AAEM Insights
Mar. 19, 2015

The use of bed-side ultrasound is growing — but are ERs ready?
By Dr. Afsaneh Motamed-Khorasani
Ultrasonographic investigation — in its traditional approach — involves many steps and multiple professionals, including radiologists and certified sonographers. This approach might not be necessarily helpful for critically-ill patients and immediate patient management. However, recent technological advances in ultrasonography, inherent safety, relative ease of use and portable machines capable of producing high-quality imaging have made it an invaluable point-of-care tool. Acute-care physicians can effectively use ultrasonography to provide important clinical information with a large impact on rapid assessment of critically-ill patients, as well as for patient care and relatively safe invasive procedures. More

March Madness at EMresource.org!

For all of March you and your students or residents can get 50% off two great EM pocketbooks written by the author of the Tarascon Emergency Department Quick Reference Guide. Log in to the AAEM Member Center to get started! More

New Special Enrollment Period (SEP) for the AAEM Health Insurance Exchange!

The Federal Government has announced there will be a special enrollment period this year for those who didn't realize they had to buy health insurance when they did their taxes. Learn more.More

Do emergency medicine physicians and EMS providers understand Physicians Orders for Life-Sustaining Treatment (POLST) documents?

On March 1, the Journal of Patient Safety released the results of the TRIAD VI & VII studies revealing concerns for understanding among providers and potential risk for patient safety. Learn more. More

AAEM Oral Board Review Course — Register today!

Six convenient locations. NEW hands-on simulation practice. Be confident on exam day — prepare with the experts for the new format! Learn more and register, here. More

Online Learning Library

Superb, AAEM-quality educational content with AMA PRA Category 1 Credits™ available. Online learning optimized for your convenience. Get started today with the 2014 Scientific Assembly or 2014 Written Board Review Course. Look for information about the 2015 Scientific Assembly coming soon!More

Doctors continue to hate their jobs — Is the ACA to blame?
By Scott E. Rupp
In news that we likely all knew (or had an inkling of), physicians are less happy than they have been or could be, a new survey suggests. There are a number of reasons for the lack of job satisfaction, including bureaucracy and a greater focus on technology and data entry, but the data reflected here — in a recent survey from the healthcare solutions group Geneia — is nothing new. Headlines have been gathering for some time that suggest similar results. More

CMS taking harder line on Medicaid expansion
FierceHealthPayer
The Centers for Medicare & Medicaid Services (CMS) appears ready to abandon its conciliatory approach to Medicaid expansion in favor of a harder line, the National Journal reported. The issue is coming to a head in Florida, where $1 billion in federal funding for a separate Medicaid program known as the Low Income Pool (LIP) is set to expire this summer.More

Efforts to instill empathy among doctors are paying dividends
MedPage Today
The patient was dying and she knew it. In her mid-50s, she had been battling breast cancer for years, but it had spread to her bones causing unrelenting pain that required hospitalization. Jeremy Force, a first-year oncology fellow at Duke University Medical Center who had never met the woman, was assigned to stop by her room last November to discuss her decision to enter hospice. Employing the skills he had just learned in a day-long course, Force sat at the end of her bed and listened intently. The woman wept, telling him she was exhausted and worried about the impact her death would have on her two daughters.More

Emergency Preparedness for Clinicians — From Guidelines to the Front Line
CDC
March 26 — 2-3 p.m. EST
Natural disasters, industrial accidents, terrorism attacks, and pandemics all have the capacity to result in large numbers of critically ill or injured patients. A barrage of patients with various clinical needs can quickly exhaust the care delivery capacity of a healthcare system. It is important for clinicians to have a disaster response plan that addresses approaches to maintaining quality care during times of patient surge and resource scarcity. During this COCA Call, participants will learn about the series of suggestions that focus on the management of multiple critically ill patients during a disaster or pandemic, and the importance of collaboration among front-line clinicians, hospital administrators, professional societies, and public health or government officials.More

Negative Predictive Value of Excluding an Embedded Snake Foreign Body by Ultrasonography
Wilderness & Environmental Medicine
Bedside ultrasonography performed by an EM physician is a feasible option to rule out embedded foreign bodies after a snake bite if imaging is warranted.More

Risperidone Long-Acting Injection and One-Year Rehospitalization Rate of Schizophrenia Patients: A Retrospective Cohort Study
Psychiatry and Clinical Neurosciences
This was a retrospective cohort study; 379 patients with schizophrenia were enrolled and treated with different kinds of antipsychotic agents at E-Da Hospital, and received a 12-month follow-up. The patients were distributed into 3 groups, including all-oral antipsychotic, oral risperidone and RLAI groups. The antipsychotic agents and dosages they used were recorded. The rate of rehospitalization, length of hospital stay, emergency room visits and medical expenditures were assessed.More

Battling opioid dependence in the emergency department
UMass Med Now
Emergency departments can play valuable roles in addressing the opioid abuse crisis, according to health psychologist Edwin Boudreaux, Ph.D. “The ED prescribes lots of opiates in order to help people manage their pain,” said Dr. Boudreaux, professor of emergency medicine, psychiatry and quantitative health sciences, vice chair of research for the Department of Emergency Medicine at UMMS, and director of Behavioral Health Services at the UMass Memorial Medical Center-University Campus emergency room.More

How to improve patient engagement in the provider community
EHR Intelligence
Patient engagement strategies have been heavily discussed in the media and among the vendor community, but digital participation on both the provider and patient side has been meek at best. The latest report from Chilmark Research on the patient engagement market shows that the healthcare sector is still participating very minimally in digital communication with patients post-discharge or between visits.More

Telehealth's true success starts behind the scenes
By Karen R. Thomas
For the last few years, telehealth has been one of the biggest buzzwords in the healthcare industry. With recent predictions indicating that the number of patients using telehealth will hit 7 million by the year 2018, businesses are scrambling to create devices that can keep up with the high demand. Telemonitoring technologies make it possible for healthcare providers to monitor symptoms and measure vital signs remotely, and they also make it easier for patients, employees and others to manage their own healthcare better and more affordably. More

Intermittent pulse oximetry OK for kids receiving room air
Medscape (free login required)
Intermittent pulse oximetry was effective for children hospitalized with asthma or bronchiolitis who were stable on room air but did not decrease the time until the child was medically ready for discharge, according to a new report from a quality improvement effort. Despite recommendations to limit the use of continuous pulse oximetry (CPOx) monitoring in these patients, it continues to be widely used, the authors note.More

FDA approves new CPR devices that may increase cardiac arrest survival
By Lynn Hetzler
On March 9, the U.S. Food and Drug Administration (FDA) approved new CPR devices that might improve patient's chances of surviving cardiac arrest. Only 7 percent of the 300,000 people who suffer cardiac arrests outside of hospitals each year survive, according to the Centers for Disease Control and Prevention (CDC), despite the fact that two-thirds of these patients receive treatment from emergency medical service providers. The CDC recommends implementing a "chain of survival," which includes early CPR with an emphasis on chest compression.More

New protocol can help emergency departments evaluate patients with acute chest pain
EurekAlert!
A recently developed risk-evaluation protocol can help hospital emergency department personnel more efficiently determine which patients with acute chest pain can be sent home safely, according to a randomized trial conducted at Wake Forest Baptist Medical Center. The study, published in the current online issue of the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes, found that chest-pain patients who were evaluated with the new protocol, called the HEART Pathway, had 12 percent fewer cardiac tests, 21 percent more early discharges, and shorter hospital stays than those who received standard care.More