Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Violence is one of the leading causes of death among youth ages 14 to 24. Hospital- and emergency department (ED)-based violence prevention programs are increasingly becoming a critical part of public health efforts; however, evaluation of prevention efforts is needed to create evidence-based best practices. Retention of study participants is key to evaluations, although little literature exists regarding optimizing follow-up methods for violently injured youth. This study aims to describe the methods for retention in youth violence studies and the characteristics of hard-to-reach participants. ⋯ The FYI study demonstrated that achieving high follow-up rates for a difficult-to-track, violently-injured ED population is feasible through the use of established contact strategies and a variety of interview locations. Results have implications for follow-up strategies planned as part of other violence prevention studies.
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Observational Study
Evaluation of a Screening Tool for Child Sex Trafficking Among Patients With High-Risk Chief Complaints in a Pediatric Emergency Department.
The objective was to apply and evaluate a screening tool to identify victims of child sex trafficking (CST) in a pediatric emergency department (PED) population. ⋯ Applied to an inner-city PED population of 203 participants with high-risk chief complaints, the screening tool has high sensitivity and high NPV. This makes it appropriate for an initial screening to rule out CST in this high-risk population. Applicability for broader use and additional practice settings are warranted given the significant positivity rate among those presenting with high-risk concerns.
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Multicenter Study
Emergency Department Adult Fiberoptic Intubations: Incidence, Indications, and Implications for Training.
The objective was to describe the frequency, indications, and outcomes of flexible fiberoptic intubations (FFI) performed in the emergency department (ED). ⋯ Emergency department FFI is uncommon and typically used as a nonsurgical alternative for airway obstruction. First-attempt ED FFI is successful in half of cases and in two-thirds of rescue attempts. These data provide an important baseline to help better characterize the nature of FFI as a rare critical procedure in the ED and offer an empiric basis for ongoing discussions on the optimal role of FFI in ED training and practice.
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Observational Study
Validation of the Brief Confusion Assessment Method for screening delirium in elderly medical patients in a German emergency department.
Delirium is frequent in elderly patients presenting in the emergency department (ED). Despite the severe prognosis, the majority of delirium cases remain undetected by emergency physicians (EPs). At the time of our study there was no valid delirium screening tool available for EDs in German-speaking regions. We aimed to evaluate the brief Confusion Assessment Method (bCAM) for a German ED during the daily work routine. ⋯ This was the first study evaluating the bCAM for a German ED and when performed by EPs during routine work. The bCAM showed good specificity, but only moderate sensitivity. Nevertheless, application of the bCAM most likely improves the delirium detection rate in German EDs. However, it should only be applied by trained physicians to maximize diagnostic accuracy and hence improve the bCAM's sensitivity. Future studies should refine the bCAM.