J Emerg Med
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Emergency departments (EDs) are often patients' first point of contact with the health care system. Race, ethnicity, and language all influence factors leading up to ED visits and patient experiences within the ED. There is limited evidence showing how race, ethnicity, and language interact to shape ED experiences, particularly during the COVID-19 pandemic when EDs were extremely strained. ⋯ Findings suggest multiple mechanisms influence hospital admissions for patients who are racially and ethnically minoritized and speak Spanish. Providers may have admitted patients as a precaution rather than because of more advanced illness. Evaluating race, ethnicity, and language concurrently can reveal how intersectional factors shape patient experiences in the ED.
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The Pulmonary Embolism Rule-Out Criteria (PERC), developed to minimize unnecessary testing in low-risk pulmonary embolism (PE) cases, lacks clear validation in the context of COVID-19. ⋯ The study demonstrates that the sensitivity and negative predictive value of the PERC are comparable in COVID-19 positive and negative patients. Furthermore, the incidence of PE among patients presenting to the emergency department did not significantly differ based on COVID-19 status. While this study highlights the relevance of the PERC in clinical decision-making, caution is advised as the PERC may not always provide reliable results when used as the sole diagnostic test.
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Multicenter Study
Association Between Emergency Medical Services Intervention Volume and Out-of-Hospital Cardiac Arrest Survival: A Propensity Score Matching Analysis.
Out of hospital cardiac arrest (OHCA) survival rates are very low. An association between institutional OHCA case volume and patient outcomes has been documented. However, whether this applies to prehospital emergency medicine services (EMS) is unknown. ⋯ 2,014 adult patients (69% male, median age 68 [57-79] years) were analyzed, 50.5% (n = 1,017) were managed by low-volume MICU and 49.5% (n = 997) by high-volume MICU. Survival on day 30 was 3.6% in the low-volume group compared to 5.1% in the high-volume group. There was no significant association between MICU volume of intervention and survival on day 30 (OR = 0.92, 95%CI [0.55;1.53]), prehospital ROSC (OR = 1.01[0.78;1.3]), ROSC at hospital admission (OR = 0.92 [0.69;1.21]), or favorable neurologic prognosis on day 30 (OR = 0.92 [0.53;1.62]).