Articles: emergency-medicine.
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Scand J Trauma Resus · Oct 2023
Effect of urban vs. remote settings on prehospital time and mortality in trauma patients in Norway: a national population-based study.
Norway has a diverse population pattern and often long transport distances from injury sites to hospitals. Also, previous studies have found an increased risk of trauma-related mortality in remote areas in Norway. Studies on urban vs. remote differences on trauma outcomes from other countries are sparse and they report conflicting results.The aim of the present study was to investigate differences in prehospital time intervals in urban and remote areas in Norway and assess how prehospital time and urban vs. remote settings were associated with mortality in the Norwegian trauma population. ⋯ In this nationwide study comparing prehospital time intervals in urban and remote areas, we found that prehospital time intervals in remote areas exceeded those in urban areas. Prolonged on-scene time was found to be associated with higher odds of mortality, but remoteness itself was not.
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Magical thinking is a cognitive process characterized by beliefs in supernatural causality and the power of rituals. Grounded in personal convictions rather than objective reality, it involves subjective beliefs rather than magic tricks. Magical thinking's effects range from potentially positive, such as bringing hope and comfort, to negative consequences, including delays in seeking appropriate medical care and refusing evidence-based treatments. ⋯ For physicians and other EM professionals, addressing magical thinking requires cultural competence and empathetic engagement. Active listening and shared decision-making are essential to promote positive patient outcomes. By recognizing and understanding magical thinking and fostering effective communication, EPs can navigate the delicate balance of addressing patients' beliefs while delivering evidence-based care.
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Preventive medicine · Oct 2023
Prevalence and correlates of knife-related victimization: Insights from the 2019 Nationwide Emergency Department Sample.
Few studies have explored the incidence and general trends in knife-related victimizations in the United States (US), especially in settings where preventive interventions can potentially be initiated such as emergency departments (EDs). The goal of the present investigation was to provide an empirical portrait of the psychosocial and behavioral health characteristics of patients assaulted by sharp objects, particularly knives, as revealed in EDs in the US, as less research has focused on knife victimization in the US than internationally. This study uses data from the 2019 Nationwide Emergency Department Sample (NEDS), which is part of the Healthcare Cost and Utilization Project distributed by the Agency for Healthcare Research and Quality. ⋯ Key factors increasing the odds of knife-related victimization treated in EDs were homelessness, legal involvement, and substance use, particularly alcohol and stimulant use disorder. Somewhat surprisingly, mental health diagnosis was not associated with increased knife-related victimization. Although EDs are critical to treating knife-related victimization, they are also potentially key points to launch prevention for high-risk individuals to reduce subsequent violence stemming from escalation of interpersonal disputes.
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ACEM has endorsed the proposal for an Aboriginal Voice to Parliament in Australia as a means of delivering its objectives to provide culturally safe care in EDs and to improve health outcomes for Aboriginal and Torres Strait Islander people. Unfortunately the Voice proposal has become a politically conentious issue. ⋯ This article argues that the claims in the ACEM statement are speculative rather than based on facts. In addition, by taking a position on this complex and controversial political matter ACEM is operating beyond its remit and risks distracting attention from its core mission.