Association of Patient English Proficiency and Diagnostic Imaging Acquisition in Emergency Department Patients with Abdominal Symptoms.

Background: Patients with limited English proficiency (LEP) are at risk for communication barriers during medical care in the United States compared with English-proficient (EP) patients. It is unknown how EP affects the utilization of advanced diagnostic imaging (ADI) in the emergency department (ED).

Objective: The aim of this study was to compare the acquisition and findings of ADI in EP and LEP patients with abdominal symptoms.

Previous exposure to violence among emergency department patients without trauma-related complaints: A cross sectional analysis.

Introduction: The Emergency Department (ED) is a critical setting for the treatment of acute violence-related complaints and violent victimization is associated with numerous long-term negative health outcomes. A trauma-informed care framework can prevent re-traumatization of victims within the healthcare setting, but currently there are insufficient mechanisms to detect previous exposures to community violence within the ED. The current study sought to determine the prevalence of community violence and characterize the types of violence exposures among adult ED patients without trauma-related complaints to determine if there may be a need for expanded screening for previous exposure to violence for ED patients.

Prehospital Intranasal Glucagon for Hypoglycemia.

Background: Prehospital hypoglycemia is usually treated with oral or intravenous (IV) dextrose in a variety of concentrations. In the absence of vascular access, intramuscular (IM) glucagon is commonly administered. Occupational needle-stick injury remains a significant risk while attempting to obtain vascular access or administer medications intramuscularly in the prehospital setting.

Assessment of intimate partner violence abuse ratings by recently abused and never abused women.

Background: There are a paucity of directly reported intimate partner violence survivors' experiences, especially in women of color. This study measures recently/currently abused women's ratings of varied abuse events compared to ratings from never abused women.

Methods: Women in a single, urban, public hospital emergency department (ED) were screened for intimate partner violence using the Abuse Assessment Screen (AAS).

Screening Electrocardiograms in Cocaine-Positive Chest Pain-Free Psychiatric Patients Requiring Medical Screening.

Background: The current practice at a large urban academic emergency department (ED) is to obtain screening electrocardiograms (ECGs) as part of the medical screening on all psychiatric patients who test positive for cocaine.

Objective: We sought to examine the impact of an ECG in the medical screening of chest pain-free psychiatric patients who test positive for cocaine.

Methods: An institutional review board-approved retrospective chart review from January 2014 to December 2015 was performed on charts of adult ED patients requiring medical screening before transfer to a psychiatric facility.

Decreased Nursing Staffing Adversely Affects Emergency Department Throughput Metrics.

Introduction: The effect of nurse staffing on emergency department (ED) efficiency remains a significant area of interest to administrators, physicians, and nurses. We believe that decreased nursing staffing adversely affects key ED throughput metrics.

Methods: We conducted a retrospective observational review of our electronic medical record database from 1/1/2015 to 12/31/2015 at a high-volume, urban public hospital.

Correction to: The Effect of a Change Agent on Use of Evidence-Based Mental Health Practices.

The original version of this article unfortunately contained a mistake.

Comparison of Result Times Between Urine and Whole Blood Point-of-care Pregnancy Testing.

Introduction: Point-of-care (POC) pregnancy testing is commonly performed in the emergency department (ED). One prior study demonstrated equivalent accuracy between urine and whole blood for one common brand of POC pregnancy testing. Our study sought to determine the difference in result times when comparing whole blood versus urine for the same brand of POC pregnancy testing.

Frequency of Fractures Identified on Post-Reduction Radiographs After Shoulder Dislocation.

Introduction: Most emergency physicians routinely obtain shoulder radiographs before and after shoulder dislocations. However, currently there is limited literature demonstrating how frequently new fractures are identified on post-reduction radiographs. The primary objective of this study was to determine the frequency of new, clinically significant fractures identified on post-reduction radiographs with a secondary outcome assessing total new fractures identified.

Agency Culture and Climate in Child Welfare: Do Perceptions Vary by Exposure to the Child Welfare System?

Organizational culture and climate play a critical role in worker retention and outcomes, yet little is known about whether perceptions of culture and climate vary depending on the demands of particular roles. In this study, 113 staff from a child welfare agency completed Organizational Social Context profiles. Staff were divided into three groups according to their proximity to child welfare tasks to assess whether involvement in higher stress child welfare tasks is related to perceptions of the social context.

The Effect of a Change Agent on Use of Evidence-Based Mental Health Practices.

Children's service systems are faced with a critical need to disseminate evidence-based mental health interventions. Despite the proliferation of comprehensive implementation models, little is known about the key active processes in effective implementation strategies. This proof of concept study focused on the effect of change agent interactions as conceptualized by Rogers' diffusion of innovation theory on providers' (N = 57) use of a behavioral intervention in a child welfare agency.

Can emergency physicians diagnose and correctly classify diastolic dysfunction using bedside echocardiography?

Objectives: The goal of this study was to determine if emergency physicians (EPs) can correctly perform a bedside diastology examination (DE) and correctly grade the level of diastolic function with minimal additional training in echocardiography beyond what is learned in residency. We hypothesize that EPs will be accurate at detecting and grading diastolic dysfunction (DD) when compared to a criterion standard interpretation by a cardiologist.

Methods: We conducted a prospective, observational study on a convenience sample of adult patients who presented to an urban emergency department with a chief concern of dyspnea.

Accuracy of a novel ultrasound technique for confirmation of endotracheal intubation by expert and novice emergency physicians.

Introduction: Recent research has investigated the use of ultrasound (US) for confirming endotracheal tube (ETT) placement with varying techniques, accuracies, and challenges. Our objective was to evaluate the accuracy of a novel, simplified, four-step (4S) technique.

Methods: We conducted a blinded, randomized trial of the 4S technique utilizing an adult human cadaver model.