Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Randomized Controlled Trial Multicenter Study
Emergency Potassium Normalization Treatment Including Sodium Zirconium Cyclosilicate: A Phase II, Randomized, Double-Blind, Placebo-Controlled Study (ENERGIZE).
Sodium zirconium cyclosilicate (SZC) is a novel, highly selective potassium binder currently approved in the United States and European Union for treatment of hyperkalemia. This pilot evaluation explored the efficacy of SZC with insulin and glucose as hyperkalemia treatment in the emergency department (ED). ⋯ This pilot study suggested that SZC with insulin and glucose may provide an incremental benefit in the emergency treatment of hyperkalemia over insulin and glucose alone.
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Providers often pursue imaging in patients at low risk of pulmonary embolism (PE), resulting in imaging yields <10% and false-positive imaging rates of 10% to 25%. Attempts to curb overtesting have had only modest success and no interventions have used implementation science frameworks. The objective of this study was to identify barriers and facilitators to the adoption of evidence-based diagnostic testing for PE. ⋯ This exploration of the use of risk stratification tools in the evaluation of PE found that barriers to use primarily exist at the provider level, whereas facilitators to the use of these tools are largely perceived at the level of the institution. Future efforts to promote the evidence-based diagnosis of PE should be informed by these determinants.
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Observational Study
Impact of Physician-Patient Language Concordance on Patient Outcomes and Adherence to Clinical Chest Pain Recommendations.
The objective was to evaluate if there is an association between patient-physician language concordance and adverse patient outcomes or physician adherence to clinical recommendations for emergency department (ED) patients with chest pain. ⋯ No associations were found between patient-physician language concordance and outcomes or physician adherence to clinical recommendations for ED patients with chest pain. Accessible and effective interpretation services, combined with a decision support tool with standard clinical recommendations, may have contributed to equitable care.
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Rapid and early severity-of-illness assessment appears to be important for critically ill patients with novel coronavirus disease (COVID-19). This study aimed to evaluate the performance of the rapid scoring system on admission of these patients. ⋯ To our knowledge, this study was the first exploration on rapid scoring systems for critically ill patients with COVID-19. The REMS could provide emergency clinicians with an effective adjunct risk stratification tool for critically ill patients with COVID-19, especially for the patients aged <65 years. The effectiveness of REMS for screening these patients is attributed to its high negative predictive value.