Annals of emergency medicine
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Case Reports
Synchronized Cardioversion Performed During Cold Water Immersion of a Heatstroke Patient.
We report a case of cardioversion that was successfully performed on a patient during cold water immersion. The patient deteriorated into unstable ventricular tachycardia while being treated for heatstroke. ⋯ There were no evident deleterious effects to the staff, the patient, or the equipment. To our knowledge, this is the first case report in the literature demonstrating the electrical cardioversion of a patient immersed in water.
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The emergency department serves as a vital source of health care for residents in the United States, including as a safety net. However, patients from minoritized racial and ethnic groups have historically experienced disproportionate barriers to accessing health care services and lower quality of services than White patients. ⋯ To address these gaps, the American College of Emergency Physicians (ACEP) convened a working group of experts in quality measurement, health disparities, and health equity to develop guidance on establishing quality measures to address racial and ethnic disparities in the provision of emergency care. Based on iterative discussion over 3 working group meetings, we present a summary of existing emergency medicine quality measures that should be adapted to track racial and ethnic disparities, as well as a framework for developing new measures that focus on disparities in access to emergency care, care delivery, and transitions of care.
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To describe characteristics and outcomes of coronavirus disease (COVID-19) patients with new supplemental oxygen requirements discharged from a large public urban emergency department (ED) with supplemental oxygen. ⋯ COVID-19 patients with new supplemental oxygen requirements discharged from the ED had survival comparable to COVID-19 ED patients with mild exertional hypoxia treated with supplemental oxygen in other settings, and this held true when the analysis was restricted to patients with nadir ED index visit oxygen saturations <90%. Discharge of select COVID-19 patients with supplemental oxygen from the ED may provide a viable alternative to hospitalization, particularly when inpatient capacity is limited.
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Social Z codes are International Classification of Diseases, Tenth Revision, Clinical Modification codes that provide one way of documenting social risk factors in electronic health records. Despite the utility and availability of these codes, no study has examined social Z code documentation prevalence in emergency department (ED) settings. ⋯ We found a very low prevalence of social Z code documentation in ED visits nationwide. More systematic social Z code documentation could support targeted social interventions, social risk payment adjustments, and future policy reforms.