Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
-
For emergency department (ED) patients, lung cancer may be detected early through incidental lung nodules (ILNs) discovered on chest CTs. However, there are significant errors in the communication and follow-up of incidental findings on ED imaging, particularly due to unstructured radiology reports. Natural language processing (NLP) can aid in identifying ILNs requiring follow-up, potentially reducing errors from missed follow-up. We sought to develop an open-access, three-step NLP pipeline specifically for this purpose. ⋯ We developed an accurate, open-access pipeline to identify ILNs with recommended follow-up on ED chest CTs. While the prevalence of recommended follow-up is lower than some prior studies, it more accurately reflects the prevalence of truly incidental findings without prior or known malignancy. Incorporating this tool could reduce errors by improving the identification, communication, and tracking of ILNs.
-
Gender-minority youth, whose gender identity differs from their sex assigned at birth, have elevated suicide risk compared to cisgender youth, yet few studies examine their suicide risk in the emergency department (ED). Our objectives were to determine the prevalence of and assess risk and protective factors associated with prior suicide attempt (SA) and recent suicide ideation (SI) among gender-minority adolescents in the ED. ⋯ Among gender-minority ED adolescent patients, one in three experienced a SA prior to the ED visit. One in four endorsed SI within 2 weeks of the ED visit. The identified risk and protective factors among gender-minority adolescents may inform future ED-based efforts to detect and reduce suicide risk.
-
Emergency department (ED) visits may serve as opportunities for firearm injury prevention and intervention efforts. Our objective was to determine ED utilization by youth before and after firearm injury. ⋯ Youth have high rates of ED utilization before and after firearm injury. Half of firearm-injured youth receive their emergency care exclusively in general EDs. Implementing firearm injury prevention and intervention efforts in all ED settings is critical.
-
Alcohol withdrawal syndrome (AWS) is a common condition prompting emergency department (ED) presentation. However, there are limited recent, large-scale, robust data available on the incidence, admission, and medical treatment of AWS in the ED. ⋯ AWS represents a common reason for ED presentation, with most patients being admitted. We identified a rising incidence with a shift in management to include agents such as phenobarbital and gabapentin. These findings provide important evidence on current trends in AWS to inform health policy and knowledge translation efforts as well as emphasizing the need for ongoing research and evaluation of clinical practices to optimize outcomes for patients with AWS.