Objective: Emergency physicians routinely encounter stressful clinical situations, including treating victims of crime, violence, and trauma; facing the deaths of patients; and delivering bad news. During a pandemic, stress may be increased for healthcare workers. This study was undertaken to identify symptoms of post-traumatic stress disorder (PTSD) among emergency physicians during the coronavirus disease 2019 (COVID-19) pandemic.
Methods: This cross-sectional survey was developed using the Life Events Checklist for Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 (DSM-5) and the PTSD Checklist for DSM-5 (PCL-5). The survey was distributed to members of the American College of Emergency Physicians from May 21, 2020, through June 22, 2020.
Results: Among 1300 emergency physicians, a significant number of participants (22.3%; 95% confidence interval, 20.3-24.3%) reported symptoms of stress consistent with PTSD (PCL score ≥ 33). Higher PCL-5 scores were associated with age younger than 50 years ( < 0.05) and <10 years in practice ( < 0.05). The major sources of stress identified by participants included disinformation about COVID-19, computer work/electronic medical record, personal protective equipment concerns, and workload. The most common consequences of workplace stress were feeling distant or cut off from other people and sleep disturbance, such as trouble falling or staying asleep.
Conclusions: A significant number of emergency physicians reported symptoms of stress consistent with PTSD. Higher PCL-5 scores were associated with age younger than 50 years and <10 years in practice.
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http://dx.doi.org/10.1002/emp2.12305 | DOI Listing |
Am J Emerg Med
January 2025
Minnesota Regional Poison Center, Department of Pharmacy, Hennepin Healthcare, Minneapolis, MN, USA; Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth Campus, Duluth, MN, USA. Electronic address:
Acute digoxin poisoning is increasingly uncommon in emergency medicine. Furthermore, controversy exists regarding indications for antidotal digoxin immune fab in acute poisoning. In healthy adults, the fab prescribing information recommends administration based on "known consumption of fatal doses of digoxin: ≥10mg," while many emergency medicine textbooks suggest fab administration be driven by clinical features or potassium concentration.
View Article and Find Full Text PDFEmerg Med J
January 2025
Department of Emergency Medicine, Medisch Centrum Leeuwarden, Leeuwarden, Fryslân, The Netherlands.
Background: Point-of-care ultrasound (POCUS) can potentially be used in the triage of patients with elbow injuries. However, the diagnostic accuracy of POCUS performed by non-radiologists for the exclusion of elbow fractures is yet unknown. This study aimed to investigate the diagnostic potential of POCUS of the posterior fatpad performed by non-radiologists in the workup of adult patients presenting with elbow injuries.
View Article and Find Full Text PDFDermatol Surg
January 2025
Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts.
Background: From the theoretical foundations of laser and energy-based applications for the skin to the development of advanced medical devices, the field of dermatologic surgery has undergone transformative changes.
Objective: To review the scientific and clinical advancement of laser and energy-based therapies within dermatologic surgery.
Materials And Methods: A literature search was conducted to identify important scientific advancements and landmark studies on light, laser, and energy-based devices within the field of dermatologic surgery.
JAMA Netw Open
January 2025
America's Physician Groups, Washington, DC.
Importance: Many physician groups are in 2-sided risk payment arrangements with Medicare Advantage plans (at-risk MA). Analysis of quality and health resource use under such arrangements may inform ongoing Medicare policy concerning payment and service delivery.
Objective: To compare quality and efficiency measures under 2 payment models: at-risk MA and fee-for-service (FFS) MA.
Ann Emerg Med
January 2025
Division of Pediatrics, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. Electronic address:
Study Objective: To cover pediatric emergency physicians' off-hours, third-year pediatric residents in Israel are trained for unsupervised administration of emergency department (ED) dissociative and deep sedation. We assessed the frequency of critical sedation events associated with resident-performed sedations.
Methods: We conducted a retrospective chart review on all patients receiving intravenous sedation across 10 pediatric EDs between January 2018 and September 2022.
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