Spoon Feed
The first direct comparison of the Clinical Institute Withdrawal Assessment-Alcohol Revised (CIWA-Ar) scale to a slightly modified Richmond Agitation and Sedation Scale (mRASS-AW) in a pre-post quality assurance study found mRASS-AW to not compromise length of stay or safety for the evaluation of alcohol withdrawal syndrome (AWS), while we already know it to be faster and more intuitive.

Source
Replacing the Clinical Institute Withdrawal Assessment-Alcohol revised with the modified Richmond Agitation and Sedation Scale for alcohol withdrawal to support management of alcohol withdrawal symptoms: potential impact on length of stay and complications. CJEM. 2024;26(6):431-435. doi:10.1007/s43678-024-00710-7

Spoon Feed
Patients are increasingly accessing electronic health portals during ED encounters, but disparities in portal access exist – male, Black, and non-commercially insured patients show lower rates of usage.

Spoon Feed
In underserved populations, where the Emergency Department may be patients' greatest contact with the healthcare system, simply asking may increase seasonal influenza vaccination.

Source
Promotion of Influenza Vaccination in the Emergency Department. NEJM Evid 2024;3(4) DOI: 10.1056/EVIDoa2300197

Spoon Feed
In a large multicenter observational cohort of patients with sepsis, the strongest mortality benefit was seen for early antibiotic administration (within 3 hours of arrival to the emergency department) in patients with metastatic cancer and with shock.

Source
Heterogeneity of Benefit from Earlier Time-to-Antibiotics for Sepsis. Am J Respir Crit Care Med. 2024 Apr 1;209(7):852-860. doi: 10.1164/rccm.202310-1800OC. PMID: 38261986; PMCID: PMC10995570.

Spoon Feed
This retrospective study found that of the 4,446 patients transferred over a 4.5-year period, 1,509 (34%) transfers could have possibly been avoided by utilizing telehealth/teleconsultation, with the most common transfer complaints being abdominal pain, asthma, and cough. 

Source
Pediatric Patients Discharged After Transfer to a Pediatric Emergency Department: Opportunities for Telehealth?. Ann Emerg Med. 2024;83(3):208-213. doi:10.1016/j.annemergmed.2023.08.489

Spoon Feed
In this retrospective study of ED physicians in one state, researchers found statistically significant differences in admission rates among clinicians but little consistency in admission tendencies across multiple conditions. Clinicians with greater tolerance to risk (as a general attitude) had associated lower rates of admission when compared to projections.

Source
Clinician Risk Tolerance and Rates of Admission From the Emergency Department. JAMA Netw Open. 2024 Feb 5;7(2):e2356189. doi: 10.1001/jamanetworkopen.2023.56189.

Spoon Feed
In the absence of a standardized approach, patients placed in hallway beds were more likely to be male, have Medicaid/self-pay payer status, and elope in this single health system study.

Source
Inequities among patient placement in emergency department hallway treatment spaces. Am J Emerg Med. 2024 Feb;76:70-74. doi: 10.1016/j.ajem.2023.11.013. Epub 2023 Nov 11.

Spoon Feed
This systematic review and meta-analysis identified multiple social determinants of health that were related to increased utilization of ED services by children from racial minority and lower socioeconomic status (SES) groups.  

Source
Social Determinants of Health and Pediatric Emergency Department Outcomes: A Systematic Review and Meta-Analysis of Observational Studies. Ann Emerg Med. Published online December 6, 2023. doi:10.1016/j.annemergmed.2023.10.010

Spoon Feed
Chair placement near the bedside is a simple intervention that increased the likelihood of physician sitting during patient encounters and yielded higher patient scores in satisfaction and communication.

Source
Effect of chair placement on physicians' behavior and patients' satisfaction: randomized deception trial. BMJ. 2023;383:e076309. Published 2023 Dec 15. doi:10.1136/bmj-2023-076309.

Please read this announcement about upgrades to JournalFeed (CME, Amal Mattu, new website)! We also need to do a price increase due to rising costs. Price changes started Dec. 1, 2023 for new subscribers and on Jan 1, 2024 for current subscriber auto-renewals. If cost is a barrier for you, please read the announcement. We want to help! ~Clay Smith

Spoon Feed
In this large, multicenter prospective cohort study in France, researchers found that patients ≥75 years who were admitted overnight boarding in the ED had higher rates of in-hospital mortality, length of stay, and adverse events.

Source
Overnight Stay in the Emergency Department and Mortality in Older Patients. JAMA Intern Med. 2023 Dec 1;183(12):1378-1385. doi: 10.1001/jamainternmed.2023.5961.