Articles: emergency-medicine.
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Severe hyperkalemia may be concealed in the electrocardiogram (ECG). We present the case of a critically ill patient with severe bradycardia and the BRASH syndrome. ⋯ In our case, hyperkalemic double counting only appeared in the ECG performed during percutaneous pacing. The Littmann sign helped with the early recognition of hyperkalemia and the BRASH syndrome.
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In recent years, the academic medicine community has produced numerous statements and calls to action condemning racism. Though health equity work examining health disparities has expanded, few studies specifically name racism as an operational construct. As emergency departments serve a high proportion of patients with social and economic disadvantage rooted in structural racism, it is critically important that racism be a focus of our academic discourse. This study examines the frequency at which four prominent emergency medicine journals, Annals of Emergency Medicine, Academic Emergency Medicine, the American Journal of Emergency Medicine, and the Western Journal of Emergency Medicine, publish on health disparities and racism. ⋯ Our findings suggest that the national discourse on racism and calls to action within emergency medicine were followed by an increase in publications on health disparities and racism. Continued investigation is needed to evaluate these trends moving forward.
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Observational Study
Assessing the precision of artificial intelligence in emergency department triage decisions: Insights from a study with ChatGPT.
The rise in emergency department presentations globally poses challenges for efficient patient management. To address this, various strategies aim to expedite patient management. Artificial intelligence's (AI) consistent performance and rapid data interpretation extend its healthcare applications, especially in emergencies. The introduction of a robust AI tool like ChatGPT, based on GPT-4 developed by OpenAI, can benefit patients and healthcare professionals by improving the speed and accuracy of resource allocation. This study examines ChatGPT's capability to predict triage outcomes based on local emergency department rules. ⋯ Our findings suggest GPT-4 possess outstanding predictive skills in triaging patients in an emergency setting. GPT-4 can serve as an effective tool to support the triage process.
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In the Emergency Department (ED), ultrasound-guided nerve blocks (UGNBs) have become a cornerstone of multimodal pain regimens. We investigated current national practices of UGNBs across academic medical center EDs, and how these trends have changed over time. ⋯ All programs participating in our study report performing UGNB in their ED, which is a 16% increase over the last 5 years. UGNB's are currently performed safely and effectively in the ED, however practice improvements can still be made. Creating multi-disciplinary committees at local and national levels can standardize guidelines and practice policies to optimize patient safety and outcomes.