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Trends In Us Emergency Department Use After Sexual Assault, 2006-2019, Emily L. Vogt, Charley Jiang, Quinton Jenkins, Maya J. Millette, Martina T. Caldwell, Kathleen S. Mehari, Erica E. Marsh

Emergency Medicine Articles

IMPORTANCE: Adult sexual assault (SA) survivors experience numerous emergent health problems, yet few seek emergency medical care. Quantifying the number and types of survivors presenting to US emergency departments (EDs) after SA can inform health care delivery strategies to reduce survivor morbidity and mortality.

OBJECTIVE: To quantify ED use and factors that influenced seeking ED care for adult SA from 2006 through 2019.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used SA data from the Nationwide Emergency Department Sample from 2006 through 2019, which includes more than 35.8 million observations of US ED visits from 989 hospitals, a 20% stratified …

Predicting At-Risk Opioid Use Three Months After Ed Visit For Trauma: Results From The Aurora Study, Brittany E. Punches, Uwe Stolz, Caroline E. Freiermuth, Rachel M. Ancona, Samuel A. Mclean, Stacey L. House, Francesca L. Beaudoin, Xinming An, Jennifer S. Stevens, Donglin Zeng, Thomas C. Neylan, Gari D. Clifford, Tanja Jovanovic, Sarah D. Linnstaedt, Laura T. Germine, Kenneth A. Bollen, Scott L. Rauch, John P. Haran, Alan B. Storrow, Christopher A. Lewandowski, Paul I. Musey, Phyllis L. Hendry, Sophia Sheikh, Christopher W. Jones, Michael C. Kurz, Nina T. Gentile, Meghan E. Mcgrath, Lauren A. Hudak, Jose L. Pascual, Mark J. Seamon, Erica Harris, Anna M. Chang, Claire Pearson, David A. Peak, Roland C. Merchant, Robert M. Domeier, Niels K. Rathlev, Brian J. O'Neil, Leon D. Sanchez, Steven E. Bruce, Robert H. Pietrzak, Jutta Joormann, Deanna M. Barch, Diego A. Pizzagalli, Jordan W. Smoller, Beatriz Luna, Steven E. Harte, James M. Elliott, Ronald C. Kessler, Kerry J. Ressler, Karestan C. Koenen, Michael S. Lyons

Emergency Medicine Articles

OBJECTIVE: Whether short-term, low-potency opioid prescriptions for acute pain lead to future at-risk opioid use remains controversial and inadequately characterized. Our objective was to measure the association between emergency department (ED) opioid analgesic exposure after a physical, trauma-related event and subsequent opioid use. We hypothesized ED opioid analgesic exposure is associated with subsequent at-risk opioid use.

METHODS: Participants were enrolled in AURORA, a prospective cohort study of adult patients in 29 U.S., urban EDs receiving care for a traumatic event. Exclusion criteria were hospital admission, persons reporting any non-medical opioid use (e.g., opioids without prescription or taking more than prescribed …

Symptomatic, Clinical And Biomarker Associations For Mortality In Hospitalized Covid-19 Patients Enriched For African Americans, Hassan Ashktorab, Antonio Pizuorno, Folake Adeleye, Adeyinka Laiyemo, Maryam Mehdipour Dalivand, Farshad Aduli, Zaki A Sherif, Gholamreza Oskrochi, Kibreab Angesom, Philip Oppong-Twene, Suryanarayana Reddy Challa, Nnaemeka Okorie, Esther S Moon, Edward Romos, Boubini Jones-Wonni, Abdoul Madjid Kone, Sheldon Rankine, Camelita Thrift, Derek Scholes, Chiamaka Ekwunazu, Abigail Banson, Brianna Mitchell, Guttu Maskalo, Jillian Ross, Julencia Curtis, Rachel Kim, Chandler Gilliard, Geetha Ahuja, Joseph Mathew, Warren Gavin, Areeba Kara, Manuel Hache-Marliere, Leonidas Palaiodimos, Vishnu R. Mani, Aleksandr Kalabin, Vijay Reddy Gayam, Pavani Reddy Garlapati, Joseph B. Miller Md, Lakshmi Gayathri Chirumamilla, Fatimah Jackson, John M. Carethers, Farin Kamangar, Hassan Brim

Emergency Medicine Articles

BACKGROUND AND AIMS: Initial reports on US COVID-19 showed different outcomes in different races. In this study we use a diverse large cohort of hospitalized COVID-19 patients to determine predictors of mortality.

METHODS: We analyzed data from hospitalized COVID-19 patients (n = 5852) between March 2020- August 2020 from 8 hospitals across the US. Demographics, comorbidities, symptoms and laboratory data were collected.

RESULTS: The cohort contained 3,662 (61.7%) African Americans (AA), 286 (5%) American Latinx (LAT), 1,407 (23.9%), European Americans (EA), and 93 (1.5%) American Asians (AS). Survivors and non-survivors mean ages in years were 58 and 68 for AA, …

Auxora Vs. Placebo For The Treatment Of Patients With Severe Covid-19 Pneumonia: A Randomized-Controlled Clinical Trial, Charles Bruen, Mukhtar Al-Saadi, Edward A. Michelson, Maged Tanios, Raul Mendoza-Ayala, Joseph B. Miller, Jeffrey Zhang, Kenneth Stauderman, Sudarshan Hebbar, Peter C. Hou

Emergency Medicine Articles

BACKGROUND: Calcium release-activated calcium (CRAC) channel inhibitors block proinflammatory cytokine release, preserve endothelial integrity and may effectively treat patients with severe COVID-19 pneumonia.

