Research on urgent and emergency care. Covers youth psychiatric emergencies, heat-wave response, and heat-related diagnoses.
A recent study found that tens of thousands of women visited the emergency room for fibroid symptoms, with only 1 in 10 leading to hospital admission. The study suggests that many cases could have been managed in an alternative non-urgent health setting.
Emergency department visits for common conditions like appendicitis and miscarriage dropped significantly during the first wave of COVID-19, but there was no increase in adverse patient outcomes. Researchers found that management strategies remained unchanged, suggesting that patients who required emergency care continued to seek help ...
A study published in Academic Emergency Medicine found that prescribed light exercise had no effect on recovery or healthcare utilization outcomes for patients with acute mild traumatic brain injury. Standard care without early exercise may be a viable option.
The Canadian Syncope Risk Score is an accurate validated prediction score for emergency department patients with unexplained syncope. The study highlights the weaknesses of several risk tools previously published, and its impact on clinical decision making is not known.
A new benefit has been implemented, allowing eligible Veterans to receive urgent care from community providers. The study found that most Veterans who used the service lived within 30 minutes of a VA primary care site and had no copays for urgent care visits.
The Association of Anaesthetists and the Intensive Care Society publish new guidelines addressing fire safety and emergency evacuations in ICUs and operating theatres. Key findings include training for staff, design features for fire safety, and ventilation requirements to prevent oxygen enrichment.
A new study found that many lupus patients with Medicaid were unvaccinated and required more acute care for vaccine-preventable illnesses. Black patients had a higher risk of needing such care compared to white patients.
The program, called Practical Alternative to Hospitalization (PATH), uses advanced practice providers and personalized plans to support patients after visiting the emergency department. Nearly 9 out of 10 patients enrolled in PATH did not need to return to the hospital for care within a month.
A new study found that unconscious biases in emergency triage protocols led to prioritization of able-bodied patients over those with intellectual disabilities. Social workers can act as advocates for these individuals, while educational changes are needed to address structural inequalities and biases.
A new case report details the treatment of a patient with VITT (vaccine-induced thrombotic thrombocytopenia) using bivalirudin, an alternative to heparin. Early outcomes suggest that this approach may be safe and effective in treating these rare but serious clot reactions.
During the pandemic, a 70% decrease was observed in heart attack patients seeking care, with those receiving treatment experiencing more severe symptoms due to delays. The study underscores the importance of early treatment and public education on cardiac care.
A randomized trial found that droperidol was more effective than lorazepam or ziprasidone for sedation in patients with acute undifferentiated agitation. Additionally, it was associated with lower rates of respiratory depression compared to the other medications. The study suggests that larger studies are needed to confirm these findings.
The HINTS exam, a bedside ocular motor test, is not accurate for central cause identification. The test is frequently misused in patients without nystagmus or intermittent symptoms.
A surveillance project found high COVID-19 vaccine acceptance among physicians and advance practice providers, but lower rates among nurses and nonclinical healthcare workers. The authors suggest educating these groups about the vaccine's safety profile to enhance vaccination rates.
A new study finds that people with HIV who experienced intimate partner violence are more likely to engage in riskier behaviors and have poor adherence to HIV treatment. IPV is associated with increased depression, anxiety, and poor clinical outcomes, highlighting the need for screening and supportive services.
A recent study published in Health Affairs found that urgent care centers are associated with increased spending for lower-acuity visits across both emergency departments and urgent care centers. For every 37 urgent care visits, one fewer lower acuity ED visit occurs, but total costs increase rather than decrease.
A new study from Michigan Medicine found that patients who had virtual 'urgent care' visits for upper respiratory infections were more likely to receive additional follow-up care compared to those with in-person visits. This contradicts the expectation that virtual care would reduce downstream visits and emergency department use.
A study is evaluating Recovery Works, a Indiana program focusing on pre-incarceration diversion and post-incarceration re-entry services to reduce recidivism by 20%. The research aims to assess the impact of services on health-related outcomes and recidivism rates among low-level offenders.
A new study found that 46.3% of US poison control center calls involving supersized alcopops were made by underage drinkers, posing a distinct threat to youth. The study highlights the need for better regulation and policies to limit the availability of these products.
A study of over 61,000 patients with acute pulmonary embolism found that disposition practices vary significantly between hospitals, resulting in high emergency department revisit rates. Most return visits did not lead to hospitalization, highlighting the need for standardized care and improved outpatient management protocols.
