Co-Occurrence of Multiple Risk Factors and Intimate Partner Violence in an Urban Emergency Department.

Introduction: Urban emergency departments (ED) provide care to populations with multiple health-related and overlapping risk factors, many of which are associated with intimate partner violence (IPV). We examine the 12-month rate of physical IPV and its association with multiple joint risk factors in an urban ED.

Methods: Research assistants surveyed patients regarding IPV exposure, associated risk factors, and other sociodemographic features.

Breast Practices: Strategies to Support Lactating Emergency Physicians.

Lactation benefits both lactating individuals and their infants. Despite high rates of breastfeeding initiation, physicians are a high-risk group for early cessation. Barriers to meeting lactation goals for physicians include lack of protected time, dedicated space, and collegial support.

Association of Default Electronic Medical Record Settings With Health Care Professional Patterns of Opioid Prescribing in Emergency Departments: A Randomized Quality Improvement Study.

Importance: Prescription opioids play a significant role in the ongoing opioid crisis. Guidelines and physician education have had mixed success in curbing opioid prescriptions, highlighting the need for other tools that can change prescriber behavior, including nudges based in behavioral economics.

Objective: To determine whether and to what extent changes in the default settings in the electronic medical record (EMR) are associated with opioid prescriptions for patients discharged from emergency departments (EDs).

How Well Do Core Faculty Understand The Emergency Medicine Milestones?

Introduction: It is unclear how emergency medicine (EM) programs educate core faculty about the use of milestones in competency-based evaluations. We conducted a national survey to profile how programs educate core faculty regarding their use and to assess core faculty's understanding of the milestones.

Methods: Our survey tool was distributed over six months in 2017 via the Council of Emergency Medicine Residency Directors (CORD) listserv.

Problem Drinking and Marijuana Use as Risks for Unidirectional and Bidirectional Partner Violence.

Despite evidence that most who perpetrate intimate partner violence (IPV) also report victimization, little is known about bidirectional IPV among Emergency Department (ED) patients and its association with problem drinking and marijuana use. We conducted an observational, cross-sectional survey among low- and moderate-acuity patients at a Northern California safety-net ED. Physical IPV was measured with the Revised Conflict Tactics Scale (CTS2).

Declared impact of the US President's statements and campaign statements on Latino populations' perceptions of safety and emergency care access.

Statements about building walls, deportation and denying services to undocumented immigrants made during President Trump's presidential campaign and presidency may induce fear in Latino populations and create barriers to their health care access. To assess how these statements relate to undocumented Latino immigrants' (UDLI) and Latino legal residents/citizens' (LLRC) perceptions of safety and their presentations for emergency care, we conducted surveys of adult patients at three county emergency departments (EDs) in California from June 2017 to December 2018. Of 1,684 patients approached, 1,337 (79.

Drinking and Intimate Partner Violence Severity Levels Among U.S. Ethnic Groups in an Urban Emergency Department.

Background: Emergency departments (EDs) provide care to ethnically diverse populations with multiple health-related risk factors, many of which are associated with intimate partner violence (IPV). This paper examines ethnic-specific 12-month rates of physical IPV by severity and their association with drinking and other sociodemographic and personality correlates in an urban ED sample.

Methods: Research assistants surveyed patients at an urban ED regarding IPV exposure as well as patterns of alcohol and drug use, psychological distress, adverse childhood experiences (ACEs), and other sociodemographic features.

A Theory-based Didactic Offering Physicians a Method for Learning and Teaching Others About Human Trafficking.

Emergency clinicians are on the frontlines of identifying and caring for trafficked persons. However, most emergency providers have never received training on trafficking, and studies report a significant knowledge gap involving this important topic. Workshops often employ a "train-the-trainer" model to address clinicians' knowledge gaps involving various topics (including trafficking).

Implementation of the Cardiac Arrest Sonographic Assessment (CASA) protocol for patients with cardiac arrest is associated with shorter CPR pulse checks.

