Addressing and limiting burnout and its significant impacts on emergency physicians is an important and ongoing challenge, requiring much more than a focus on individual resilience. This is a key understanding which guides and informs the Australasian College for Emergency Medicine's holistic approach and advocacy efforts when it comes to the wellness of emergency physicians and the health systems in which they operate.
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Risk stratification for violent behavior in critically ill patients: Current assessment tools.
Intensive Crit Care Nurs
January 2025
Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Basel, Switzerland; Medical Faculty, University of Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland.
Background: Workplace violence (WPV) presents challenges in intensive care units (ICUs) calling for reliable prediction of violence. This narrative review aimed to identify and evaluate risk assessment tools from acute care settings which are or might be used to predict violent behavior in adult ICU patients focusing on their performance and clinical utility.
Methods: A screening of PubMed, Scopus and Google Scholar was conducted to identify risk scores used in the acute care setting such as emergency departments, hospitals and ICUs.
PEN-FAST-ED: Utilizing the PEN-FAST decision tool to guide antibiotic prescribing in the emergency department.
Am J Emerg Med
January 2025
Department of Pharmacy, Sarasota Memorial Health Care System, 1700 S Tamiami Trail, Sarasota, FL 34239, USA.
Background: Patient-reported penicillin allergies are frequently encountered in the emergency department (ED), which often lead to non-beta-lactam antibiotic use despite beta-lactams' place as first-line therapy in most bacterial infections. The PEN-FAST clinical decision tool was developed and validated to identify patients with a low risk of true penicillin allergies that do not require formal skin testing for rechallenging. The tool consists of four questions that add up to a total score ranging from 0 to 5.
View Article and Find Full Text PDFAssociation between the hemoglobin A1c/High-density lipoprotein cholesterol ratio and stroke incidence: a prospective nationwide cohort study in China.
Lipids Health Dis
January 2025
Department of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, 213000, China.
Background: Stroke has emerged as an escalating public health challenge among middle-aged and older individuals in China, closely linked to glycolipid metabolic abnormalities. The Hemoglobin A1c/High-Density Lipoprotein Cholesterol (HbA1c/HDL-C) ratio, an integrated marker of glycolipid homeostasis, may serve as a novel predictor of stroke risk.
Methods: Our investigation utilized data from the China Health and Retirement Longitudinal Study cohort (2011-2018).
What's the bug?: An unusual cause of bacterial meningitis in a patient with history of transsphenoidal surgery.
Am J Emerg Med
January 2025
Department of Emergency Medicine, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States of America. Electronic address:
Bacterial meningitis is an increasingly rare disease that carries significant morbidity and mortality. We describe the case of a 38-year-old male with a past medical history of pituitary macroadenoma with prior endonasal surgeries on prednisone therapy daily for resultant hypopituitarism and juvenile myoclonic epilepsy on lamotrigine daily who was transferred to an academic tertiary emergency department due to concern for developing pituitary apoplexy. At the outside emergency department, the patient presented complaining of sudden onset severe headache.
View Article and Find Full Text PDFEmergency physician ultrasound diagnosis of pneumoperitoneum in intraoperative patients with peritoneal insufflation.
Am J Emerg Med
January 2025
Maimonides Medical Center, Department of Emergency Medicine, 965 48th Street, Brooklyn, NY 11219, United States. Electronic address:
Objectives: To determine the accuracy of emergency physicians (EPs) in diagnosing pneumoperitoneum with POCUS, and if the volume of pneumoperitoneum affects accuracy.
Methods: POCUS clips were obtained from patients undergoing intraperitoneal insufflation for an elective laparoscopic procedure. Video clips of the right upper quadrant and epigastric regions were obtained prior to insufflation and then after 500 ml, 1000 ml, and 1500 ml of insufflation.
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