Does Suicide Risk Screening…Actually Reduce Suicide?
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Depression screening (with varying forms of intervention) reduces depression symptoms in follow up, and the screening tools are fairly accurate. Suicide screening (with various interventions) does not reduce suicidal ideation or suicide attempts and may actually increase attempts, though the evidence is very limited.
Source
Depression and Suicide Risk Screening: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2023 Jun 20;329(23):2068-2085. doi: 10.1001/jama.2023.7787.
Leaving So Soon? Why Women Are Retiring from EM Early
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On average, female EM physicians leave clinical practice 12 years younger than their male counterparts, after fewer years of practice, and the amount of time spent in the workforce is decreasing over time. We need to identify and implement systemic fixes to stop this.
Source
Emergency medicine physician workforce attrition differences by age and gender. Acad Emerg Med. 2023 Jun 14. doi: 10.1111/acem.14764. Online ahead of print.
Teamwork – It’s a Matter of Life and Death
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There was an increased number of patient deaths on ICU shifts with low nurse-to-nurse familiarity.
Source
Nurse-to-Nurse Familiarity and Mortality in the Critically Ill: A Multicenter Observational Study. Am J Respir Crit Care Med. 2023 Apr 15;207(8):1022-1029. doi: 10.1164/rccm.202204-0696OC.
New SQuID Game? SQ Insulin, DKA, and Length of Stay
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The use of a subcutaneous insulin protocol for mild-to-moderate diabetic ketoacidosis (DKA) resulted in significant reductions in ED LOS.
Source
The SQuID Protocol (Subcutaneous Insulin in Diabetic Ketoacidosis): Impacts on ED Operational Metrics. Acad Emerg Med. 2023 Feb 12. doi: 10.1111/acem.14685. Online ahead of print.
Mistriaged – How Good Is ESI?
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The Emergency Severity Index (ESI) mistriaged roughly 1 of every 3 patients who presented to 21 EDs in the Kaiser Permanente health system.
Source
Evaluation of the Emergency Severity Index in US Emergency Departments for the Rate of Mistriage. JAMA network open vol. 6,3 e233404. 1 Mar. 2023, doi:10.1001/jamanetworkopen.2023.3404
It’s Getting…Crowded In Here
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Crowding in the Emergency Department (ED) can be attributed to systems failures across three different phases of ED care: input, throughput, and output of patients. This paper evaluates the reasons behind crowding and proposes solutions to mitigate this burdensome issue.
Source
Crowding in the Emergency Department: Challenges and Best Practices for the Care of Children. Pediatrics. 2023 Feb 20;e2022060972. doi: 10.1542/peds.2022-060972. Online ahead of print.
Six Vital Signs? Should We Measure ETCO2 in Triage?
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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.
Do STEMI Time Goals Impact Mortality?
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Patients with STEMI or STEMI equivalent who were treated within goal treatment times had significantly lower in-hospital mortality.
Source
Treatment time and In-Hospital Mortality Among Patients with ST-Segment Elevation Myocardial Infarction, 2018-2021. JAMA. 2022 Nov 22; 328(20): 2033-2040.
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.
Lunacy? Does a Full Moon Mean More 911 Calls?
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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.