Tools used to measure the impact of comorbidities on surgical outcomes in children with complex chronic conditions: A scoping review.

Aim: To identify and describe assessment tools used to measure the impact of comorbidities on postoperative outcomes in children with complex chronic conditions (CCC).

Method: This was a scoping review using five electronic databases. The search was conducted in March 2022 by a medical librarian.

Racial differences in triage assessment at rural vs urban Maine emergency departments.

Data continue to accumulate demonstrating that those belonging to racialized groups face implicit bias in the emergency care delivery system across many indices, including triage assessment. The Emergency Severity Index (ESI) was developed and widely implemented across the US to improve the objectivity of triage assessment and prioritization of care delivery; however, research continues to support the presence of subjective bias in triage assessment. We sought to assess the relationship between perceived race and/or need for translator and assigned ESI score and whether this was impacted by hospital geography.

"I don't want to be the squeaky wheel": Addressing bias as a leader in emergency medicine.

Background: Implicit bias poses a barrier to inclusivity in the health care workforce and is detrimental to patient care. While previous studies have investigated knowledge and training gaps related to implicit bias, emergency medicine (EM) leaders' self-awareness and perspectives on bias have not been studied. Using art to prompt reflections on implicit bias, this qualitative study explores (1) the attitudes of leaders in EM toward implicit bias and (2) individual or structural barriers to navigating and addressing bias in the workplace.

Utilization of the Fordham Risk Screening Tool for violence risk assessment in an emergency department.

Background: Violence is a critical problem in the emergency department (ED) and patients experiencing mental health crises are at greater violence risk; however, tools appropriate for assessing violence risk in the ED are limited. Our goal was to evaluate the utility of the Fordham Risk Screening Tool (FRST) in reliability assessing violence risk in adult ED patients with acute mental health crises through evaluation of test characteristics compared to a reference standard.

Methods: We evaluated performance of the FRST when used with a convenience sample of ED patients undergoing acute psychiatric evaluation.

The research escape hunt: An escape room-scavenger hunt for resident education.

Objectives: Research and evidence-based medicine (EBM) education are important elements of emergency medicine (EM) residency training; however, curricular time is limited and integrating novel strategies to engage learners and improve understanding of complex concepts is challenging. We sought to develop a unique research escape hunt educational experience to teach EM residents basic research and EBM skills using an active-learning, team-based strategy.

Methods: A nine-station escape room-scavenger hunt was designed around educational content including (1) predictive statistics and diagnostic test characteristics, (2) interpretation of data and statistical analysis, (3) study design, (4) informed consent for research, and (5) the ethical principles guiding research.

Scheduling practices for pregnant emergency medicine residents.

Background: Night shift work is associated with adverse pathophysiologic effects on maternal and fetal well-being. Although emergency medicine (EM) residents work frequent night shifts, there is no existing guidance for residency program directors (PDs) regarding scheduling pregnant residents. Our study assessed scheduling practices for pregnant EM residents, differences based on program and PD characteristics, barriers and attitudes toward implementing a formal scheduling policy, and PDs' awareness of literature describing adverse effects of night shifts on maternal-fetal outcomes.

"Going through the motions": A qualitative exploration of the impact of emergency medicine resident burnout on patient care.

Objectives: Burnout occurs frequently in emergency medicine (EM) residents and has been shown to have a negative impact on patient care. The specific effects of burnout on patient care are less well understood. This study qualitatively explores how burnout may change the way EM residents provide patient care.

Assessing Diabetes Distress in Emerging Adults With Type 1 Diabetes: Development and Validation of the Problem Areas in Diabetes-Emerging Adult Version.

Objectives: Emerging adults (18 to 30 years of age) with type 1 diabetes experience suboptimal glycemic and psychological outcomes compared with other groups. The emotional burden of the unending self-care needs of diabetes management appears to be related to these poor health outcomes. However, there is no validated measure of this emotional burden in the developmental context of emerging adulthood.

Ultrasound-Guided Serratus Anterior Plane Block (SAPB) Improves Pain Control in Patients With Rib Fractures.

Objectives: The serratus anterior plane block (SAPB) is an ultrasound-guided compartment block; limited data suggest that it can decrease pain in patients with rib fractures or chest wall pain. We sought to determine the effect of SAPB on pain and incentive spirometry (IS) maximal vital capacity in adult patients with rib fractures.

Methods: We enrolled a prospective sample of adult patients with at least two unilateral rib fractures who were being admitted for pain control.

Epistemic Beliefs: Relationship to Future Expectancies and Quality of Life in Cancer Patients.

