Gender dynamics and academic rank in emergency medicine collaboration networks: A social network and gender propensity analysis.

Background: Academic productivity is bolstered by collaboration, which is in turn related to connectivity between individuals. Gender disparities have been identified in academics in terms of both academic promotion and output. Using gender propensity and network analysis, we aimed to describe patterns of collaboration on publications in emergency medicine (EM), focusing on two Midwest academic departments.

Permissive Hypotension in a Patient with Severe Hypernatremia: A Case Report.

Introduction: Severe hypernatremia is a critical situation, and when coupled with intravascular depletion and hypotension can create a treatment dilemma.

Case Report: We present the case of a medically complex patient who had gradually worsening alteration of mental status and mean arterial pressures in the 50s on presentation to the emergency department.

Conclusion: Final diagnoses included severe hypernatremia and hypovolemic shock secondary to poor oral intake.

The Other Aortic Syndrome-Intramural Hematoma and Neurological Deficit: Case Report.

Introduction: Acute thoracic aortic syndromes are among the most concerning presentations in emergency medicine and are associated with significant morbidity and mortality. Thoracic aortic dissection is most common, followed by penetrating aortic ulcer and, least commonly, intramural hematoma.

Case Report: A 67-year-old woman presented to the emergency department with chest and back pain, and sudden onset of paraparesis.

Adult Congenital Heart Disease in the Emergency Department.

While congenital heart disease historically was a pathology primarily restricted to specialized pediatric centers, advances in technology have dramatically increased the number of people living into adulthood, the number of complications faced by these patients, and the number of patients visiting non-specialized emergency departments for these concerns. Clinicians need to be aware of the issues specific to patients' individual congenital defects but also have an understanding of how typical cardiac pathology may manifest in this special group of patients. This manuscript attempts to provide an overview of this diverse but increasingly common group of adult patients with congenital heart diseases, including a review of their anatomical variants, the complications they face at the highest rates, and ways that emergency physicians may need to manage these patients differently to avoid causing harm.

The Impact of Trauma System Implementation on Patient Quality of Life and Economic Burden: A Systematic Review Study Protocol.

Background: Trauma accounts for 10% of global mortality, with increasing rates disproportionally affecting low- and middle-income countries. In an attempt to improve clinical outcomes after injury, trauma systems have been implemented in multiple countries over recent years. However, whilst many studies have subsequently demonstrated improvements in overall mortality outcomes, less is known about the impact trauma systems have on morbidity, quality of life, and economic burden.

Emergency department utilization among patients who receive outpatient specialty care for headache: A retrospective cohort study analysis.

Objectives: To compare clinical characteristics among outpatient headache clinic patients who do and do not self-report visiting the emergency department for headache.

Background: Headache is the fourth most common reason for emergency department visits, compromising 1%-3% of visits. Limited data exist about patients who are seen in an outpatient headache clinic but still opt to frequent the emergency department.

Improving Timely Antibiotic Administration for Pediatric Oncology Patients With Neutropenic Fever Seen in the Emergency Department.

Objective: To improve the care for pediatric oncology patients with neutropenic fever who present to the emergency department (ED) by administering appropriate empiric antibiotics within 60 minutes of arrival.

Patients And Methods: We focused on improving the care for pediatric oncology patients at risk of neutropenia who presented to the ED with concern for fever. Our baseline adherence to the administration of empiric antibiotics within 60 minutes for this population was 53% (76/144) from January 1, 2010, to December 21, 2014.

Comparison of emergency department throughput and process times between male and female patients: A retrospective cohort investigation by the Reducing Disparities Increasing Equity in Emergency Medicine Study Group.

Introduction: Health equity for all patients is an important characteristic of an effective healthcare system. Bias has the potential to create inequities. In this study, we examine emergency department (ED) throughput and care measures for sex-based differences, including metrics such as door-to-room (DTR) and door-to-healthcare practitioner (DTP) times to look for potential signs of systemic bias.

Using network analysis to model the effects of the SARS Cov2 pandemic on acute patient care within a healthcare system.

Consolidation of healthcare in the US has resulted in integrated organizations, encompassing large geographic areas, with varying services and complex patient flows. Profound changes in patient volumes and behavior have occurred during the SARS Cov2 pandemic, but understanding these across organizations is challenging. Network analysis provides a novel approach to address this.

Incorporating RTLS-Based Spatiotemporal Information in Studying Physical Activities of Clinical Staff.

Clinicians and staff who work in intense hospital settings such as the emergency department (ED) are under an extended amount of mental and physical pressure every day. They may spend hours in active physical pressure to serve patients with severe injuries or stay in front of a computer to review patients' clinical history and update the patients' electronic health records (EHR). Nurses on the other hand may stay for multiple consecutive days of 9-12 working hours.

