Articles: emergency-medicine.
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Historical Article
SEMES' long road to specialty status for emergency medicine in Spain.
July 2 of this year saw the publication of Spanish Royal Decree 610/2024, which establishes emergency medicine as an official specialization. This event represents the culmination of a long-running effort to improve the care of patients in the emergency and urgent care system and throughout the national health service. This article offers a brief account of some of the legal, administrative, and political steps the Spanish Society of Emergency Medicine(SEMES) took to achieve this goal over the course of nearly 40 years. ⋯ Competences in these areas have been shown to fall short in Spain. The article provides examples of some of the bright lights and dim shadows in our rule of law. Nonetheless, the long road traveled has also shown us how skills and knowledge are developed in adverse circumstances and crises, provided there is vocation for public service.
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Pediatric emergency care · Jun 2024
Gender Differences in Work-Life Integration, Career Satisfaction, and Burnout in Pediatric Emergency Medicine Physicians: A Cross-Sectional Analysis.
Women physicians report worse work-life integration, career satisfaction, and burnout than men. No studies have evaluated work-life integration and career satisfaction in pediatric emergency medicine (PEM) or explored gender differences for these outcomes. This study aims to (1) compare work-life integration, career satisfaction, and burnout in women and men PEM physicians and (2) compare associated individual and occupational factors to distinguish modifiable factors. ⋯ Of PEM physicians, women have worse work-life integration, less career satisfaction, and more burnout than men. The PEM community should devote resources to modifiable occupational factors to improve gender disparities in well-being parameters.
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Most children in the United States present to community hospitals for emergency department (ED) care. Those who are acutely ill and require critical care are stabilized and transferred to a tertiary pediatric hospital with intensive care capabilities. During the fall of 2022 "tripledemic," with a marked increase in viral burden, there was a nationwide surge in pediatric ED patient volume. ⋯ To combat these challenges, the pediatric ED leadership applied a disaster management framework based on the 4 S's of space, staff, stuff, and structure. We worked collaboratively with general emergency medicine leadership, nursing, respiratory therapy, pharmacy, local clinicians, our regional health care coalition, and emergency medical services (EMS) to create and implement the pediatric surge strategy. Here, we present the disaster framework strategy, the interventions employed, and the barriers and facilitators for implementation in our community hospital setting, which could be applied to other community hospital facing similar challenges.
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Natural language processing (NLP) tools including recently developed large language models (LLMs) have myriad potential applications in medical care and research, including the efficient labeling and classification of unstructured text such as electronic health record (EHR) notes. This opens the door to large-scale projects that rely on variables that are not typically recorded in a structured form, such as patient signs and symptoms. ⋯ The study demonstrated the utility of LLMs and transformer-based models in particular for extracting UTI symptoms from unstructured ED clinical notes; models were highly accurate for detecting the presence or absence of any UTI symptom on the note level, with variable performance for individual symptoms.
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Observational Study
Estimated plasma volume status is a simple and quick tool that could help define the severity of patients with infection on arrival at the emergency department.
Infectious states are subtle and rapidly evolving conditions observed daily in the emergency department (ED), and their prognostic evaluation remains a complex clinical challenge. Recently, estimated plasma volume status (ePVS) has been suggested to have a prognostic role in conditions where volemic alteration is central to the pathophysiology. The aim of this study was to verify whether ePVS recorded at ED admission can provide prognostic indications of 30-day mortality in patients with infection. ⋯ ePVS recorded on ED admission of patients with infection was an independent predictor of risk for 30-day mortality.