Objective: We aim to evaluate whether implementation of the "Cardiac Arrest Sonographic Assessment" (CASA) protocol reduces the duration of interruptions in CPR during resuscitation of cardiac arrest (CA) compared to the pre-intervention period.

Methods: This was a quasi-experimental pre and post intervention study completed over 19 months in an urban Emergency Department. CA resuscitations were filmed and analyzed with respect to pulse check duration and use of point-of-care ultrasound (POCUS).

Slow Infusion of Low-dose Ketamine Reduces Bothersome Side Effects Compared to Intravenous Push: A Double-blind, Double-dummy, Randomized Controlled Trial.

Objective: We compared the analgesic efficacy and incidence of side effects when low-dose (0.3 mg/kg) ketamine (LDK) is administered as a slow infusion (SI) over 15 minutes versus an intravenous push (IVP) over 1 minute.

Methods: This was a prospective, randomized, double-blind, double-dummy, placebo-controlled trial of adult ED patients presenting with moderate to severe pain (numerical rating scale [NRS] score ≥ 5).

New directions in point-of-care ultrasound at the crossroads of paediatric emergency and critical care.

Purpose Of Review: The diagnostic capability, efficiency and versatility of point-of-care ultrasound (POCUS) have enabled its use in paediatric emergency medicine (PEM) and paediatric critical care (PICU). This review highlights the current applications of POCUS for the critically ill child across PEM and PICU to identify areas of progress and standardized practice and to elucidate areas for future research.

Recent Findings: POCUS technology continues to evolve and advance bedside clinical care for critically ill children, with ongoing research extending its use for an array of clinical scenarios, including respiratory distress, trauma and dehydration.

Happier Healers: Randomized Controlled Trial of Mobile Mindfulness for Stress Management.

Purpose: Medical students have higher rates of depression and psychologic distress than the general population, which may negatively impact academic performance and professional conduct. This study assessed whether 10-20 min of daily mindfulness meditation for 30 days, using a mobile phone application, could decrease perceived stress and improve well-being for medical students.

Methods: Eighty-eight medical students were stratified by class year and randomized to either intervention or control groups to use the mobile application Headspace, an audio-guided mindfulness meditation program, for 30 days.

Successful emergency pain control for posterior rib fractures with ultrasound-guided erector spinae plane block.

The Eastern Association for the Surgery of Trauma and Trauma Anesthesiology Society Guidelines recommend prompt and effective multimodal analgesia for rib fractures that combines regional anesthesia (RA) techniques with pharmacotherapy to treat pain, optimize pulmonary function, and reduce opioid related complications. However, RA techniques such as epidurals and paravertebral blocks, are generally underutilized or unavailable for emergency department (ED) patients. The recently described serratus anterior plane block (SAPB) is a promising technique, but failures with posterior rib fractures have been observed.

Material Needs of Emergency Department Patients: A Systematic Review.

Background: Interest in social determinants of health (SDOH) has expanded in recent years, driven by a recognition that such factors may influence health outcomes, services use, and health care costs. One subset of SDOH is material needs such as housing and food. We conducted a systematic review of the literature on material needs among emergency department (ED) patients in the United States.

Point-of-care ultrasound use in patients with cardiac arrest is associated prolonged cardiopulmonary resuscitation pauses: A prospective cohort study.

Objective: We aim to evaluate if point-of-care ultrasound use in cardiac arrest is associated with CPR pause duration.

Methods: This is a prospective cohort study of patients with cardiac arrest (CA) presenting to an urban emergency department from July 2016 to January 2017. We collected video recordings of patients with CA in designated code rooms with video recording equipment.

Violent Injury and Neighborhood Racial/Ethnic Diversity in Oakland, California.

Racial and ethnic segregation has been linked to a number of deleterious health outcomes, including violence. Previous studies of segregation and violence have focused on segregation between African Americans and Whites, used homicide as a measure of violence, and employed segregation measures that fail to take into account neighborhood level processes. We examined the relationship between neighborhood diversity and violent injury in Oakland, California.