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ETCO2 measured during emergency department triage outperforms standard vital signs in predicting in-hospital mortality, ICU admission, and correlates with markers of metabolic acidosis.
Source
End-Tidal Carbon Dioxide Measured at Emergency Department Triage Outperforms Standard Triage Vital Signs in Predicting In-Hospital Mortality and ICU admission. Acad Emerg Med. 2023 Feb 21. doi: 10.1111/acem.14703. Epub ahead of print.
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Patients with STEMI or STEMI equivalent who were treated within goal treatment times had significantly lower in-hospital mortality.
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Treatment time and In-Hospital Mortality Among Patients with ST-Segment Elevation Myocardial Infarction, 2018-2021. JAMA. 2022 Nov 22; 328(20): 2033-2040.
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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.Â
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.
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A full moon has no association with EMS activation patterns in the United States.
Source
Full moons are not associated with increases in emergency medical services (EMS) activations (911 calls) in the United States. Am J Emerg Med. 2022 Nov;61:227-228. doi: 10.1016/j.ajem.2022.07.044. Epub 2022 Jul 20.
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This is a joint policy statement by the American Academy of Pediatrics (AAP), the American College of Emergency Physicians (ACEP), and the Emergency Nurses Association (ENA) to optimize safety in the care of pediatric patients in emergency care settings.
Source
Optimizing Pediatric Patient Safety in the Emergency Care Setting. Pediatrics. 2022 Oct 3;e2022059673. doi: 10.1542/peds.2022-059673. Online ahead of print.
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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.
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A novel comprehensive methodized process is presented for the proper disclosure of incidental findings on ED imaging and for ensuring proper follow up and subsequent management.
Source
Catching Those Who Fall Through the Cracks: Integrating a Follow-Up Process for Emergency Department Patients with Incidental Radiologic Findings. Ann Emerg Med. 2022 Sep;80(3):235-242. doi: 10.1016/j.annemergmed.2022.04.026. Epub 2022 Jun 23.
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A review of actionable standards set forth by the Joint Commission in 2018-2019 showed that the majority of required changes were only partly, or not at all, supported by quality evidence.
Source
The evidence base for US joint commission hospital accreditation standards: cross sectional study. BMJ. 2022 Jun 23;377:e063064. doi: 10.1136/bmj-2020-063064.
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There is undeniable corporate influence in the practice of emergency medicine, and this could cause problems for patients or for those of us who care for them. We need to thoughtfully consider this.
Source
Corporate Control of Emergency Departments: Dangers from the Growing Monster. J Emerg Med. 2022 Apr 7;S0736-4679(22)00074-9. doi: 10.1016/j.jemermed.2022.01.026. Online ahead of print.
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This large study shows that all-cause 30-day mortality increases with delayed hospital admission from the ED, starting at 5 hours after patient arrival.
Source
Association between delays to patient admission from the emergency department and all-cause 30-day mortality. Emerg Med J. 2022 Mar;39(3):168-173. doi: 10.1136/emermed-2021-211572. Epub 2022 Jan 18.
