Limited access to resources promoting optimal health outcomes can lead to increased emergency department utilization for conditions often manageable by primary care resulting in rising healthcare costs, overcrowding in emergency departments, and poor patient outcomes. Social determinants of health often affect an individual's ability to achieve optimal health. To examine the association between social determinants of health and hypertension-related patient encounters among adults, we analyzed data from a 340-bed community hospital in the southeast region of the United States. Gender, race, and geographic location were strongly associated with hypertension-related encounters. Hypertension-related encounters in the emergency department were highest in women, African Americans, and young adults. Insurance status and geographic location were also strongly associated. Public health nursing is positioned to prevent disease and increase access to care, considering hypertension-related encounters in the emergency department account for a significant number of overall visits.
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http://dx.doi.org/10.1111/phn.13152 | DOI Listing |
JAMA Cardiol
January 2025
Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois.
Importance: Lung ultrasound (LUS) aids in the diagnosis of patients with dyspnea, including those with cardiogenic pulmonary edema, but requires technical proficiency for image acquisition. Previous research has demonstrated the effectiveness of artificial intelligence (AI) in guiding novice users to acquire high-quality cardiac ultrasound images, suggesting its potential for broader use in LUS.
Objective: To evaluate the ability of AI to guide acquisition of diagnostic-quality LUS images by trained health care professionals (THCPs).
JAMA
January 2025
Department of Emergency Medicine, Henry Ford Health, Detroit, Michigan.
Importance: The emergency department (ED) offers an opportunity to initiate palliative care for older adults with serious, life-limiting illness.
Objective: To assess the effect of a multicomponent intervention to initiate palliative care in the ED on hospital admission, subsequent health care use, and survival in older adults with serious, life-limiting illness.
Design, Setting, And Participants: Cluster randomized, stepped-wedge, clinical trial including patients aged 66 years or older who visited 1 of 29 EDs across the US between May 1, 2018, and December 31, 2022, had 12 months of prior Medicare enrollment, and a Gagne comorbidity score greater than 6, representing a risk of short-term mortality greater than 30%.
Purpose Of Review: The 2024 mpox outbreak, primarily driven by the possibly more virulent clade Ib strain, prompted the WHO declaring it a public health emergency of international concern (PHEIC) on August 14, 2024. This review provides essential guidance for clinicians managing mpox cases, as it contrasts the features of the 2024 outbreak with those of the 2022 epidemic to support better clinical decision-making.
Recent Findings: The review highlights significant differences between the 2024 and 2022 outbreaks, including total case numbers, demographic distribution, and fatality rates.
Curr Hypertens Rep
January 2025
Department of Emergency Medicine, Integrative Biosciences Center, Wayne State University, Detroit, MI, USA.
Purpose Of Review: To review the most current recommendations regarding assessment and treatment of asymptomatic hypertension treatment in the emergency department (ED) and to provide guidance for prescribing oral antihypertensive therapy for ED providers.
Recent Findings: There are varying management strategies for the treatment of asymptomatic hypertension in the ED likely due to a lack of direct guidelines for treatment. There is an increasing body of evidence for the safety of initiating therapy to treat chronic asymptomatic hypertension in the ED.
Drugs Aging
January 2025
Department of Military and Emergency Medicine, Uniformed Services University, Bethesda, MD, USA.
Background: Untreated low back pain (LBP) in older adults can lead to disability and development of chronicity. Due to the potential development of medical comorbidities and negative risks associated with pharmacological use, chronic LBP management for older adults requires a responsive approach.
Methods: The objective of this study is to evaluate the probability of (1) opioid prescription receipt and (2) opioid-sedative coprescription, in a sample of military-service-connected patients enrolled in the Veterans Health Administration (VHA) or TRICARE, ages 30-85 years, receiving care in three systems: VHA, Military Health System (MHS), and nonfederal (civilian) healthcare facilities.
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