Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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The objective was to assess the incidence of psychiatric visits among frequent emergency department (ED) users and utilization among frequent psychiatric users. ⋯ While patients with primary psychiatric visits were more likely to be frequent users of the ED, only a small percentage of frequent ED users were seen primarily and repeatedly for psychiatric care. However, this small group of frequent psychiatric users visited the ED at a much higher rate than other frequent users and was burdened with both chronic medical and psychiatric conditions.
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Multicenter Study
Factors Associated With Burnout During Emergency Medicine Residency.
While the prevalence of burnout in practicing emergency physicians has been studied, little is known of the prevalence and risk factors in emergency medicine (EM) residents. The aim of this study was to assess the prevalence of burnout among EM residents and the individual-level factors associated with burnout. ⋯ Burnout is highly prevalent in EM residents. Interventions should be targeted at 1) improving resident autonomy in the emergency department where possible, 2) supervision and instruction on medical decision-making that may affect or teach individuals to cope with risk tolerance, and 3) social supports to reduce work-home conflicts during training.
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The current paradigm of bystander cardiopulmonary resuscitation (CPR) blankets a community with training. Recently, the authors have found that high-risk neighborhoods can be identified, and CPR training can be targeted in the neighborhoods in which it is most needed. This article presents a novel method and pilot implementation trial for the HANDDS (identifying High Arrest Neighborhoods to Decrease Disparities in Survival) program. ⋯ The HANDDS program is a systematic approach to implementing a community-based CPR training program. Further research is currently being conducted in four large metropolitan U. S. cities to examine whether the results from the HANDDS program can be successfully replicated in other locations.
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The objectives were to evaluate general emergency department (ED) variation in head computed tomography (CT) use for pediatric head trauma, hospital factors associated with CT use, and recent secular trends in CT utilization for pediatric head trauma. ⋯ There is significant variability among general EDs in CT use for pediatric head trauma, indicating the need for strategies to reduce variation and improve ED imaging practices for this population.
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Ultrasonography (US) has been shown to be helpful in diagnosing fractures in the emergency department (ED) setting. The aim of this study was to determine the diagnostic accuracy of US for fractures in patients presenting to the ED with foot and/or ankle sprain and positive Ottawa foot and ankle rules. ⋯ Ultrasound had good sensitivity and specificity for diagnosing fifth metatarsal, lateral, and medial malleolus fractures in the patients with foot and/or ankle sprain. However, sensitivity and specificity of US for navicular fractures were low.