CJEM
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Artificial intelligence (AI) offers opportunities for managing the complexities of clinical care in the emergency department (ED), and Clinical Decision Support has been identified as a priority application. However, there is a lack of published guidance on how to rigorously develop and evaluate these tools. We sought to answer the question, "What methodological standards should be applied to the development of AI-based Clinical Decision Support tools in the ED?". ⋯ These 11 recommendations provide guiding principles and methodological standards for emergency medicine researchers to rigorously develop AI-based Clinical Decision Support tools and for clinicians to gain knowledge and trust in using them.
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Intersex people make up 1.7-4% of the population of North America. A recent scoping review of emergency department (ED) relevant literature for the care of sexual and gender minorities found almost no representation of this population. Intersex people have unique equity, diversity, and inclusion needs in the ED, so we undertook a review of international guidelines to identify ED-relevant recommendations. ⋯ A systematic review of the literature for ED-relevant guidelines for the care of Intersex populations returned no results. Given the risk of increasing barriers to care for intersex people, and the increasing use of the ED for primary care, the requirements of Intersex people need to be investigated and integrated into future development of a CPG for care of sexual and gender minority populations in the ED.
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Patients requiring emergent endotracheal intubation are at higher risk of post-intubation hypotension due to altered physiology in critical illness. Post-intubation hypotension increases mortality and hospital length of stay, however, the impact of vasopressors on its incidence and outcomes is not known. This scoping review identified studies reporting hemodynamic data in patients undergoing emergent intubation to provide a literature overview on post-intubation hypotension in cohorts that did and did not receive vasopressors. ⋯ Patients requiring emergent intubation have a high rate of post-intubation hypotension and in-hospital mortality. While there is an intuitive rationale for the use of vasopressors during emergent intubation, current evidence is limited to support a definitive change in clinical practice at this time.
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Patients requiring emergent endotracheal intubation are at higher risk of post-intubation hypotension due to altered physiology in critical illness. Post-intubation hypotension increases mortality and hospital length of stay, however, the impact of vasopressors on its incidence and outcomes is not known. This scoping review identified studies reporting hemodynamic data in patients undergoing emergent intubation to provide a literature overview on post-intubation hypotension in cohorts that did and did not receive vasopressors. ⋯ Patients requiring emergent intubation have a high rate of post-intubation hypotension and in-hospital mortality. While there is an intuitive rationale for the use of vasopressors during emergent intubation, current evidence is limited to support a definitive change in clinical practice at this time.
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Although point of care ultrasound (POCUS) use has become prevalent in medicine, clinicians may not be familiar with the evidence supporting its utility in patient care. The objective of this study is to identify the top five most influential papers published on the use of cardiac POCUS and lung POCUS in adult patients. ⋯ We have created a list of the top five influential papers on cardiac POCUS and lung POCUS as an evidence-based resource for trainees, clinicians, and researchers. This will help trainees and clinicians better understand how to use POCUS when scanning the heart and lungs, and it will also help researchers better understand where to direct their scholarly efforts with future research.