Exploring Cannabis-Associated Presentations to Canadian Pediatric Emergency Departments: A Cross-Sectional Study.

Objective: Recent studies found that recreational legalization of cannabis consumption for Canadian adults has increased presentation to the emergency department (ED) among children. In this descriptive study, our objectives were to (1) understand Canadian pediatric emergency medicine (PEM) providers' training and knowledge of clinical presentations associated with cannabis exposure in children and (2) describe pediatric ED presentations related to cannabis exposure across Canada following legalization in 2018.

Method: In 2021, following ethics board approval, 230 Pediatric Emergency Research Canada (PERC) network pediatric emergency medicine (PEM) physicians were invited to share about their knowledge, training, and experience with patients presenting with cannabis-associated emergencies using an anonymized survey administered through REDCap.

Intravenous branched-chain amino acid administration for the acute treatment of hepatic encephalopathy: a systematic review and meta-analysis.

Background: Hepatic encephalopathy (HE) is a severe complication of acute hepatic failure requiring urgent critical care management. Branched-chain amino acids (BCAAs) such as leucine, isoleucine, and valine have been investigated as potential treatments to improve outcomes in patients with acute HE. However, the effectiveness of BCAA administration during the acute phase remains unclear.

Prevalence and prognostic value of dementia in atrial fibrillation patients in emergency departments: Insights from a national-wide multicenter registry study.

Introduction: Atrial fibrillation (AF) and dementia are two common comorbidities in emergency departments (ED) that can significantly affect patients' quality of life. The aim of this study was to evaluate the prevalence and long-term impact of dementia on survival in patients with AF.

Methods: We conducted a multicenter prospective observational study and consecutively recruited 2016 AF patients from 20 hospitals in China.

Hypothermia-associated acute pancreatitis: A multicenter prospective observational study.

Aim: Hypothermia-associated pancreatitis lacks comprehensive understanding owing to limited studies exploring its mechanism, epidemiology, risk factors, and outcomes. We aimed to investigate the frequency, characteristics, and predictive factors associated with the development of acute pancreatitis in patients with accidental hypothermia.

Methods: This study comprised a post hoc analysis of data from a multicenter prospective observational study (ICE-CRASH study) conducted in 36 tertiary emergency hospitals in Japan.

An Unexpected Case of Generalized Tetanus.

Tetanus is a disease of the nervous system caused by a toxin produced by , an anaerobe found in high concentrations in the soil. The occurrence of tetanus is related to contaminated traumatic wounds, and most patients have had some failure in their immunization. However, there are rare case reports of generalized tetanus in patients with proper vaccination schemes who failed to receive appropriate prophylaxis after high-risk exposure.

Pediatric Snowboarding-Related Concussions and Musculoskeletal Injuries Decreased From 2012 to 2022.

Purpose: To analyze mechanisms, diagnoses, and incidence of youth snowboarding-related injuries presenting to US emergency departments.

Methods: Data from the National Electronic Injury Surveillance System were analyzed for pediatric snowboarding injuries (≤18 years old) from 2012 to 2022. Data were collected for mechanism of injury, diagnosis, location of injury, and disposition.

Rural Canadian emergency physician experiences using point-of-care ultrasound.

Objectives: Point-of-care ultrasound (POCUS) is a rapidly evolving and clinically significant skill set that has potential for improving patient care for the approximately 7 million Canadians living in rural and under-resourced environments. A national appraisal of rural POCUS training and utilization is needed to understand barriers to funding and training for rural emergency physicians in Canada. The primary objective of this study was to determine the current level of training and types of POCUS utilization by rural emergency physicians in Canada.

Hospital and physician-based mental healthcare during 12 months of opioid agonist treatment for opioid use disorder: Exploring costs and factors associated with acute care.

Background: Individuals with opioid use disorder (OUD) have a high prevalence of co-occurring mental health disorders; however, there exists little information on mental health service use for this population. We aimed to determine the prevalence of non-substance use-related mental health emergency department (ED) visits, hospitalizations, and outpatient physician visits for individuals receiving treatment for OUD over one year. We also explored individual-level characteristics associated with mental health care service use and estimated the costs of this care.

