Tramadol as a fentanyl adulterant: Prevalence and management in a ToxIC Fentalog study prospective cohort.

Background: Tramadol is an adulterant of illicit opioids. As it is a serotonin-norepinephrine reuptake inhibitor as well as a μ-opioid agonist, tramadol adulteration may worsen overdose signs and symptoms or affect the amount of naloxone patients receive.

Methods: This is a multicenter, prospective cohort of adult patients with suspected opioid overdoses who presented to one of eight United States emergency departments and were included in the Toxicology Investigators Consortium's Fentalog Study.

A novel interpretable deep learning model for diagnosis in emergency department dyspnoea patients based on complete data from an entire health care system.

Background: Dyspnoea is one of the emergency department's (ED) most common and deadly chief complaints, but frequently misdiagnosed and mistreated. We aimed to design a diagnostic decision support which classifies dyspnoeic ED visits into acute heart failure (AHF), exacerbation of chronic obstructive pulmonary disease (eCOPD), pneumonia and "other diagnoses" by using deep learning and complete, unselected data from an entire regional health care system.

Methods: In this cross-sectional study, we included all dyspnoeic ED visits of patients ≥ 18 years of age at the two EDs in the region of Halland, Sweden, 07/01/2017-12/31/2019.

Primary Iliopsoas Abscess and Drug-Induced Liver Injury in the Emergency Department: A Case Report.

Background And Objective: Iliopsoas abscess (IPA) is a rare condition with varied symptomology and etiology. Less than one-third of patients with IPA present in the emergency department (ED) with the traditional triad of fever, back pain, and restricted hip motion (or limp), leading to delays in diagnosis and management. Acute liver failure is also a rare clinical presentation in the ED, being associated with high morbidity and mortality.

A 3D-Printed Educational Model for First-Line Management of BPPV in Emergency Departments.

Background: We present a feasibility study on the development of a 3D-printed (3DP) model of benign paroxysmal positional vertigo (BPPV) and its validation as an educational tool for training in therapeutic maneuvers.

Methods: A 1.5:1 3DP model of the human labyrinth, supplemented by a 1:1 3DP model of the skull, was obtained from a computed tomography scan.

Analysis of the relationship between medical achievement self-efficacy perception and impostor phenomenon in the postgraduate education process: a cross-sectional study.

Background: This study aimed to assess the correlation between the impostor phenomenon and the level of academic self-efficacy. The secondary aim was to determine the sociodemographic variables affecting these two conditions. Based on the acquired findings, it is possible to take supportive and preventive measures.

Outpatient follow-up and future care-seeking for pediatric ambulatory care-sensitive conditions.

Objectives: Outpatient follow-up visits are often recommended for children with ambulatory care-sensitive conditions (ACSCs) who are discharged from emergency departments or urgent care centers (acute care settings). We sought to assess whether attending a follow-up visit within 7 days is associated with seeking initial office-based care rather than acute care during a subsequent ACSC illness. Understanding this association is crucial to guide recommendations for routine short-term follow-up visits in children who seek acute care for these common conditions.

Mobile health teleconsultation and telemedicine in operating outpatient departments during COVID-19 pandemic at a hospital in Eastern Nepal.

Background: Telemedicine provides a means to deliver healthcare across distances, enhancing efficiency and accessibility, especially in low- and middle-income countries. The COVID-19 pandemic highlighted its importance by reducing the risk of virus transmission while maintaining healthcare delivery. This study evaluates the telemedicine program implemented at B.

Shortened NIHSS for Rapid Stroke Assessment in Emergency Care Settings.

Objectives: The National Institutes of Health Stroke Scale (NIHSS) is widely used to assess ischemic stroke severity, but its full 11-item version can be time-consuming. This study evaluates the NIHSS-8, a shortened version, for its efficacy compared with NIHSS-11 in an emergency department setting.

Methods: A cohort study was conducted from May 2018 to May 2019 at Imam Reza Hospital, Tabriz, Iran.

Critical Diagnoses to Consider in the Assessment of Pediatric Patients Presenting with Limp in the Rheumatology Ward: A Cross-Sectional Study.

Objectives: Limping is a frequent reason for visits to emergency departments. The causes of limping in children are various, ranging from benign musculoskeletal problems to serious etiologies, such as malignancy and infections.

Methods: In this recent cross-sectional study, we evaluated the causes of limps in children referred to the pediatric rheumatology ward in northeast Iran.

New Fresnel lens loupe for nystagmus observation suitable for use by medical staff in emergency departments.

Background: Reduction of spontaneous nystagmus by fixation, a characteristic feature of peripheral nystagmus, is important for differentiating between peripheral and central vestibular disorders. In the emergency room, Frenzel goggles are recommended to observe spontaneous nystagmus for the differential diagnosis of acute vestibular syndrome. We developed a portable loupe with a Fresnel lens to observe nystagmus.

Duration, course and caregiver burden of croup in children: two observational cohorts.

Objectives: Although croup is a common respiratory illness, there is little published regarding symptom course. We aimed to assess symptom progression and caregiver burden, and whether age, sex or season and initial severity of disease are associated with symptom duration.

Design, Setting And Participants: We conducted a secondary analysis of two Canadian prospective cohorts of children 0-16 years old diagnosed with croup; one recruited from a paediatric emergency department (ED) (307 children) between November 1999 and March 2000, and the other from 26 general EDs (1214 children) between September 2002 and April 2006.

