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Emergency medicine practice is going to be increasingly influenced by artificial intelligence (AI). This article discusses some of the ways we can expect it to impact our practice.

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The AI Future of Emergency Medicine. Ann Emerg Med. 2024 May 22:S0196-0644(24)00043-X. doi: 10.1016/j.annemergmed.2024.01.031. Online ahead of print. PMID: 38795081

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Unprofessional behaviors were reported most often among surgeons when comparing physician specialty subgroups.

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Physician Specialty Differences in Unprofessional Behaviors Observed and Reported by Coworkers. JAMA Netw Open. 2024;7(6):e2415331. doi:10.1001/jamanetworkopen.2024.15331

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In a controlled hypoxemia study, pulse oximetry was falsely elevated in subjects with darker skin pigmentation and low perfusion.

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Low Perfusion and Missed Diagnosis of Hypoxemia by Pulse Oximetry in Darkly Pigmented Skin: A Prospective Study. Anesth Analg. 2024 Mar 1;138(3):552-561. doi: 10.1213/ANE.0000000000006755. Epub 2023 Dec 18. PMID: 38109495.

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This single centre RCT investigated the link between IV cannula diameter and how painful it will be to insert. 18G cannulas were not more painful nor more difficult to place than 20G cannulas across the spectrum of experience levels. Pain and insertion success rates being equal, patients are better off with cannulas that can accommodate higher flow rates.

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Spiced RCT: Success and Pain Associated with Intravenous Cannulation in the Emergency Department Randomized Controlled Trial. J Emerg Med. 2024;66(2):57-63. doi:10.1016/j.jemermed.2023.10.008.

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In a self-described “quasi-experimental” analysis of Medicare claims data, private equity owned hospitals were associated with a 25% increase in hospitalization-acquired adverse events when compared with non-private equity hospitals. Notably, there was a 27% increase in falls, a 38% increase in the volume of central line-associated infections, despite the placement of 16% fewer central lines, and a doubling of surgical site infections despite 8% fewer surgical procedures being performed (underpowered assertion). 

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Changes in Hospital Adverse Events and Patient Outcomes Associated With Private Equity Acquisition. JAMA. 2023 Dec 26;330(24):2365-2375. doi: 10.1001/jama.2023.23147.

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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.

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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.

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These are the top articles from 2023. Enjoy!

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Our words during handoff can bias our colleagues against our patients. Here's how it happens and what we can do to improve.

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Patient Factors Associated With Biased Language in Nightly Resident Verbal Handoff. JAMA Pediatr. 2023 Oct 1;177(10):1098-1100. doi: 10.1001/jamapediatrics.2023.2581.

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Normal oral temperature is hard to define, but this large cross-sectional study suggests that the average is not 37^oC (98.6^oF).

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Emergency physician (EP) advancing age was associated with higher 7-day patient mortality. This is a call to keep current with literature, clinical skills, and best practices.

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Association Between Emergency Physician's Age and Mortality of Medicare Patients Aged 65 to 89 Years After Emergency Department Visit. Ann Emerg Med. 2023 Sep;82(3):301-312. doi: 10.1016/j.annemergmed.2023.02.010. Epub 2023 Mar 23.