Analyzing the association of critical illness and cardioversion success in patients with atrial fibrillation at the emergency department.

In critically ill patients with atrial fibrillation (AF), standard treatment algorithms might not be applicable. Emergency departments (ED) play a crucial role in implementing individualized treatment approaches. The aim of this study was to assess the association of lactate and cardioversion success rates in AF patients presenting to an ED.

External validation of an artificial intelligence model using clinical variables, including ICD-10 codes, for predicting in-hospital mortality among trauma patients: a multicenter retrospective cohort study.

Artificial intelligence (AI) is being increasingly applied in healthcare to improve patient care and clinical outcomes. We previously developed an AI model using ICD-10 (International Classification of Diseases, Tenth Revision) codes with other clinical variables to predict in-hospital mortality among trauma patients from a nationwide database. This study aimed to externally validate the performance of the AI model.

Enhanced D614G and Omicron Variants Antibody Persistence in Infants at 2 Months of Age Following Maternal mRNA Booster Vaccination During Pregnancy or Postpartum.

Background: Following maternal COVID-19 vaccination, the persistence of antibodies in sera and breast milk for mothers and infants is not well characterized. We sought to describe the persistence of antibodies through 2 months after delivery in maternal and infant serum and breast milk following maternal COVID-19 mRNA vaccination and to examine differences by receipt of booster dose during pregnancy or postpartum.

Methods: This is a prospective cohort study with enrollment from July 2021 to January 2022 at 9 US academic sites.

Diabetes Mellitus Is Not a Risk Factor for Difficult Intubation Among Critically Ill Adults: A Secondary Analysis of Multicenter Trials.

Objectives: Diabetes mellitus has been associated with greater difficulty of tracheal intubation in the operating room. This relationship has not been examined for tracheal intubation of critically ill adults. We examined whether diabetes mellitus was independently associated with the time from induction of anesthesia to intubation of the trachea among critically ill adults.

Advancing Delirium Treatment Trials in Older Adults: Recommendations for Future Trials From the Network for Investigation of Delirium: Unifying Scientists (NIDUS).

Objectives: To summarize the delirium treatment trial literature, identify the unique challenges in delirium treatment trials, and formulate recommendations to address each in older adults.

Design: A 39-member interprofessional and international expert working group of clinicians (physicians, nurses, and pharmacists) and nonclinicians (biostatisticians, epidemiologists, and trial methodologists) was convened. Four expert panels were assembled to explore key subtopics (pharmacological/nonpharmacologic treatment, methodological challenges, and novel research designs).

Safety and Efficacy of Opioid-sparing Anesthesia Compared With Traditional Opioid Anesthesia: A Scoping Review.

Objectives: The rationale of adoption opioid-sparing anesthesia (OSA) is to achieve perioperative analgesia with a minimal amount of opioids combined with nonopioid adjuvants during and after surgery, namely multimodal anesthesia. The OSA approach was originally developed to overcome the known complications of opioid-based anesthesia (OA), and the present scoping review (ScR) aims at providing clinical evidence of the safety and efficacy of OSA with respect to OA.

Methods: This ScR is mainly focused on studies presenting evidence on the safety and efficacy of OSA versus OA.

The technical expert/clinical user/patient panel (TECUPP): centering patient and family perspectives in patient-reported measure development.

Patient and caregiver perspectives are increasingly incorporated into health care research and policymaking, but their inclusion in the quality measure development process often is not robust. We describe a stakeholder panel model for incorporating patient/caregiver voices in the development of patient-reported measures, the Technical Expert/Clinical User/Patient Panel (TECUPP) model. This model is characterized by significant or equal representation of people with lived experience of the disease or condition (as patients or caregivers) to the clinicians and others with technical expertise who typically comprise technical expert panels.

Regional readiness for sodium nitrite-induced methemoglobinemia: availability of methemoglobin testing and methylthioninium chloride (methylene blue) stocking in the Upper Midwestern United States.