METHODS: CARDEA was a phase 2, randomized, double-blind, placebo-controlled trial evaluating the addition of Auxora, a CRAC channel inhibitor, to corticosteroids and standard of care in adults with severe COVID-19 pneumonia. Eligible patients were adults with ≥ 1 symptom consistent with COVID-19 infection, a diagnosis of COVID-19 confirmed by laboratory testing using polymerase chain reaction or other assay, and pneumonia documented by chest imaging. Patients were also required to be receiving oxygen therapy using either a high …

Identifying Indicators Influencing Emergency Department Performance During A Medical Surge: A Consensus-Based Modified Fuzzy Delphi Approach, Egbe-Etu Etu, Leslie Monplaisir, Celestine Aguwa, Suzan Arslanturk, Sara Masoud, Ihor Markevych, Joseph B. Miller

Emergency Medicine Articles

During a medical surge, resource scarcity and other factors influence the performance of the healthcare systems. To enhance their performance, hospitals need to identify the critical indicators that affect their operations for better decision-making. This study aims to model a pertinent set of indicators for improving emergency departments' (ED) performance during a medical surge. The framework comprises a three-stage process to survey, evaluate, and rank such indicators in a systematic approach. The first stage consists of a survey based on the literature and interviews to extract quality indicators that impact the EDs' performance. The second stage consists of forming a …

Facemasks: Perceptions And Use In An Ed Population During Covid-19, Vidya Eswaran, Anna Marie Chang, R. Gentry Wilkerson, Kelli N. O'Laughlin, Brian Chinnock, Stephanie A. Eucker, Brigitte M. Baumann, Nancy Anaya, Daniel G. Miller, Adrianne N. Haggins, Jesus R. Torres, Erik S. Anderson, Stephen C. Lim, Martina T. Caldwell, Ali S. Raja, Robert M. Rodriguez

Emergency Medicine Articles

STUDY OBJECTIVE: Facemask use is associated with reduced transmission of SARS-CoV-2. Most surveys assessing perceptions and practices of mask use miss the most vulnerable racial, ethnic, and socio-economic populations. These same populations have suffered disproportionate impacts from the pandemic. The purpose of this study was to assess beliefs, access, and practices of mask wearing across 15 urban emergency department (ED) populations.

METHODS: This was a secondary analysis of a cross-sectional study of ED patients from December 2020 to March 2021 at 15 geographically diverse, safety net EDs across the US. The primary outcome was frequency of mask use outside the …

Efficacy Of Losartan In Hospitalized Patients With Covid-19-Induced Lung Injury: A Randomized Clinical Trial, Michael A. Puskarich, Nicholas E. Ingraham, Lisa H. Merck, Brian E. Driver, David A. Wacker, Lauren Page Black, Alan E. Jones, Courtney V. Fletcher, Andrew M. South, Thomas A. Murray, Christopher A. Lewandowski, Joseph Farhat, Justin L. Benoit, Michelle H. Biros, Kartik Cherabuddi, Jeffrey G. Chipman, Timothy W. Schacker, Faheem W. Guirgis, Helen T. Voelker, Joseph S. Koopmeiners, Christopher J. Tignanelli

Emergency Medicine Articles

Importance: SARS-CoV-2 viral entry may disrupt angiotensin II (AII) homeostasis, contributing to COVID-19 induced lung injury. AII type 1 receptor blockade mitigates lung injury in preclinical models, although data in humans with COVID-19 remain mixed.

Objective: To test the efficacy of losartan to reduce lung injury in hospitalized patients with COVID-19.

Design, Setting, and Participants: This blinded, placebo-controlled randomized clinical trial was conducted in 13 hospitals in the United States from April 2020 to February 2021. Hospitalized patients with COVID-19 and a respiratory sequential organ failure assessment score of at least 1 and not already using a renin-angiotensin-aldosterone system (RAAS) …

Association Of A Longitudinal, Preclinical Ultrasound Curriculum With Medical Student Performance, David A. Haidar, Ross Kessler, Neil K. Khanna, Michael T. Cover, John C. Burkhardt, Nik Theyyunni, Ryan V. Tucker, Rob D. Huang, Elizabeth Holman, Patrick D. Bridge, Katherine A. Klein, Christopher M. Fung

Emergency Medicine Articles

INTRODUCTION: Point-of-care ultrasound (US) is used in clinical practice across many specialties. Ultrasound (US) curricula for medical students are increasingly common. Optimal timing, structure, and effect of ultrasound education during medical school remains poorly understood. This study aims to retrospectively determine the association between participation in a preclinical, longitudinal US curriculum and medical student academic performance.

METHODS: All first-year medical students at a medical school in the Midwest region of the United States were offered a voluntary longitudinal US curriculum. Participants were selected by random lottery. The curriculum consisted of five three-hour hands on-sessions with matching asynchronous content covering anatomy …

Faculty Recruitment, Retention, And Representation In Leadership: An Evidence-Based Guide To Best Practices For Diversity, Equity, And Inclusion From The Council Of Residency Directors In Emergency Medicine, Dayle Davenport, Al'ai Alvarez, Sreeja Natesan, Martina T. Caldwell, Moises Gallegos, Adaira Landry, Melissa Parsons, Michael Gottlieb

Emergency Medicine Articles

Improving the recruitment, retention, and leadership advancement of faculty who are under-represented in medicine is a priority at many academic institutions to ensure excellence in patient care, research, and health equity. Here we provide a critical review of the literature and offer evidence-based guidelines for faculty recruitment, retention, and representation in leadership. Recommendations for recruitment include targeted recruitment to expand the candidate pool with diverse candidates, holistic review of applications, and incentivizing stakeholders for success with diversity efforts. Retention efforts should establish a culture of inclusivity, promote faculty development, and evaluate for biases in the promotion and tenure process. We …