Articles: emergency-medicine.
-
This study aimed to determine whether myocardial infarction (MI) could be safely diagnosed or excluded within 30 min instead of 1 h. ⋯ The 0-h/30-min algorithm is as effective as the 0-h/1-h algorithm in safely ruling out MI and may offer improved diagnostic efficiency in ruling in MI.
-
Large language models (LLMs) have grown in popularity in recent months and have demonstrated advanced clinical reasoning ability. Given the need to prioritize the sickest patients requesting emergency medical services (EMS), we attempted to identify if an LLM could accurately triage ambulance requests using real-world data from a major metropolitan area. ⋯ Our preliminary analysis indicates LLMs may have the potential to become a useful tool for triage and resource allocation in emergency care settings, especially in cases where there is consensus among subject matter experts. Further research is needed to better understand and clarify how they may best be of service.
-
Pediatric emergency care · Dec 2024
Use of Emergency Telemedicine Physicians for Telephone Triage Disposition of Pediatric Patients.
Telemedicine is a growing field, with limited data around its utility supporting pediatric emergency care telephone triage. We instituted telemedicine physician support for nurse telephone triage decisions. When the nursing protocols recommended urgent or emergent care, a telemedicine physician reviewed and modified care urgency if appropriate. Our primary study objectives were to evaluate the proportion of patients who were downgraded to less urgent care and assess for potential harm related to the downgrade in care urgency. ⋯ Our data suggests that telemedicine physicians can safely downgrade nurse triage care recommendations for pediatric patients. Most downgraded patients sought outpatient care, avoiding unnecessary utilization of the emergency department without evidence of associated harm.
-
Pediatric emergency care · Dec 2024
Pediatric Emergency Medicine Physicians' Perspectives of Concussion in Young Children.
Traumatic brain injury (TBI) during early childhood (before 6 years) is prevalent, accounting for rising rates of emergency department visits. These injuries may lead to postconcussive symptoms, which may be subtle and difficult to diagnose in young children. Inadequate discharge counseling may lead to prolonged duration of symptoms and possible developmental delays. We aimed to explore pediatric emergency medicine (PEM) physicians' perspectives on "concussion" terminology, diagnosis, and management, specifically in a young child with mild TBI. ⋯ Variability exists among PEM physicians in diagnosis and management of concussions in young children. Discomfort with lack of reliability of symptoms and underappreciation of typical early childhood characteristics may account for findings. Educational initiatives, age-appropriate clinical tools and treatment-guided outcomes research are needed to guide PEM physicians in the care of young children with head injuries.