A study found no racial disparities in simulated patient prioritization for resource allocation using crisis standards of care guidelines at two Miami hospitals. However, experts warn that further research is needed to ensure these guidelines do not disproportionately harm marginalized communities during public health crises.
Researchers found that low-dose aspirin reduced the need for mechanical ventilation, ICU admission, and in-hospital mortality in hospitalized COVID-19 patients. Aspirin use was associated with a decreased risk of these severe outcomes, including a 44% reduction in mechanical ventilation.
A new study finds that mobile stroke units (MSUs) improve patient outcomes and lessen the chance for disability by delivering care faster than standard stroke care. MSU patients received tPA treatment within 60 minutes, resulting in better outcomes and less disability.
A recent Loyola Medicine study found that reducing the standard dose of IV-administered ketamine in half is as effective as the larger dose in reducing pain in adults. The study involved 98 patients and showed similar results at 30 minutes, with lower adverse event rates in the low-dose group.
A hospital-based violence intervention program effectively engages vulnerable populations by addressing specific client needs. The study highlights the complexities of program attrition and altering life courses for victims of violence, emphasizing the need for targeted strategies to address upstream factors of community violence.
A study found that alcohol withdrawal rates among hospitalized patients rose 34% during the COVID-19 pandemic. The study, conducted at ChristianaCare, suggests that hospital systems need to screen for and treat alcohol use withdrawal and refer patients for ongoing treatment.
A study published in Academic Emergency Medicine found that methoxyflurane administration resulted in lower pain scores compared to standard care. However, it did not achieve the desired substantial reduction in pain as prescribed.
Specialized geriatric emergency care reduces hospitalizations and costs for Medicare beneficiaries, with savings ranging up to $2,905 after 30 days. The study found a significant reduction in total costs of care when patients were seen by transitional care nurses or social workers trained in geriatric emergency care.
Researchers found that financial incentives encouraged hospitals to enact rapid system and practice changes to support treatment for opioid use disorder. However, smaller or independent hospitals struggled to invest in resources due to internal barriers.
Researchers found paracetamol alone is superior to high-dose NSAID alone for posttraumatic extremity pain. A study published in Academic Emergency Medicine shows taking paracetamol as a first-line therapy can effectively manage mild to moderate post-traumatic extremity pain after discharge from the emergency department.
A new Canadian TIA Score tool helps emergency physicians predict patients at greatest risk of having a major stroke within the week. The study showed the Canadian TIA Score accurately categorized patients into three risk groups, outperforming existing ABCD2 score.
The Arizona Rural EMS Advanced Telemedicine Demonstration Initiative (AzREADI) provides rural EMS responders with real-time consultations with board-certified EMS physicians. This improves the time from symptom onset to treatment, especially for stroke or traumatic brain injury cases.
A study found that lesbian, gay, and bisexual medical students experience higher rates of burnout compared to their heterosexual peers. LGB students reported frequent perceived mistreatment, leading to increased emotional strain and a higher likelihood of burnout.
A Yale University study found that hospitals with fewer resources per COVID-19 patient were associated with more deaths in April 2020. The study showed a strong correlation between ICU bed availability and a one-fifth decrease in death incidence rate.
Research examines the role of transforming cardiovascular care in rural clinics, optimizing emergency room use, and successful adoption of virtual care. Studies show that hybrid models can provide more than 30% virtual care after COVID-19 restrictions lift, while also reducing unnecessary ER visits by 55.7%.
Researchers discovered racial and ethnic differences in diagnostic imaging for children at pediatric emergency departments in the United States. The study found that these disparities are not solely due to patient factors, but also reflect biases in healthcare providers' decision-making.
A study published in Academic Emergency Medicine found that advanced practice providers (APPs) and emergency physicians deliver similar care to ED patients presenting with chest and abdominal pain. The authors recommend further research on the optimal use of APPs in the emergency department.
A survey found nearly 1 in 4 families reluctant to bring their child to the Emergency Department for non-COVID emergencies, exacerbating health inequities. Greater hesitancy was observed in under-resourced communities, families of color, and those relying on public insurance.
Children under 3 years old presenting with rib fractures are 77% likely to be abused; those under 18 months with humeral fractures show similar results. Diagnostic evaluation for abuse is recommended in these cases to minimize morbidity and mortality.
Over a 15-year period, the total number of unique patients seeing PCPs decreased by 2.5%, while frequency of contact dropped from 4.3 to 3.7 visits per patient, contributing to the primary care decline.
