Abstract Objectives One of the most pivotal decisions an emergency physician (EP) makes is whether to admit or discharge a patient. The emergency department (ED) work-up leading to this decision involves several resource-intensive tests. Previous studies have demonstrated significant differences in EP resource utilization, measured by lab tests, advanced imaging (magnetic resonance imaging [MRI], computed tomography [CT], ultrasound), consultations, and propensity to admit a patient. However, how an EP's years of experience may impact their resource utilization and propensity to admit patients ..read more

Journal of the American College of Emergency Physicians Open, Volume 5, Issue 2, April 2024 ..read more

Abstract Objectives Clinical examination alone cannot reliably rule out significant traumatic abdominal injury. Computed tomography (CT) has become the primary method for evaluating blunt abdominal trauma and clinicians rely heavily on it to rule out abdominal injury. Ultrasound examination may miss significant abdominal injury particularly in stable patients. The use of a contrast agent improves ultrasound sensitivity to visceral abdominal injuries. The objective of this diagnostic study is to compare bedside contrast enhanced ultrasound (CEUS) performed by emergency physicians to CT in hemod ..read more

Journal of the American College of Emergency Physicians Open, Volume 5, Issue 2, April 2024 ..read more

Abstract Objectives We aimed to assess the impact of in-person and distance school learning models on children's visits to the emergency department (ED) for psychological or social (“psychosocial”) complaints. Methods We analyzed presentations to one emergency department in a mid-sized Midwestern city. We used the public school system schedule to determine in-person and distance learning periods by the grade level. We calculated the incidence of visits to the emergency department during academic years 2018–2019, 2019–2020, and 2020–2021, with particular attention to the time after March 13, 20 ..read more

Abstract Objectives Patients with chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF) exacerbations present with similar history and physical examination findings. This complicates both the diagnostic process and the creation of appropriate treatment plans for patients presenting in respiratory distress, particularly in the prehospital setting. Thoracic point-of-care-ultrasound (POCUS) may increase diagnostic accuracy; however, its potential to improve patient management by emergency medical services clinicians is unknown. We aimed to determine whether a brief thora ..read more

Journal of the American College of Emergency Physicians Open, Volume 5, Issue 2, April 2024 ..read more

Abstract Objective Recent clinical guidelines for sepsis management emphasize immediate antibiotic initiation for suspected septic shock. Though hypotension is a high-risk marker of sepsis severity, prior studies have not considered the precise timing of hypotension in relation to antibiotic initiation and how clinical characteristics and outcomes may differ. Our objective was to evaluate antibiotic initiation in relation to hypotension to characterize differences in sepsis presentation and outcomes in patients with suspected septic shock. Methods Adults presenting to the emergency department ..read more

Journal of the American College of Emergency Physicians Open, Volume 5, Issue 2, April 2024 ..read more

Journal of the American College of Emergency Physicians Open, Volume 5, Issue 2, April 2024 ..read more