Annals of emergency medicine
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Comparative Study
National Study of the Emergency Physician Workforce, 2020.
We describe the current US emergency physician workforce. ⋯ Urban emergency physicians in 2020 remain substantially younger than rural emergency physicians, with many rural ones near the US retirement age. We did not observe a continued increase in the percentage of female physicians among emergency physicians. Given the ongoing demand for physicians in all US emergency departments, this analysis provides essential information for understanding the current emergency physician workforce and the challenges ahead.
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Case Reports
Urgent Subconjunctival Needle Decompression for Orbital Compartment Emphysema Caused by Compressed Air Injury.
Orbital compartment syndrome is a critical ophthalmic emergency that needs urgent diagnosis and treatment to prevent permanent vision loss caused by optic nerve compression or retinal ischemia. In this article, we present a child with orbital compartment syndrome caused by orbital emphysema as a result of a rare type of ocular trauma and introduce a simple technique to decompress the pressure. The patient was a 4-year-old boy who experienced a compressed air blast to his left eye. ⋯ The pressure was immediately relieved under intravenous sedation by inserting a 27-gauge needle into the chemotic subconjunctival space at the lower lid fornix, followed by gentle manipulation of the globe to help the air escape through the needle. Compressed air injury is a rare type of orbital trauma, and this patient constituted the youngest case ever reported in the English literature, to our knowledge. Air decompression through the conjunctiva as described in this article is a useful technique that can be applied by emergency medicine specialists with special caution for patients with orbital compartment syndrome and orbital emphysema caused by compressed air injury.
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Concurrent use of amphetamine-type stimulants among individuals with opioid use disorder can exacerbate social and medical harms, including overdose risk. The study evaluated rates of amphetamine-type stimulant use among patients with untreated opioid use disorder presenting at emergency departments in Baltimore, MD; New York, NY; Cincinnati, OH; and Seattle, WA. ⋯ Amphetamine-type stimulant use among ED patients with untreated opioid use disorder was associated with distinct sociodemographic, social, and health factors. Improved ED-based screening, intervention, and referral protocols for patients with opioid use disorder and amphetamine-type stimulant use are needed.