Paths of Emergency Department Care: Development of a Decision Aid to Facilitate Shared Decision Making in Goals of Care Discussions in the Acute Setting.

Background: Goals of care (GOC) conversations in the emergency department (ED) are often a brief discussion of code status rather than a patient-oriented dialogue. We aimed to develop a guide to facilitate conversations between ED clinicians and patients to elicit patient values and establish goals for end-of-life care, while maintaining ED efficiency. , a conversation guide, is the product of this work.

A big white dot after CPR.

Introduction: Patients may remain comatose after the resumption of spontaneous circulation with cardiopulmonary resuscitation. A primary neurologic event may precede a cardiac standstill.

Case Report: We present a 33-year-old patient with successful resuscitation for pulseless electrical activity and a "normal computed tomography (CT) scan.

A Comprehensive Departmental Care Review Model: Requirements, Structure, and Flow.

Background: The Institute of Medicine, the National Patient Safety Foundation, and The Joint Commission have advocated for increased systematic care review to inform future quality improvement. Developing a system to efficiently gather meaningful feedback, review care, and identify areas for improvement can take years to construct. Yet, these systems are vital to reducing future medical error.

The Hidden Cost of Hemolyzed Blood Samples in the Emergency Department.

Background: On average, patients with hemolyzed potassium samples spend about 1 h longer in the emergency department (ED), regardless of acuity level or disposition. We aimed to quantify the direct expenses associated with poor-quality preanalytic blood samples collected in the ED.

Methods: We created a simple table with a range of direct expenses (i.

Impact of the SARS-CoV-2 Pandemic on Emergency Department Presentations in an Integrated Health System.

Objective: To quantify the impact of the severe acute respiratory syndrome coronavirus 2 pandemic on emergency department volumes and patient presentations and evaluate changes in community mortality for the purpose of characterizing new patterns of emergency care use.

Patients And Methods: This is an observational cross-sectional study using electronic health records for emergency department visits in an integrated multihospital system with academic and community practices across 4 states for visits between March 17 and April 21, 2019, and February 9 and April 21, 2020. We compared numbers and proportions of common and critical chief symptoms and diagnoses, triage assessments, throughput, disposition, and selected hospital lengths of stay and out-of-hospital deaths.

Palliative care in the emergency department: A survey assessment of patient and provider perspectives.

Background: Palliative care has been identified as an area of low outpatient referral from our emergency department, yet palliative care has been shown to improve the quality of patient's lives.

Aim: This study investigates both provider and patient perspectives on palliative care for the purpose of identifying barriers to increased palliative care utilization within our healthcare system.

Design: Two surveys were developed, one for patients/caregivers and one for healthcare providers.

Non-pharmacologic interventions improve comfort and experience among older adults in the Emergency Department.

Objective: Determine if a comfort cart would improve older adults' comfort and facilitate communication during Emergency Department (ED) visits.

Methods: A comfort cart containing low-cost, non-pharmacological interventions to improve patient comfort and ability to communicate (e.g.

Interventions to improve older adults' Emergency Department patient experience: A systematic review.

Study Objective: To summarize interventions that impact the experience of older adults in the emergency department (ED) as measured by patient experience instruments.

Methods: This is a systematic review to evaluate interventions aimed to improve geriatric patient experience in the ED. We searched Ovid CENTRAL, Ovid EMBASE, Ovid MEDLINE and PsycINFO from inception to January 2019.

Validation of the Elderly Risk Assessment Index in the Emergency Department.

Objectives: The Elderly Risk Assessment (ERA) score is a validated index for primary care patients that predict hospitalizations, mortality, and Emergency Department (ED) visits. The score incorporates age, prior hospital days, marital status, and comorbidities. Our aim was to validate the ERA score in ED patients.

Progression of Emergency Medicine Resident Patient Experience Scores by Level of Training.

Background: Patient satisfaction surveys are vital to measuring a patient's experience of care. How scores of patients managed by emergency medicine (EM) residents change as residents progress through training is not known.

Objectives: To evaluate whether EM residents' patient satisfaction scores improve as residency training progresses, similar to clinical skill improvement.

Impact of scribes on throughput metrics and billing during an electronic medical record transition.

Objective: Evaluate an established scribe program on throughput and revenue capture in an Emergency Department (ED) undergoing an EMR transition.

Methods: A prospective cohort design comparing patients managed with and without scribes in an academic ED. Throughput metrics (medians, min) and relative value units (RVUs, means) were collected.