A study aims to reduce return visits to ED by low-risk patients with anxiety-caused chest pain. Researchers will explore online and telehealth care delivery options for anxious patients.
A significant number of patients with sudden loss of consciousness require pre-hospital critical care, according to a recent study. The research found that air ambulance dispatch teams can select patients needing HEMS-specific interventions and identify opportunities to improve triage.
A standardized tool for assessing chest pain risk was associated with comparable care for high-risk women, while low- and intermediate-risk women received consistent care with guidelines. Despite less care, women had fewer reports of heart attacks or death within 30 days compared to men.
The LOOP technique has been found to be a safe and effective alternative to traditional incision and drainage (I&D) with packing for treating subcutaneous abscesses in adults. In children, the technique resulted in significantly fewer failures compared to standard I&D techniques.
Researchers analyzed Medicaid databases to identify predictors of timely enrollment in treatment for opioid use disorder among Medicaid recipients. Prior overdose, alcohol use disorder, and back problems were associated with non-enrollment, while frequent emergency room visits or primary care provider visits were linked to timely enrol...
A national poll of people aged 50 to 80 found that nearly one in four have visited an emergency department in the last two years due to cost, COVID-19 risk, or delays. Health providers can improve acute care by better supporting older adults during and after medical emergencies.
A study published in Circulation found that women are significantly less likely to survive out-of-hospital cardiac arrest compared to men. Women received therapeutic hypothermia and coronary angiography at lower rates, leading to a 22.5% survival rate compared to 36.3% for men.
Only 1.8% of US obstetrician-gynecologists have an X-waiver, allowing them to prescribe buprenorphine for opioid addiction. Rural areas and cities with high neonatal abstinence syndrome rates have higher X-waiver rates among OB-GYNs.
A study of 21,231 UK urgent care register records found that advance care planning significantly influenced the place of death, with patients who had recorded preferences dying at home or in their chosen setting. Patients without a recorded preference were more likely to die in hospital.
Researchers at UTHealth analyzed data from over 18,000 out-of-hospital cardiac arrests to identify disparities in automated external defibrillator use. Hispanic/Latino and black neighborhoods showed significantly lower rates of AED use compared to non-Hispanic/Latino white communities.
A new study reveals an average of 120,232 firearm injuries per year in the US, with nonfatal cases being twice as prevalent as deaths. The research highlights the need for effective prevention strategies beyond just addressing fatal injuries.
Advanced practice providers (APPs) have lower productivity compared to emergency department physicians, but no apparent impact on patient satisfaction and safety metrics. The study suggests that APPs can be effectively integrated into EDs with staffing models accounting for their lower productivity.
A new study by UC San Francisco researchers found that California's Black and Hispanic communities received less benefit from regionalized heart attack care protocols. Despite improved access to PCI-capable hospitals, survival rates remained unchanged for minority groups, whereas whites in non-minority communities showed better outcomes.
The University of Arizona College of Medicine is developing a lung ultrasound education program for rural emergency medicine providers to better diagnose COVID-19. Lung ultrasound can be particularly useful in rural EDs due to limited access to COVID-19 testing and the disparate impact of COVID-19 on rural populations.
A study by Massachusetts General Hospital found that expanded access to health insurance significantly reduced ambulance dispatches for asthma emergencies in New York City. Improved access to outpatient management of the chronic condition is believed to be the likely reason for this decline.
Research finds that buprenorphine therapy in primary care can be financially sustainable, with rural practices and physician-led treatment generating the most revenue. Effective hearing loss screening also shows promise, with increased referral rates to audiology specialists leading to improved health outcomes.
Patient clinical data leverages reduce healthcare spending and utilization by reminding patients for preventive services, setting health goals, and improving quality improvement. Practices with targeted outreach and population health monitoring also see lower Medicare spending and utilization
A recent study by Washington State University's Bidisha Mandal found that the Affordable Care Act's Medicaid expansion program has reduced the number of uninsured low-income residents, particularly in rural areas. However, the likelihood of repeated emergency room visits for non-urgent reasons has not decreased.
A survey of over 4,000 UK emergency care doctors found their median average 'need for recovery' score was 70, higher than previous studies. Factors like reducing antisocial shift patterns and improving access to leave could help alleviate wellbeing issues.
The American College of Physicians publishes COVID-19 news from Annals of Internal Medicine. Experts from the University of Pennsylvania and NYU Grossman School of Medicine discuss the legal, ethical, and clinical ramifications of restricting patient access to EUA-approved COVID-19 drugs and vaccines.