The American journal of emergency medicine
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Primary disasters may result in mass casualty events with serious injuries, including crush injury and crush syndrome. ⋯ Crush injury and crush syndrome are common in natural and human-made disasters. Emergency clinicians must understand the pathophysiology, evaluation, and management of these conditions to optimize patient care.
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Riding a motorcycle without a helmet represents a public health risk that can result in disabling injuries or death. We aim to provide a comprehensive analysis of the impact of helmet use on motorcycle injuries, injury types, and fatalities, to highlight areas requiring future intervention. ⋯ Prognostic and epidemiological, level III.
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Thyroid storm is a rare but serious condition that carries a high rate of morbidity and even mortality. ⋯ An understanding of thyroid storm can assist emergency clinicians in diagnosing and managing this potentially deadly disease.
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The HEART score for risk stratifying chest pain patients in the emergency department (ED) has been widely adopted in clinical practice, but is often employed with nonconformant serial troponin measurements. ⋯ Our data suggest serial measurement of conventional troponin provides limited added benefit in low risk HEART score patients, regardless of duration and timing of symptoms. Conversely, serial troponin measurement may confer utility in moderate/high risk HEART score patients, particularly those presenting within 3 h of symptoms.
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Peer recovery coaches and emergency department utilization in patients with substance use disorders.
Although Emergency Departments (ED) frequently provide care for patients with substance use disorders (SUD), there are many barriers to connecting them with appropriate long-term treatment. One approach to subside risk in this population is the Peer Recovery Coach (PRC). PRCs are individuals with a lived experience of the rehabilitation process and are a powerful resource to bridge this gap in care by engaging patients and their families and providing system navigation, self-empowerment for behavior change, and harm reduction strategies. The purpose of this project is to describe an ED-based PRC program, evaluating its feasibility and efficacy. ⋯ We describe the implementation of an ED-based PRC program for patients with substance use disorders. While we demonstrated that it is feasible for the PRC to engage the patient while in the ED, there was poor follow-up with the program outpatient. For patients with at least one previous SUD visit to the ED, there was a statistically significant reduction in ED utilization after engaging with a PRC while in the ED, suggesting this may be a population that could be targeted to link patients to long term care and decrease repeated ED utilization.