Journal of the American College of Emergency Physicians open
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J Am Coll Emerg Physicians Open · Feb 2021
Delayed emergencies: The composition and magnitude of non-respiratory emergency department visits during the COVID-19 pandemic.
COVID-19 has been associated with excess mortality among patients not diagnosed with COVID-19, suggesting disruption of acute health care provision may play a role. ⋯ COVID-19 has resulted in significant avoidance of ED care, comprising a mix of deferrable and high severity care. Hospital and public health pronouncements should emphasize appropriate care seeking.
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J Am Coll Emerg Physicians Open · Feb 2021
The impact of COVID-19 on statewide EMS use for cardiac emergencies and stroke in Massachusetts.
To evaluate the impact of coronavirus disease 2019 (COVID-19) on emergency medical services (EMS) use for time-sensitive medical conditions. We examined EMS use for cardiac arrest, stroke, and other cardiac emergencies across Massachusetts during the peak of the COVID-19 pandemic, evaluating their relationship to statewide COVID-19 incidence and a statewide emergency declaration. ⋯ EMS use for certain time-sensitive conditions decreased after a statewide emergency declaration, irrespective of actual COVID-19 incidence, suggesting the decrease was related to perception instead of actual case counts. These findings have implications for public health messaging. Measures must be taken to clearly inform the public that immediate emergency care for time-sensitive conditions remains imperative.
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J Am Coll Emerg Physicians Open · Feb 2021
The "double eights mask brace" improves the fit and protection of a basic surgical mask amidst COVID-19 pandemic.
The COVID-19 pandemic has resulted in widespread shortages of personal protective equipment, including N95 respirators. Although basic surgical facemasks are more commonly available, their efficacy is limited due primarily to their poor face seal. This pilot study examined the impact of a rubber band mask brace on a basic surgical mask, as determined by quantitative fit testing. ⋯ Of the 11 subjects included in the analysis, across a range of body habitus and N95 mask fit types, all passed the quantitative fit test when the mask brace was anchored on either face shield or with a paperclip. This data suggests that although the brace does not create an N95 equivalent in terms of filtration, it would offer improved protection from airborne viruses when worn with a basic surgical mask.
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J Am Coll Emerg Physicians Open · Feb 2021
Public perspectives on firearm sales in the United States during the COVID-19 pandemic.
Amidst the COVID-19 pandemic crisis, firearm sales surged to record-breaking levels in the United States. The purpose of this study was to conduct a national assessment of the views of Americans on the change in firearm sales, the perceived impact of the changes in sales, and how these perceptions differ by a recent purchase of a firearm. ⋯ This study delineated the characteristics of those who purchased a firearm during the pandemic and the reasons for such purchases during the COVID-19 pandemic. Additional research is needed to understand the long-term impact of firearm sales during the pandemic on public health.
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J Am Coll Emerg Physicians Open · Dec 2020
Not all HEART scores are created equal: identifying "low-risk" patients at higher risk.
We sought to identify sub-groups of "low-risk" HEART score patients (history, ECG, age, risk factors, and troponin) at elevated risk of acute myocardial infarction or death within 30 days. ⋯ Among "low-risk" suspected acute coronary syndrome encounters, increasing points within each of the 5 categories demonstrated small increases in risk of death or acute myocardial infarction, with the troponin and ECG components representing the largest risk increases.