STUDY OBJECTIVE Emergency department (ED) staffing shortages have increased reliance on locum tenens physicians (locums). We compared productivity, quality, utilization, and clinical practice measures between permanent staff, employed travelers, and locums during their first 100 shifts at a site. METHODS We performed a retrospective cohort study comparing outcomes between the 3 physician types with

STUDY OBJECTIVE To assess whether Emergency Procedures App (EPApp) use among emergency physicians improves knowledge and skill in performing corneal foreign body removal compared with usual practice. METHODS This single-blinded, multicenter, randomized trial involved emergency physicians assessing their knowledge and performance in corneal foreign body removal. Participants were randomized into 2 groups

STUDY OBJECTIVE Injury is a leading cause of hospitalization in people experiencing homelessness, yet post-injury care use is unknown. We sought to understand care use patterns in the 12 months after injury in people experiencing homelessness versus housed low-income Medicaid beneficiaries. METHODS We conducted a retrospective cohort study examining injured Medicaid beneficiaries in San Francisco from

STUDY OBJECTIVE Sepsis bundles are effective in reducing mortality for sepsis, the leading cause of admissions to intensive care units. However, little is known about factors that hinder and facilitate the delivery of sepsis bundles in emergency departments. Guided by the Exploration, Preparation, Implementation, and Sustainment (EPIS) Framework, the objective of the present study was to characterize

Hospital-at-home is an evidence-based model for delivering care in patient homes in lieu of a traditional hospital admission. Recent policy changes and technological advancement have spurred growth in hospital-at-home programs across the United States. The role of emergency medicine in hospital-at-home programs has not been clearly defined. We argue that emergency medicine should contribute to the

STUDY OBJECTIVES Brain biomarkers have been used to predict intracranial injury in both adults and children following mild traumatic brain injury (mTBI). Several biomarkers have been evaluated, including S100B, NfL, Tau, glial fibrillary acidic protein (GFAP), and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1). The combined measurement of GFAP and UCH-L1 has recently been recommended by scientific

STUDY OBJECTIVE Children with upper respiratory infections (URIs) have an increased risk of respiratory adverse events when undergoing operative anesthesia and in general populations of children receiving procedural sedation. It is unclear if children with URI undergoing emergency department (ED) sedation share the same increased risk. We aimed to determine if the presence of a URI in children undergoing

STUDY OBJECTIVE As a safety net for adolescents, the emergency department (ED) is considered an opportune setting for suicide screening and response (ie, safety assessments, brief interventions, and referrals). This study explored adolescent and caregiver perspectives on the ED's response when nonacute suicide risk was identified during universal screening. METHODS This was a qualitative study of adolescents

Suicide remains one of the leading causes of death among youth, as the incidence of suicidal ideation and attempts continue to rise. Mental health-related concerns now account for nearly 1 in 7 presentations to the emergency department (ED) among youth-approximately 7.5 million visits annually. For many children in the United States, the ED serves as their first or only point of medical contact, placing

STUDY OBJECTIVE Mismatches in the supply and demand for hospital care are important causes of emergency department (ED) crowding. The extent to which short-stay hospitalizations contribute to overall hospital capacity constraints has not been well described. METHODS Retrospective cross-sectional analysis of hospitalizations at 4 US EDs (January 2018 to June 2024). Total occupancy hours were calculated

STUDY OBJECTIVE This study sought to explore the clinical and process factors that, alone or in combination, influence the accuracy of stroke diagnosis in the emergency department (ED) by applying a novel design of experiments methodology. METHODS We used design of experiments, a branch of applied statistics, to create a screening experiment comprised of patient simulation scenarios in which purposeful

To enable emergency physicians to make well-informed triage and treatment decisions, accurate tools to evaluate the severity of diquat poisoning are needed. This study establishes severity indices for diquat poisoning (SIDPs) in assessing the risk of death for patients with acute diquat poisoning for triage purposes and 28-day mortality.

STUDY OBJECTIVE To compare the effectiveness of high-sensitivity cardiac troponin (hs-cTn) point-of-care testing to central laboratory hs-cTn measurements when investigating patients presenting to the emergency department (ED) with symptoms of acute coronary syndrome. METHODS The WESTCOR point-of-care study was a single-center prospective randomized controlled trial where we randomized patients presenting

The evaluation for suspected acute coronary syndrome is a common and high-risk presentation in emergency departments (EDs). After exclusion of acute myocardial infarction (MI), patients often undergo early (within 72 hours) noninvasive cardiac testing. We evaluated the association between early noninvasive testing and death/acute MI in ED patients suspected of acute coronary syndrome.

