Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Early antibiotics reduce mortality in patients with severe sepsis and septic shock. Recent work demonstrated that women experience greater delays to antibiotic administration, but it is unknown if this relationship remains after adjusting for factors such as source of infection. ⋯ Women experience longer delays to initial antibiotics among patients with severe sepsis or septic shock, even after adjusting for infectious source. Pneumonia was associated with shorter times to antibiotic administration. Future research is necessary to investigate contributors to delayed antibiotic administration in women.
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Mental illness is a growing, and largely unaddressed, problem for the population and for emergency department (ED) patients in particular. Extensive literature outlines sex and gender differences in mental illness' epidemiology and risk and protective factors. ⋯ Our consensus group used the nominal group technique to outline major gaps in knowledge and research priorities for these areas, including the influence of violence and other risk factors on the course of mental illness for ED patients. Our consensus group urges the pursuit of this research in general and conscious use of a gender lens when conducting, analyzing, and authoring future ED-based investigations of mental illness.
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Emergency physicians are confronted daily with the care of traumatically injured patients. A considerable proportion of blunt trauma cases are due to motor vehicle crashes. While men have historically been overrepresented in crash-related injuries and deaths, unfavorable trends for women in alcohol-impaired driving crashes have emerged. This extended commentary with in-depth review presents an examination of the evolving role of sex and gender in alcohol-impaired driving and its outcomes.
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Randomized Controlled Trial
A Randomized Controlled Trial of the Effects of a Brief Intervention to Increase Chlamydia and Gonorrhea Testing Uptake Among Young Adult Female Emergency Department Patients.
The objective of this study was to test the effect of a brief educational and counseling intervention on increasing the uptake of free testing for Chlamydia trachomatis (chlamydia) and Neisseria gonorrhea (gonorrhea) among young female emergency department (ED) patients. Women are particularly vulnerable to more serious consequences of these infections due to asymptomatic presentation. Increased testing is important to detect, treat, and halt the spread of these infections among asymptomatic women. ⋯ The brief intervention used in this study did not increase the uptake of testing for chlamydia and gonorrhea infections in this sample, in comparison to receiving no intervention. Although Hispanic women were more likely to accept chlamydia and gonorrhea testing, it is concerning that those women who report STI risk factors were not more likely to accept the offer of chlamydia and gonorrhea testing. Future research should focus on the refinement of an intervention protocol to focus on prior STI and lack of condom use to increase the uptake of testing among this high-risk group.
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The relationship between gender, violence, and substance use in the emergency department (ED) is complex. This article examines the role of gender in the intersection of substance use and three types of violence: peer violence, intimate partner violence, and firearm violence. Current approaches to treatment of substance abuse and violence are similar across both genders; however, as patterns of violence and substance abuse differ by gender, interventions may be more effective if they are designed with a specific gender focus.