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In this study, the authors first sought to empirically derive centiles for heart rate (HR), respiratory rate (RR), and systolic blood pressure (SBP) for adults with out-of-hospital emergencies who were transported to an ED. Second, they aimed to evaluate the impact of adjusting for age in the evaluation of centile curves for vital signs to identify practical targets for adjustment of vital signs classification in adult patients based on age categories. Third, they examined the association of both unadjusted and age-adjusted vital signs with hospital admission and in-hospital mortality.
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Timely reperfusion is necessary to reduce morbidity and mortality in patients with ST-elevation myocardial infarction (STEMI). Initial care by facilities with percutaneous coronary intervention (PCI) capabilities reduces time to reperfusion. The authors sought to examine whether insurance status was associated with initial care at EDs with PCI capabilities amongst adult patients with STEMI.
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The use of generative artificial intelligence (AI) tools, such as ChatGPT, are gaining popularity for a variety of academic writing tasks and offer an innovative solution to relieve the burden of letter writing. The authors conducted a study aimed at determining whether academic physicians can distinguish between AI and human-generated letters of recommendation.
In the podcast the author references a gendered language calculator, which can be found here:
https://slowe.github.io/genderbias/
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Conversations about code status in seriously ill patients at end of life is unfortunately a frequent event in the emergency department. Today we are discussing a paper in AEM entitled The differences in code status conversation approaches reported by emergency medicine and palliative care clinicians: a mixed method study. Lead author Dr. Kei Ouchi is here to discuss it with us.
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Emergency care workforce concerns have gained national prominence given recent data suggesting higher than previously estimated attrition. With little known regarding characteristics of physicians leaving the workforce, this paper sought to investigate the age and number of years since residency graduation at which male and female EM physicians exhibited workforce attrition. We speak with primary author Dr. Cameron Gettel.
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General emergency physicians provide most pediatric emergency care in the United States yet report more challenges managing emergencies in children than adults. Recommendations for standardized pediatric emergency medicine (PEM) curricula to address educational gaps due to variations in pediatric exposure during emergency medicine (EM) training lack learner input. This study surveyed senior EM residents and recent graduates about their perceived preparedness to manage pedi- atric emergencies to better inform PEM curricula design.
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Amiodarone and lidocaine have not been shown to have a clear survival benefit
compared to placebo for out-of-hospital cardiac arrest (OHCA). However, randomized trials may have been impacted by delayed administration of the study drugs. Today we’re talking with Dr. Joshua Lupton, first author on a new AEM paper entitled “ Survival by Time-to-Administration of Amiodarone, Lidocaine, or Placebo in Shock-Refractory Out-of-Hospital Cardiac Arrest.” -
Demographic differences in opioid prescribing by patient race and ethnicity have been widely reported; Black and Hispanic patients receive lower rates and dosages of opioid prescriptions for the same conditions and reported pain level as white patients. At the same time, higher dosage opioid prescriptions have been associated with higher rates of new long-term opioid use and high-risk use, and opioid stewardship is being increasingly emphasized. Today we’re talking aout a new study in this area with lead author Aidan Crowley: Disparities in Emergency Department and Urgent Care Opioid Prescribing Before and After Randomized Clinician Feedback Interventions.
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Delirium, altered mental status or confusion among older adults are common presentations to the emergency department (ED). We discuss this new AEM paper with author Dr. Shan Liu, whose team aimed to report the proportion of older ED patients presenting with delirium who have acute abnormal findings on head imaging. We also assessed whether anticoagulation, neurological deficits, trauma or headache were associated with head imaging abnormalities in these patients.
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Paper abstract: Point-of-care ultrasound (US) has been suggested as the primary imaging in evaluating patients with suspected diverticulitis. Discrimination between simple and complicated diverticulitis may help to expedite emergent surgical consults and determine the risk of complications. This study aimed to: (1) determine the accuracy of an US protocol (TICS) for diagnosing diverticulitis in the Emergency Department (ED) setting and (2) assess the ability of TICS to distinguish between simple and complicated diverticulitis.
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