STUDY OBJECTIVE It is unclear which opioid-naïve emergency department (ED) patients prescribed an opioid progress to opioid use disorder. We tested the hypothesis that opioid-induced euphoria and persistent pain 2 weeks after an ED visit would be associated with persistent prescribed opioid use among opioid-naïve ED patients who presented to the ED with pain and were discharged with an opioid prescription

STUDY OBJECTIVE The COVID-19 pandemic posed exposure risk for health care personnel, potentially affecting the care for patients with cardiac arrest. We compare emergency department (ED) cardiac arrest management in patients who were suspected and not suspected of COVID-19 early in the pandemic in 2020. METHODS This was a multicenter prospective observational cohort study of cardiac arrest patients

STUDY OBJECTIVE Violence in health care settings is a growing threat to patients and clinicians. This study's objective was to describe the demographic distribution of the Dynamic Appraisal of Situational Aggression (DASA) score at emergency department (ED) triage, identifying patterns in score variability across different patient groups and exploring associations with demographic factors. METHODS

Blind placement of a transvenous pacemaker is a core emergency medicine resuscitative procedure. The commonly used balloon-tipped pacing wire is designed to allow the flow of blood returning to the heart to carry the pacer wire through the tricuspid valve and into the right ventricle. Presented here is a case of misdirection of such a pacemaker into the left pericardiophrenic vein.

STUDY OBJECTIVES We sought to identify physician and environmental factors (eg, crowding) associated with emergency physician productivity, measured as patients per hour. We also assessed whether physician productivity is associated with higher emergency department (ED) return rates. METHODS We used data from 184 EDs in 24 states staffed by a national ED group from January 2021 to December 2022. Clinical

STUDY OBJECTIVE In 2022, Choosing Wisely released recommendations to decrease the frequency of low-value testing in pediatric emergency medicine. The extent to which low-value testing occurs in US emergency departments (EDs) may vary by ED experience. We compared the frequency of low-value testing with ED volume. METHODS We conducted a cross-sectional study using data from the Healthcare Cost and Utilization

STUDY OBJECTIVE To compare 30-day mortality and return emergency department (ED) visits among older adults with delirium who are discharged home with those discharged home without delirium and those who are admitted to the hospital with and without delirium. METHODS Adults aged 75 and older years were assessed for delirium using the Delirium Triage Screen followed by the Brief Confusion Assessment

This study investigated the 1-year risk of injuries and poisonings among anabolic androgenic steroid users compared with controls from the general population.

The objective of this study was to evaluate the optimal duration of monitoring for patients with presumed opioid overdoses prior to a non-ICU admission, particularly in the context of the increasing prevalence of fentanyl analogs and other potent synthetic opioids. Given the critical role of emergency physicians in managing this public health crisis, the study aims to inform clinical decisionmaking

Practice patterns of the emergency physician workforce have garnered increasing attention in recent years. Our objective was to assess the clinical service volume preceding and settings practiced following emergency physician workforce attrition.

The National Association of Emergency Medical Services Physicians (NAEMSP), American College of Surgeons Committee on Trauma (ACS-COT), and American College of Emergency Physicians (ACEP) believe that evidence-based, pragmatic, and collaborative protocols addressing the care of patients with traumatic out-of-hospital circulatory arrest (TOHCA) are needed to optimize patient outcomes and clinician safety

To examine the effectiveness of an education intervention on emergency physician accuracy in identifying pregnancy-related findings from first-trimester point-of-care ultrasound. Case features associated with the odds of a correct response were also determined.

Cannabinoid hyperemesis syndrome is an underrecognized condition associated with recurrent vomiting and abdominal pain in individuals with prolonged cannabis use. This study used an internet-based survey targeting individuals with self-reported cannabinoid hyperemesis syndrome to assess the burden of disease and to examine associations between heavy cannabis use, early initiation of cannabis use, and

Assault-related injuries in youth are associated with poor outcomes related to physical and mental health. These youth often seek acute injury-related care in the emergency department (ED), making this an important location for violence prevention and intervention efforts. This scoping review sought to describe ED-initiated and ED-based interventions for youth with assault-related injury. We searched

STUDY OBJECTIVE To determine whether oral olanzapine or oral diazepam was more effective at achieving behavioral containment for young people presenting to the emergency department with acute severe behavioral disturbance. METHODS We conducted an open-label, multicenter, randomized controlled trial from October 22, 2021, to November 6, 2023. We enrolled young people aged between 9 and 17 years with