Gastrointestinal illness among attendees of the FIFA Football World Cup 2022 in Qatar.

Objectives: Mass gathering events may facilitate the transmission of foodborne diseases. We determined the presentations and causative organisms of gastrointestinal illness among the attendees of the Fédération Internationale de Football Association Football World Cup 2022 (FIFA 2022).

Methods: The study was conducted at Hamad Medical Corporation in Qatar, which served as the national reference laboratory for all microbiology testing.

Nonfatal Strangulation Injuries: Improving Physician Knowledge and Attitudes.

In the emergency department, physicians evaluate patients who have experienced nonfatal strangulation resulting from sexual assault or intimate partner violence. Given the prevalence and potential consequences of nonfatal strangulation injuries, physicians need confidence in their decision-making for these patients. Previous educational interventions effectively improved physician knowledge of sexual assault and intimate partner violence patients; however, no studies have been conducted with the goal of improving physician knowledge about nonfatal strangulation injuries in this population.

Enhancing Emergency Room Mental Health Crisis Response: A Systematic Review of Integrated Models.

The integration of psychiatric treatment into emergency services is critical to improving the management of severe mental health emergencies. Emergency departments (EDs) are frequently the initial point of contact for patients with mental emergencies, but they are not always prepared to offer adequate care. This systematic review aims to analyze the effectiveness of collaborative care models (CCMs), psychiatric consultation-liaison (C-L) teams, and telepsychiatry in enhancing psychiatric treatment in emergencies.

Assessment of Continuous Pulse Oximetry Monitoring in Infants With Bronchiolitis in the Pediatric Emergency Department: A Cross-Sectional Study.

Purpose Bronchiolitis guidelines recommend intermittent pulse oximetry monitoring for stable infants. Continuous pulse oximetry can lead to harm for some infants with bronchiolitis but is still frequently used in emergency departments (EDs) for infants who do not require oxygen supplementation. Measuring continuous pulse oximetry use from medical charts can be challenging.

Key Aspects of Recovery-Oriented Practice in Caring for People With Mental Ill-Health in General Emergency Departments: A Modified Delphi Study.

Aim: To identify key aspects of recovery-oriented practice in caring for people with mental ill-health in general emergency departments.

Design: A modified Delphi study with three rounds.

Methods: A 24-member expert panel was recruited consisting of people with lived experience of mental ill-health, registered nurses working in emergency care, registered nurses specialised in psychiatric and mental health nursing and mental health recovery researchers.

[Analysis of symptomatic differences in 391 patients with Brucella infections in different age groups].

In order to investigate the clinical manifestations and laboratory findings associated with brucellosis for the purpose of facilitating prompt clinical diagnosis and effective treatment, as well as to offer a laboratory reference for the prevention of brucellosis outbreaks. In this study, a retrospective cohort design was employed to gather epidemiological characteristics, clinical symptoms, and associated laboratory data from 391 patients diagnosed with bacterial culture-positive brucellosis at the People's Hospital of Ningxia Hui Autonomous Region between 2019 and 2023. The patients were categorized into four age groups, with each group representing a 20 years age interval.

Multifaceted approach to reduce duplicate therapy errors in the emergency department.

Medication errors continue to pose a significant risk to patient safety, accounting for half of the avoidable harm in healthcare systems around the world. In emergency departments (EDs), factors such as high patient loads and emergent nature of care increase the likelihood of such errors. An audit conducted at the ED of Changi General Hospital Singapore from January 2019 to July 2022 revealed that the duplicate therapy error comprised 31% of all reported medication errors.

Catalogue of inherited autosomal recessive disorders found amongst the Roma population of Europe.

Background: The Roma population are an endogamous, genetically isolated, minority population who migrated from North-Western India to Europe from the 10th Century throughout the Byzantine period and continues to the present day. Approximately 10-12 million Romani people reside in segregated settlements in Europe, and smaller populations live in North America and China. In addition to the endogamy, they also practice consanguinity.

GRADE-based procalcitonin guideline for emergency departments.

Procalcitonin is a useful biomarker for infection. Over the past two decades, there has been much research on the clinical applications of procalcitonin, yet the majority of these studies have been conducted in the intensive care setting. Despite the extensive use of procalcitonin in emergency departments, there have been no guidelines focusing specifically on these clinical settings.

A propensity score-matched comparison between single-stage and multistage anterior/posterior lumbar fusion surgery: a Michigan Spine Surgery Improvement Collaborative study.

Objective: Patients undergoing anterior/posterior lumbar fusion surgery can undergo either a single-stage or multistage operation, depending on surgeon preference. The goal of this study was to assess different patient outcomes between single-stage and multistage lumbar fusion procedures in a multicenter setting.

Methods: The Michigan Spine Surgery Improvement Collaborative database was queried for anterior/posterior lumbar fusion surgeries between July 2018 and January 2022.

A national cross-sectional survey of health literacy of caregivers attending Canadian pediatric emergency departments.

Background: Health literacy assessment is key to better meeting family needs and developing informed strategies to promote positive health outcomes for children. The objective of this study was to describe the health literacy of caregivers who use Canadian pediatric emergency departments and relate it to demographic and visit-specific variables.

Methods: This study utilized a descriptive, cross-sectional survey design with medical record review.