The American journal of emergency medicine
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Multicenter Study
A simple scoring rule to predict survival to discharge after out of hospital cardiac arrest at the time of ED arrival.
It is important to be able to predict the chance of survival to hospital discharge upon ED arrival in order to determine whether to continue or terminate resuscitation efforts after out of hospital cardiac arrest. This study was conducted to develop and validate a simple scoring rule that could predict survival to hospital discharge at the time of ED arrival. ⋯ A simple scoring rule consisting of five, binary variables could aid in the prediction of the survival to hospital discharge at the time of ED arrival, showing comparable results to conventional machine learning classifiers.
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Multicenter Study
Injuries caused by defensive bullet launchers and resource utilization during the French yellow vests protests: A retrospective study.
In 2018, the French "Yellow Vest" social protest movement spread with weekly demonstrations resulting in confrontations between protesters and law enforcement. Non-lethal weapons, such as defensive bullet launchers (DBL) were used, and significant injuries have been reported through media, leading to public controversy regarding their use. These injuries are not well-known to civilian emergency physicians. The aim of this study is to describe the injuries caused by DBL among Emergency Department (ED) patients during these demonstrations and to identify the characteristics that required specialized care and hospital admission. ⋯ The use of DBL during the "yellow vest" civil strikes was associated with a high rate of head, face, eye or neck injuries among injured ED patients. Hospital admission was associated with a higher rate of fractures, with most of them requiring maxillofacial, orthopedic and neurosurgeries.
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Magical thinking is a cognitive process characterized by beliefs in supernatural causality and the power of rituals. Grounded in personal convictions rather than objective reality, it involves subjective beliefs rather than magic tricks. Magical thinking's effects range from potentially positive, such as bringing hope and comfort, to negative consequences, including delays in seeking appropriate medical care and refusing evidence-based treatments. ⋯ For physicians and other EM professionals, addressing magical thinking requires cultural competence and empathetic engagement. Active listening and shared decision-making are essential to promote positive patient outcomes. By recognizing and understanding magical thinking and fostering effective communication, EPs can navigate the delicate balance of addressing patients' beliefs while delivering evidence-based care.
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This study evaluates the time to attempted patient contact for positive blood cultures in patients discharged from the Emergency Department (ED) resulting when an Emergency Medicine (EM) pharmacist is on-duty compared to off-duty. ⋯ In patients discharged from the ED with subsequent positive blood cultures, time to attempted patient contact was significantly shorter when a pharmacist was on-duty. Our data emphasizes the importance of having a standardized practice in place to optimize ED patient care and outcomes and the benefit of a pharmacist's involvement in the process.
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The role of the Emergency Department (ED) as a vital constituent in Hepatitis C (HCV) screening has become increasingly evident. A key component of the ED's role in HCV screening is the ability to effectively link HCV-RNA positive patients to definitive, HCV-specific care, to include direct-acting antiviral (DAA) medication with resultant sustained virologic response (SVR). We sought to consider the rate of HCV-specific linkage, DAA initiation, and SVR obtained in HCV patients identified from an ED screening program. ⋯ An ED-based HCV screening program can result in successful HCV-specific linkage and care, to include DAA initiation and ultimately, SVR. Among linked patients, specific cohort considerations may demonstrate differences in age and insurance status which may have implications on DAA application and adherence, and therefore, individual ability to achieve SVR.