The American journal of emergency medicine
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The impact of coronavirus disease 2019 (COVID-19) on unintentional pediatric poisonings is unclear. We examined changes in emergency department (ED) visits and hospitalizations for poisonings before and during the COVID-19 pandemic. We compared changes in cannabis vs non-cannabis poisoning events given the recent legalization of cannabis in October 2018 and cannabis edibles in January 2020. ⋯ The COVID-19 pandemic was not associated with increases in any type of unintentional pediatric poisonings, with the exception of cannabis poisonings. Increased cannabis poisonings may be explained by the legalization of non-medical cannabis edibles in Canada in January 2020.
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Observational Study
Code De-Escalation: Decreasing restraint use during agitation management in a community hospital emergency department.
Restraint use in the emergency department (ED) can pose significant risks to patients and health care workers. We evaluate the effectiveness of Code De-escalation- a standardized, team-based approach for management and assessment of threatening behaviors- in reducing physical restraint use and workplace violence in a community ED. ⋯ A standardized de-escalation algorithm can be effective in helping ED's decrease their use of physical restraints in management of psychiatric patients experiencing agitation.
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The "allergy epidemic" of the Western World, has led to an overwhelming number of emergency department presentations with allergic rhinitis, allergic conjunctivitis, atopic eczema, and asthma. Careful consideration should be given to screening for the typical signs and symptoms of Mixed connective tissue disease (MCTD) in patients presenting to the ED with what appears to be a simple allergic process. MCTD is a rare systemic rheumatic disease characterized by high levels of anti-U1RNP antibodies and various clinical signs and symptoms. ⋯ The patient was evaluated by the Allergy and Rheumatology services. The patient was ultimately diagnosed with MCTD-Myositis Overlap Syndrome and started on steroids and IVIG with improvement in symptoms. While MCTD is not a diagnosis readily made in the ED, early identification and treatment of the disease is critical for prevention of long term complications.
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As artificial intelligence (AI) expands its presence in healthcare, particularly within emergency medicine (EM), there is growing urgency to explore the ethical and practical considerations surrounding its adoption. AI holds the potential to revolutionize how emergency physicians (EPs) make clinical decisions, but AI's complexity often surpasses EPs' capacity to provide patients with informed consent regarding its use. This article underscores the crucial need to address the ethical pitfalls of AI in EM. ⋯ The central question arises: Are EPs equipped with the necessary knowledge to offer well-informed consent regarding clinical AI? Collaborative efforts between EPs, bioethicists, AI researchers, and healthcare administrators are essential for the development and implementation of optimal AI practices in EM. To facilitate informed consent about AI, EPs should understand at least seven key areas: (1) how AI systems operate; (2) whether AI systems are understandable and trustworthy; (3) the limitations of and errors AI systems make; (4) how disagreements between the EP and AI are resolved; (5) whether the patient's personally identifiable information (PII) and the AI computer systems will be secure; (6) if the AI system functions reliably (has been validated); and (7) if the AI program exhibits bias. This article addresses each of these critical issues, aiming to empower EPs with the knowledge required to navigate the intersection of AI and informed consent in EM.