency Physicians addresses key issues in the evaluation and management of adult patients with suspected venous thromboembolism, and offers evidence-based recommendations based on the strength of the available data.

TL;DR: In this large observational series, there did not detect an association between paralytic choice and first‐pass rapid sequence intubation success or peri‐intubation adverse events.

TL;DR: This clinical policy from the American College of Emergency Physicians addresses key issues in the evaluation and management of patients with suspected non–ST‐elevation acute coronary syndromes.

TL;DR: Intramuscular midazolam achieved more effective sedation in agitated ED patients at 15 minutes than haloperidol, ziprasidone, and perhaps olanzapine.

TL;DR: In this article, transesophageal echocardiography has many advantages over transthoracic ECG in a cardiac arrest resuscitation, and guidelines are needed to assist emergency providers in acquiring the equipment and skills necessary to successfully incorporate it into the management of cardiac arrest victims.

TL;DR: Preliminary data on SEP‐1 performance suggest wide hospital‐level variation in performance, with modest improvement during the first year of data collection.

TL;DR: A new baseline estimate of the emergency care workforce is established, encompassing nearly 60,000 emergency medicine clinicians, of whom fewer than 2 in 3 were emergency physicians.

TL;DR: The Social Media Index's correlation with multiple quality evaluation instruments over time supports the hypothesis that it is associated with overall Web site quality.

TL;DR: This work states that organizational principles to Guide and Define the Child Health Care System and/or improve the Health of All Children should be considered.

TL;DR: In adult out‐of‐hospital cardiac arrest patients, intraosseous vascular access was associated with poorer neurologic outcomes than intravenous access, and this results confirmed the results with multiple imputation, propensity score matching, and generalized estimating equations.

TL;DR: Among ED patients with acute, nontraumatic, nonradicular low back pain, combining Naproxen with either orphenadrine or methocarbamol did not improve functional outcomes compared with naproxen+placebo.

TL;DR: Total number of years in practice and visit volume were the only identified factors associated with being named, suggesting that exposure to higher patient volumes and longer practice experience are the primary contributors to malpractice risk.

TL;DR: Although transgender and gender‐nonconforming people represent a minority of ED patients nationwide, the majority of respondents reported personally providing care to members of this population, and most respondents lacked basic clinical knowledge about transgender andGender‐ nonconforming care.

TL;DR: There appears to be considerable variability in interpretation of cardiac standstill among physician sonographers, which would improve the quality of cardiac arrest ultrasonographic research and standardize the use of this technology at the bedside.

TL;DR: Eye‐tracking technology was successfully applied as a tool to aid in the qualitative analysis of expert performance in a clinical setting and has the potential to enhance educational methods and to create new assessment modalities of these previously tacit aspects of expertise in this field.