Annals of emergency medicine
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Observational Study
Impact of Atrial Fibrillation Case Volume in the Emergency Department on Early and Late Outcomes of Patients With New Atrial Fibrillation.
To define the association between atrial fibrillation case volume in the emergency department and death or all-cause hospitalization at 30 days and 1 year in patients with new atrial fibrillation. Secondary objectives examined repeat ED visits and the management of atrial fibrillation within 90 days. ⋯ Treatment in higher volume EDs was associated with significantly lower admission rates and repeat ED visits but no difference in survival.
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In a large-scale disaster, recruiting from all retired and nonworking registered nurses is one strategy to address surge demands in the emergency nursing workforce. The purpose of this research was to estimate the workforce capacity of all registered nurses who are not currently working in the nursing field in the United States by state of residence and to describe the job mobility of emergency nurses. ⋯ There is an additional and reserve capacity available for recruitment that may help to meet the workforce needs for nursing, specifically emergency nurses and nurse practitioners, across the United States under conditions of a large-scale disaster. The results from this study may be used by the emergency care sector leaders to inform policies, workforce recruitment, workforce geographic mobility, new graduate nurse training, and job accommodation strategies to fully leverage the potential productive human capacity in emergency department care for registered nurses who are not currently working.
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We performed a methodological appraisal of the history, electrocardiogram, age, risk factors, and troponin (HEART) score and its variants in the context of Annals of Emergency Medicine's methodological standards for clinical decision rules. We note that this chest pain risk stratification tool was not formally derived, omits sex and other known predictors, has weak interrater reliability, and its 0, 1, and 2 score weightings do not align with their known predictivities. ⋯ Two variants (HEART Pathway, HEART-2) have the same inherent structural limitations and demonstrate slightly better but still suboptimal sensitivity. Although a simple prediction tool for chest pain outcomes is appealing, we believe that the widespread use of the HEART score and its variants should be reconsidered.