Journal of the American College of Emergency Physicians open
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J Am Coll Emerg Physicians Open · Aug 2021
Initial prehospital Rapid Emergency Medicine Score (REMS) to predict outcomes for COVID-19 patients.
The Rapid Emergency Medicine Score (REMS) has not been widely studied for use in predicting outcomes of COVID-19 patients encountered in the prehospital setting. This study aimed to determine whether the first prehospital REMS could predict emergency department and hospital dispositions for COVID-19 patients transported by emergency medical services. ⋯ Initial prehospital REMS was modestly predictive of ED and hospital dispositions for patients with COVID-19. Prediction was stronger for outcomes more proximate to the first set of emergency medical services (EMS) vital signs. These findings highlight the potential value of first prehospital REMS for risk stratification of individual patients and system surveillance for resource planning related to COVID-19.
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J Am Coll Emerg Physicians Open · Aug 2021
Factors associated with clinical severity in emergency department patients presenting with symptomatic SARS-CoV-2 infection.
To measure the association of race, ethnicity, comorbidities, and insurance status with need for hospitalization of symptomatic emergency department patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. ⋯ Comorbidities and public insurance are predictors of more severe illness for patients with SARS-CoV-2. This study suggests that the disparities in severity seen in COVID-19 among Black patients may be attributable, in part, to low socioeconomic status and chronic health conditions.
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J Am Coll Emerg Physicians Open · Aug 2021
Emergency medical services education research priorities during COVID-19: A modified Delphi study.
Our objective was to identify research priorities to understand the impact of COVID-19 on initial emergency medical services (EMS) education. ⋯ The identified research priorities are an important first step to begin evaluating the EMS educational infrastructure, processes, and outcomes that were affected or threatened through the pandemic.
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J Am Coll Emerg Physicians Open · Aug 2021
Comparison of adult weight estimation methods for use during emergency medical care.
Many emergency drug and fluid doses are weight dependent in adults, but in resuscitation and low-resource settings it can be impractical or impossible to weigh a patient. It is especially important to obtain accurate weight estimation for dose calculations for emergency drugs with narrow therapeutic ranges. Several weight estimation methods have been proposed for use in adults, but none is widely established. The aim of this study was to compare the accuracy of adult weight estimation methods. ⋯ The ideal weight estimation method should be accurate, rapid, simple, and feasible. This study has demonstrated the accuracy of 7 methods. The Lorenz method performed best but is complex and likely to be difficult to apply in resuscitation settings. Other simpler and quicker methods are at least as accurate as the best methods widely used in children, and there is potential for further calibrating these for use in adults before validation in real-world studies.