Articles: emergency-medicine.
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When weighing the costs and benefits of "choosing wisely," in a healthcare climate that continues to stress cost-saving practices, it is difficult to argue with approaching low-risk patients with conservative approaches and treatments. In defense of liberal and broad approaches to patient workups, however, one must also weigh the bounce-back emergency department (ED) visit, which may represent either a failure of initial evaluation or a success of appropriate return precautions. ⋯ Magnetic Resonance Imaging (MRI) of the brain and spine demonstrated extensive and multifocal areas of signal abnormalities consistent with active demyelination concerning for acute disseminated encephalomyelitis (ADEM). Additional lab workup demonstrated seropositive myelin oligodendrocyte glycoprotein (MOG) antibodies, further supporting the diagnosis of ADEM, an immune-mediated disorder which can lead to rapid multifocal neurologic dysfunction.
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In the management of large vessel occlusion stroke (LVOS), patients are frequently evaluated first at a non-endovascular stroke center and later transferred to an endovascular stroke center (ESC) for endovascular treatment (EVT). The door-in-door-out time (DIDO) is frequently used as a benchmark for transferring hospitals though there is no universally accepted nor evidenced-based DIDO time. The goal of this study was to identify factors affecting DIDO times in LVOS patients who ultimately underwent EVT. ⋯ Vascular imaging and non-stroke certified stroke centers were associated with longer DIDO times. Non-ESCs should integrate vascular imaging into their workflow as feasible to reduce DIDO times. Further work examining other details regarding the transfer process such as transfer via ground or air, could help further identify opportunities to improve DIDO times.
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Given the popularity of educational blogs and podcasts in medicine, learners and educators need tools to identify trusted and impactful sites. The Social Media Index was a multi-sourced formula to rank the effect of emergency medicine and critical care blogs. In 2022, a key data point for the Social Media Index became unavailable. This bibliometric study aimed to develop a new measure, the Digital Impact Factor, as a replacement. ⋯ The Digital Impact Factor is a measure of the relative effect of educational blogs and podcasts within emergency medicine and critical care.