Articles: emergency-medicine.
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Emerg Med Australas · Feb 2025
ReviewReview article: Coaching in emergency medicine: A systematic review and future research agenda.
Coaching as a discipline has seen significant growth in medicine over the last decade, especially in medical education, but is at the early stages of recognition in emergency medicine. The objective of this systematic review was to provide insight into the state of coaching practice and research in emergency medicine and outline a future research agenda. Based on PRISMA guidelines, a structured electronic literature search of Embase, Scopus and EBSCOhost was conducted. ⋯ Our review revealed three key findings: coaching is examined in relation to clinician well-being and resilience, non-technical skills, and clinician technical skills, however its influence upon non-technical skills is the main focus; coaching studies are predominantly outcome studies, with process studies receiving little attention and; a range of theories and models are used in studies of coaching in emergency medicine. This review revealed that coaching research in emergency medicine is in its infancy, highly fragmented and largely disconnected from the wider coaching research literature. Nevertheless, despite the early stages of the current research base of coaching in emergency medicine, this nascent field is rich with opportunities for future research.
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Pediatric emergency care · Feb 2025
Clinical Practice Guideline Development in Pediatric Emergency Medicine Departments Across the United States: A Cross-sectional Study.
This cross-sectional study aimed to assess the process of clinical practice guideline (CPG) development in pediatric emergency medicine departments (PEDs) across the United States, with a focus on identifying areas for improvement to enhance the quality of CPGs. ⋯ Our findings highlight need for improvement in the CPG development process in PEDs. Including patients in committees, providing formal training for committee members, and adopting a rigorous approach to grading recommendations are crucial steps toward enhancing guideline quality. Emphasizing these improvements has the potential to improve the quality of CPGs for pediatric emergency care.
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Observational Study
Pragmatic evaluation of point of care lung ultrasound for the triage of COVID-19 patients using a simple scoring matrix: Intraclass-classification and predictive value.
The value of routine bedside lung ultrasound (LUS) for predicting patient disposition during visits to the Emergency Department (ED) is difficult to quantify. We hypothesized that a simplified scoring of bedside-acquired LUS images for the triage of acute respiratory symptoms in the ED would be associated with patient disposition. ⋯ A simplified scoring of bedside-acquired LUS images from patients with acute respiratory symptoms at the emergency department reliably predicts patient disposition.
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In patients with a high clinical probability of pulmonary embolism (PE), the high prevalence can lower the D-dimer negative predictive value and increase the risk of diagnostic failure. It is therefore recommended that these high-risk patients should undergo chest imaging without D-dimer testing although no evidence supports this recommendation. ⋯ In this study, ruling out PE in high-risk patients based on D-dimer below the age-adjusted threshold was safe, with no missed PE. However, the large CI of the primary endpoint precludes a definitive conclusion.
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Emerg Med Australas · Feb 2025
Rate and yield of imaging for acute pyelonephritis in the emergency department: A retrospective cohort study.
The role of imaging in acute pyelonephritis (APN) in the ED is poorly understood, with variability among clinical guidelines for when patients should be imaged, and the modality of imaging. The objective of this study was to identify the proportion of patients with APN being imaged, the proportion abnormal findings, and the association between abnormal imaging and discharge disposition. ⋯ Among patients with APN, abnormalities on imaging were common and both imaging and abnormalities on imaging were associated with hospital ward admission. This suggests that there is possible utility of early and routine imaging for patients with APN to allow clinicians to efficiently make decisions about patient disposition.