Articles: emergency-medical-services.
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We described the experiences and preferences of people with opioid use disorder who access emergency department (ED) services regarding ED care and ED-based interventions. ⋯ Based on participant experiences, we recommend addressing potentially stigmatizing practices, increasing patient involvement in their care during ED visits, and increasing access to various opioid use disorder-related treatments and community support.
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Racism has not only contributed to disparities in health care outcomes, but also has negatively impacted the recruitment, retention, and promotion of historically excluded groups in academic medicine. The 2022 Society for Academic Emergency Medicine (SAEM) consensus conference, "Diversity, Equity, and Inclusion: Developing a Research Agenda for Addressing Racism in Emergency Medicine," convened a diverse group of researchers, educators, administrative leaders, and health care providers to help address the impact of racism in three domains in academic emergency medicine: clinical research, education and training, and academic leadership. The main goals of the consensus process were to identify current knowledge gaps and create a research agenda within each domain using an iterative consensus-building methodology. ⋯ This article reports the results of the consensus conference with the goal of influencing emergency care research, education, and policy and facilitating collaborations, grant funding, and publications in these domains.
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In cardiac arrest (CA), time is directly predictive of patients' prognosis. The increase in mortality resulting from delayed cardiopulmonary resuscitation has been quantified minute by minute. Times reported in CA management studies could reflect a timestamping bias referred to as "digit preference". This phenomenon leads to a preference for certain numerical values (such as 2, 5, or 10) over others (such as 13). Our objective was to investigate whether or not digit preference phenomenon could be observed in reported times of the day related to CA management, as noted in a national registry. ⋯ Prospectively collected times were considerably influenced by digit preference phenomenon. Studies that are not based on automatic time recordings and that have not evaluated and considered this bias should be interpretated with caution.
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Pediatric emergency care · Jul 2023
Effect of Prearrival Orders on Time to Antibiotics for Immunocompromised Oncology Patients Presenting to the Emergency Department With Fever.
Pediatric cancer patients with fever are at risk for invasive bacterial infection. The administration of antibiotics to these patients within the first hour of evaluation is viewed as a quality of care metric with potential to improve outcome. We sought to evaluate the impact of prearrival patient orders on the timeliness of antibiotic administration for this patient population presenting to the emergency department (ED) because of fever. ⋯ Standardizing elements of prehospital communication and ED-based care using PAO sets resulted in significant improvements in time to antibiotics and in the proportion of febrile immunocompromised oncology patients receiving antibiotics within 60 minutes of ED arrival.
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Since its publication in 2001, the National EMS Research Agenda has brought attention to a relative paucity of emergency medical services (EMS)-specific research and has called for an increase in funding and infrastructure to support EMS research. We investigated the trends in EMS-specific publications and National Institutes of Health (NIH)-funded research grants in the 20 years since this landmark publication. ⋯ Although total publications have doubled in the United States over the past 20 years, EMS-specific research has more than tripled and the number of funded EMS research grants has increased nearly 5-fold. Future evaluation should examine the quality of this research and its application to clinical practice.