CJEM
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The history, ECG, age, risk factor (HEAR) score has been proposed to identify patients at sufficiently low risk of acute coronary syndrome that they may not require troponin testing. The objective of this study was to externally validate a low HEAR score to identify emergency department (ED) patients with chest pain at very low risk of 30-day major adverse cardiac events (MACE). ⋯ A HEAR score ≤ 1 can identify more than 17% of all patients as very low risk for index AMI and 30-day MACE and unlikely to benefit from troponin testing. Broad implementation of this strategy could lead to significant resource savings.
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The primary objective of this study is to identify emergency physician reported barriers to initiating patients on buprenorphine/naloxone in the emergency department (ED) for treatment of opioid use disorder. Secondary objectives include (1) physician reported attitudes about initiating buprenorphine/naloxone in the ED, and (2) comparison of barriers reported based on urban versus rural practice setting. ⋯ In this convenience sample of physicians working in urban and rural Canadian emergency departments, most physicians perceive barriers that inhibit their ability to initiate buprenorphine/naloxone for patients with opioid use disorder, but overall there is support for making changes to better facilitate this practice.