Annals of emergency medicine
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We describe the overall risk and factors associated with transitioning to persistent opioid or high-risk use after an initial emergency department (ED) opioid prescription. ⋯ Medicaid recipients are at moderate risk for conversion to persistent or high-risk opioid use after a new ED prescription. Longer or higher-dose prescriptions are associated with increased risk for conversion; however, even visits that lead to guideline-concordant prescriptions bear some risk for long-term or high-risk use.
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We examine racial and ethnic differences in opioid prescribing and dosing for long bone fractures at emergency department (ED) discharge. ⋯ Racial and ethnic minority groups with long bone fractures receive similar frequencies of opioid prescriptions at discharge, with a small potency difference. How this affects pain relief and why it happens is unclear.
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The contribution of emergency medicine clinicians' nontechnical skills in providing safe, high-quality care in the emergency department (ED) is well known. In 2015, the UK Royal College of Emergency Medicine introduced explicit validated descriptors of nontechnical skills needed to function effectively in the ED. A new nontechnical skills assessment tool that provided a score for 12 domains of nontechnical skills and detailed narrative feedback, the Extended Supervised Learning Event (ESLE), was introduced and was mandated as part of the Royal College of Emergency Medicine assessment schedule. We aim to evaluate the psychometric reliability of the ESLE in its first year of use. ⋯ Board-certified-equivalent emergency medicine supervisors are able to provide reliable assessments of emergency medicine trainees' nontechnical skills in the workplace by using the ESLE.