Emergency
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EDs, Community Partners Play Central Role in Slashing HIV Diagnoses in San Francisco
Emergency providers have played a strong role in helping San Francisco drastically reduce the number of new HIV infections as part of the city’s Getting to Zero initiative. In particular, the ED at Zuckerberg San Francisco General Hospital (ZSFGH) has identified 10% of all new HIV infections in the city. Working in partnership with Ward 86, the nation’s first HIV clinic, these patients and their partners have been connected to care quickly, greatly diminishing subsequent transmissions. It is a model that has been duplicated across the city to great effect.
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As Cannabis Use Proliferates, Investigators Probe What Brings Patients to the ED With Adverse Drug Events
Investigators are beginning to unearth important findings from a rich data set regarding cannabis-related ED visits at a large, academic medical center in Colorado. As states move to legalize recreational and/or medicinal cannabis use, the information is important to helping frontline providers understand how to recognize and treat such patients.
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Pilot Program in Pennsylvania Prompts EDs to Invest in Care Coordination
A more pronounced focus on care coordination is taking shape in the EDs at a cadre of rural hospitals that are participating in Pennsylvania’s new global budgeting pilot. The pilot is designed to provide a more secure revenue stream to hospitals that have been operating at a loss or with very small operating margins. However, it also signals a strong shift away from the traditional focus on volume toward value-based care and population health.
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Procedural Sedation and Analgesia in the Emergency Department
Procedural sedation and analgesia (PSA) is performed in the emergency department (ED) to alleviate anxiety, decrease pain, and provide amnesia to patients undergoing painful procedures or diagnostic imaging.This article will review guidelines for performing PSA in the ED, including suggested training, preprocedural assessment, and intraprocedural monitoring.
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Physicians Cannot Agree on Who Benefits From ICU Care
The authors of a study randomizing U.S. critical care physicians to analyze hypothetical patient vignettes found that estimates of whether a patient would benefit from ICU care were widely dissimilar among those surveyed and influenced by factors unrelated to severity of illness.
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Maintaining Oxygenation Without Increasing Aspiration Risk During Induction
In this multicenter, randomized, unblinded trial, bag-mask ventilation from time of induction to laryngoscopy was associated with higher oxygen saturations and lower incidence of severe hypoxemia compared to those not “bagged.”
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Management Guidelines for Acute Pancreatitis
There are more than 275,000 hospitalizations for acute pancreatitis per year, with more than $2.6 billion spent on care worldwide. Many of these cases require ICU admission. Mortality rates vary between 2% and 17% depending on illness severity. Despite this burden of illness, questions remain regarding the most basic elements of care.
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Sleep Tight, and Don’t Let the Ectoparasites Bite: Part 2
Providers in the pediatric emergency department frequently encounter ectoparasitic infestations. Infestations require early recognition and knowledge of effective treatment strategies. Last month, the author reviewed scabies, chiggers, and lice. This month, the bedbugs and ticks will come biting!
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New EMTALA Data Show Decline in Settlements
EMTALA’s status as an unfunded mandate and efforts to repeal the Affordable Care Act threaten the financial viability of safety-net hospitals, researchers warn, which could lead to more EMTALA violations.
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Facial Trauma Lawsuits: Half of Cases Involve Delayed or Missed Diagnosis
Lawsuits stemmed from a variety of issues, but when EPs were sued, it was usually for failure to diagnose a fracture.