Introduction: Sodium nitrite is a potent oxidizer, which may precipitate rapidly lethal methemoglobinemia. Prompt diagnosis and treatment may salvage otherwise fatal cases. It is unclear if emergency departments are prepared for increasing cases.

Experience and Perspectives on Antibacterial Therapy for Listeriosis in a Tertiary Teaching Hospital in China: A Retrospective Study and Health Care Provider Survey.

Listeriosis is a rare, life-threatening bacterial infection. Prompt, appropriate antibiotic treatment is essential to save lives. We aimed to investigate antibiotic selection and listeriosis knowledge among health care providers.

Clinical and Radiological Features of an Adenovirus Type 7 Outbreak in Split-Dalmatia County, Croatia, 2022-2023.

Human adenoviruses (HAdVs) are known to be highly contagious pathogens. They are commonly associated with mild respiratory infections in young children but can also cause severe life-threatening infections. Human adenovirus types 4 and 7 have frequently been reported to cause pneumonia in immunocompetent youths and adults.

Respiratory Pathogen Coinfection During Intersecting COVID-19 and Influenza Epidemics.

Respiratory pathogen coinfections pose significant challenges to global public health, particularly regarding the intersecting epidemics of COVID-19 and influenza. This study investigated the incidences of respiratory infectious pathogens in this unique context. We collected throat swab samples from 308 patients with a fever from outpatient and emergency departments at sentinel surveillance hospitals in Xiamen, southeast of China, between April and May 2023, testing for SARS-CoV-2 and 26 other respiratory pathogens.

Interaction Effects Between COVID-19 Outbreak and Fever on Mortality Among OHCA Patients Visiting Emergency Departments.

: Fever in patients who have suffered an out-of-hospital cardiac arrest (OHCA) has been linked to poor clinical outcomes, as a fever can exacerbate neurological damage, increase metabolic demands, and trigger inflammatory responses. This study evaluates the impact of the COVID-19 outbreak and associated fevers on OHCA outcomes and examines how they can worsen patient prognosis. : Our retrospective observational analysis used data from the National Emergency Department Information System (NEDIS), comprising adult OHCA patients at 402 EDs in Korea between 27 January and 31 December 2020 (COVID-19 pandemic period) and the corresponding period in 2019 (pre-COVID-19).

Overuse of CT for Minor Head Trauma Patients: A Retrospective Analysis from Poland and Lithuania Trauma Centres.

: Head trauma is one of many conditions that trauma centres deal with daily. This study aimed to analyse the utilisation of head CT scans for patients with minor head trauma in two major hospitals in Lithuania and Poland. : We conducted a retrospective, descriptive study of CT utilisation in minor head trauma patients presenting to the Level 1 trauma centre Hospital of the Lithuanian University of Health Sciences Kaunas Clinics (HLUHS KC) and Jan Biziel University Hospital in Bydgoszcz emergency departments (EDs), during the study period from 01 February to 30 April 2023.

Evaluating the Accuracy of the SIL Score for Predicting the Sepsis Mortality in Emergency Department Triages: A Comparative Analysis with NEWS and SOFA.

Sepsis is a disease with a high mortality rate, which emphasizes the importance of developing tools for the early identification of high-risk patients and to initiate timely treatments to reduce mortality. The SIL score is a scale that uses the shock index and arterial lactate level to identify early on the patients that are at a high risk of in-hospital mortality due to sepsis. The purpose of this study was to validate the SIL score as a tool for estimating the probability of sepsis in-hospital mortality from the triage room in emergency departments.

Infectious Risk in Pediatric Emergency Departments in Italy: A Survey by the Italian Society for Pediatric Emergency and Urgent Medicine (SIMEUP) on Available Preventive and Diagnostic Tools.

The COVID-19 pandemic has emphasized the importance of preparedness in preventing the spread of infectious diseases, especially in Emergency Departments (EDs), where initial patient assessments and triage occur. This study aims to evaluate the current practices and available tools for infection control in Pediatric EDs across Italy, focusing on the differences between various hospital types and regional settings. A cross-sectional national survey was conducted in February 2022, targeting healthcare workers in Pediatric EDs across Italy.