The Human Cost of 24/7/365
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Emergency physicians (EPs) suffer from poor sleep quality and lower sleep quantity than recommended. EPs were also objectively more fatigued during late afternoon and evening shifts and spend almost a quarter of their shift in a fatigued state.
Source
Objective assessment of sleep and fatigue risk in emergency medicine physicians. Acad Emerg Med. 2022 Oct 14. doi: 10.1111/acem.14606. Epub ahead of print.
Showing Vulnerability When We Miss the Diagnosis
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This op-ed piece highlights the emotional toll missed diagnoses may take on physicians. The author eloquently reflects on how this experience taught her vulnerability and ultimately strengthened her relationship with this patient.
Source
Elizabeth A Fleming Notes on Healing After a Missed Diagnosis. JAMA. 2022 Oct 4;328(13):1297-1298. doi: 10.1001/jama.2022.15724.
New RCT – Teamwork Makes the… Hospital Work
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Resident and nurse teams that worked together exclusively performed better on advanced medical simulations, were more likely to have nurses present on patient rounds, and had improved teamwork earlier in the year than rotating resident/nurse teams.
Source
Effect of Increased Interprofessional Familiarity on Team Performance, Communication, and Psychological Safety on Inpatient Medical Teams: A Randomized Clinical Trial. JAMA Intern Med. 2022 Oct 10. doi: 10.1001/jamainternmed.2022.4373. Online ahead of print.
Guess the Radiation Risk – Portable X-Rays in the Emergency Department
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Despite a high number of portable radiographs obtained in the ED, exposure to this ionizing radiation does not appear to be a significant occupational hazard, and existing precautions appear to be adequate.
Source
Risk of Radiation Exposure to Emergency Department Personnel From Portable Radiographs. J Emerg Med. 2022 Oct 12;S0736-4679(22)00449-8. doi: 10.1016/j.jemermed.2022.08.002. Online ahead of print.
Do Burned Out Doctors Give Low Quality Care?
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Physician burnout has extensive negative effects, not just on individuals, but on hospital systems and on patient safety and satisfaction.
Source
Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis. BMJ. 2022 Sep 14;378:e070442. doi: 10.1136/bmj-2022-070442.
Let’s Talk About Long COVID – What Is It?
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Patients with long COVID had a host of symptoms, poorer quality of life, and more anxiety and depression, but they did not have a specific cause identified for symptoms despite a comprehensive exam and battery of tests.
Source
A Longitudinal Study of COVID-19 Sequelae and Immunity: Baseline Findings. Ann Intern Med. 2022 Jul;175(7):969-979. doi: 10.7326/M21-4905. Epub 2022 May 24.
Should We Add Spiritual Care to Our Critical Care?
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Spirituality is a part of the human experience and can be a mechanism to improve patient-centered care.
New RCT – Does Uttering the “Q” Word Wreak Havoc in the Emergency Department?
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Using the word “quiet” in the emergency department (ED) did not increase patient volumes nor did staff perceive there were increased volumes, unless the staff were already superstitious about the word “quiet.”
Source
The use of the word "quiet" in the emergency department is not associated with patient volume: A randomized controlled trial. Am J Emerg Med. 2022 Jun;56:10-12. doi: 10.1016/j.ajem.2022.03.020. Epub 2022 Mar 16.
Mental Gymnastics – Does Yoga Help Migraines?
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This meta-analysis supports the recommendation of yoga as a treatment for migraine. How this generalizes to the emergency department is unknown.
Source
Effectiveness of yoga therapy for migraine treatment: A meta-analysis of randomized controlled studies. Am J Emerg Med. 2022 May 2;58:95-99. doi: 10.1016/j.ajem.2022.04.050. Epub ahead of print.
It’s Crazy, Disgusting, and Unsafe to Reuse PPE
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Reusing personal protective equipment risks contamination for healthcare workers and should be eliminated as much as possible. See image of contamination below.
Source
Reuse of Personal Protective Equipment: Results of a Human Factors Study Using Fluorescence to Identify Self-Contamination During Donning and Doffing. J Emerg Med. 2022 Mar;62(3):337-341. doi: 10.1016/j.jemermed.2021.12.010. Epub 2022 Feb 4.