The American journal of emergency medicine
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Hand injuries represent the most common and potentially serious injuries associated with the use of snow blowers. Little research has been conducted on a national scale to examine these types of injuries. Therefore, the purpose of the study was to examine hand injuries among patients treated in an emergency department (ED) related to attempting to clear snow out of a clogged snow blower. ⋯ Hand injuries remain the main threat of injury among snow blower operators. While trends are declining, given the seriousness of the injuries involved, further public health education campaigns and design modifications are warranted.
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Identifying communities at high risk of stroke is an important step in improving systems of stroke care. Stroke is known to show spatial clustering at the state and county levels, but it is not known if clusters are present within city boundaries. ⋯ This is the first study to demonstrate that stroke shows clustering at the neighborhood level within many major cities in the United States and within all of the largest cities. Understanding where stroke clusters exist within cities can form the basis of optimizing emergency medical services deployment and improving systems of stroke care.
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Observational Study
Multiple intubation attempts in the emergency department and in-hospital mortality: A retrospective observational study.
Multiple intubation attempts in the Emergency Department (ED) have been associated with adverse events, but no study examined the influence of multiple intubation attempts on survival during hospitalization. Our aim was to compare one or more intubation attempts in the ED with risk of morbidity and mortality during hospitalization. ⋯ We found multiple intubation attempts were not associated with increased mortality and morbidity during hospitalization.
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Observational Study
Initiation of the ABCD3-I algorithm for expediated evaluation of transient ischemic attack patients in an emergency department.
The use of ABCD3-I score for Transient ischemic attack (TIA) evaluation has not been widely investigated in the ED. We aim to determine the performance and cost-effectiveness of an ABCD3-I based pathway for expedited evaluation of TIA patients in the ED. ⋯ The initiation of an ABCD3-I based pathway for TIA evaluation in the ED significantly decreased hospital admissions and cost with similar 90-day neurological outcomes.
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Prescription opioid related deaths have increased dramatically over the past 17 years. Although emergency physicians (EPs) have not been the primary force behind this rise, previous literature have suggested that EPs could improve their opioid prescribing practices. We designed this study to evaluate the trend in emergency department (ED) opioid prescriptions over time during the US opioid epidemic. ⋯ ED physicians are prescribing less opiates, while increasing the amount of non-narcotic analgesic prescriptions. This may be in response to the literature suggesting that prescription opioids play a large role in the opioids crisis. This decrease in opioid prescriptions did not increase the need for repeat ED visits.