Context: Expectations about the future (future expectancies) are important determinants of psychological well-being among cancer patients, but the strategies patients use to maintain positive and cope with negative expectancies are incompletely understood.

Objectives: To obtain preliminary evidence on the potential role of one strategy for managing future expectancies: the adoption of "epistemic beliefs" in fundamental limits to medical knowledge.

Methods: A sample of 1307 primarily advanced-stage cancer patients participating in a genomic tumor testing study in community oncology practices completed measures of epistemic beliefs, positive future expectancies, and mental and physical health-related quality of life (HRQOL).

A retrospective multistate analysis: Do regional football games impact emergency department patient volume?

Objective: We sought to assess the effect of National Football League (NFL) games played by a regional sports team, the New England Patriots, on emergency department (ED) patient volume.

Methods: We conducted a multicenter, retrospective chart review at the following 3 tertiary centers in New England from 2012 to 2019: Beth Israel Deaconess Medical Center, Boston, MA; Dartmouth Hitchcock Medical Center, Lebanon, NH; and Maine Medical Center, Portland, ME.

Results: Within the NFL season, we observed a 2.

"Pulling the Parachute": A Qualitative Study of Burnout's Influence on Emergency Medicine Resident Career Choices.

Objectives: About half of all resident physicians report symptoms of burnout. Burnout negatively influences multiple aspects of their education and training. How burnout may impact residents' career choices remains unclear.

"Necessary Compromises": A Qualitative Exploration of the Influence of Burnout on Resident Education.

Objective: Burnout is prevalent among resident physicians and has a negative impact on their well-being and effectiveness at work. How burnout shapes residents' educational experiences, attitudes, habits, and practices is not well understood. There is also a lack of research regarding self-identified mitigation strategies for residents.

How Physicians Manage Medical Uncertainty: A Qualitative Study and Conceptual Taxonomy.

Background: Medical uncertainty is a pervasive and important problem, but the strategies physicians use to manage it have not been systematically described.

Objectives: To explore the uncertainty management strategies employed by physicians practicing in acute-care hospital settings and to organize these strategies within a conceptual taxonomy that can guide further efforts to understand and improve physicians' tolerance of medical uncertainty.

Design: Qualitative study using individual in-depth interviews.

How Well Does the Surprise Question Predict 1-year Mortality for Patients Admitted with COPD?

Background: Patients with chronic obstructive pulmonary disease (COPD) often receive burdensome care at end-of-life (EOL) and infrequently complete advance care planning (ACP). The surprise question (SQ) is a prognostic tool that may facilitate ACP.

Objective: To assess how well the SQ predicts mortality and prompts ACP for COPD patients.

Serotonin Syndrome Associated With Vilazodone Overdose in a 22-Month-Old Treated With Dexmedetomidine.

Background: Vilazodone was approved by the U.S. Food and Drug Administration in 2011 as a treatment for major depression disorder.

COVID-19 and preeclampsia with severe features at 34-weeks gestation.

The evolving coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to a rapid expansion of knowledge on the disease's clinical manifestations, laboratory and radiographic abnormalities, and patient trajectories. One area of particular focus is the effect that this illness may have on pregnancy and maternal-fetal disease. As of April 24, 2020, we identified 55 English language reports in the scientific literature summarizing data for 339 women and 258 fetuses and neonates.

Academic Emergency Medicine Faculty Experiences with Racial and Sexual Orientation Discrimination.

Introduction: Despite the increasing diversity of individuals entering medicine, physicians from racial and sexual minority groups continue to experience bias and discrimination in the workplace. The objective of this study was to determine the current experiences and perceptions of discrimination on the basis of race and sexual orientation among academic emergency medicine (EM) faculty.

Methods: We conducted a cross-sectional survey of a convenience sample of EM faculty across six programs.

#MeToo in EM: A Multicenter Survey of Academic Emergency Medicine Faculty on Their Experiences with Gender Discrimination and Sexual Harassment.

Introduction: Gender-based discrimination and sexual harassment of female physicians are well documented. The #MeToo movement has brought renewed attention to these problems. This study examined academic emergency physicians' experiences with workplace gender discrimination and sexual harassment.

Electrical cardioversion for atrial fibrillation in the emergency department: A large single-center experience.

Objective: Electrical cardioversion of ED patients is a well-described treatment strategy for certain patients presenting with atrial fibrillation (AF). The objective of this study was to describe the safety and outcomes of this practice in a cohort of patients undergoing ED electrical cardioversion for AF.

Methods: This retrospective health records survey investigated a 5-year cohort of consecutive ED patients presenting with AF who underwent electrical cardioversion in an academic, tertiary ED.