Urgent care centers (UC) play an important role in addressing non-emergent health concerns, offering a convenient alternative to emergency departments (ED). However, accessibility to UCs can vary based on transportation availability and socioeconomic factors. In this study we evaluated the geospatial accessibility of UCs and EDs in Milwaukee County, Wisconsin, and sought to characterize the relationship between transit options, socioeconomic vulnerability, and access to care.

Syncope is a common emergency department (ED) presentation and frequently results in low-yield hospitalizations. The Canadian Syncope Risk Score (CSRS) is a validated risk stratification score that identifies 30-day risk of serious adverse events for patients presenting with syncope. In this retrospective, cross-sectional study we aimed to evaluate syncope admissions with the CSRS to determine potentially unnecessary hospitalizations.

Effective airway management is critical for optimal patient outcomes in the emergency department (ED). Additionally, airway management is significantly influenced by the clinician's selection of equipment, specifically the choice of intubating stylet. Also of note, the duration of intubation (time to intubate) impacts overall success. The choice of intubation device may influence first-pass success and intubation times. In this study we evaluated equipment trends for first-pass success and intubation duration. We collected data by reviewing a video database of recorded airways. Three commonly used intubating stylets were reviewed: the hyperangulated stylet; bougie (Eschmann stylet); and malleable stylet.

Hip fractures are a common reason for presentation to the emergency department (ED) and are associated with significant morbidity. Nerve blocks have emerged as a safe and effective tool to treat pain associated with hip fractures. In this study, we aimed to measure the frequency with which nerve blocks were performed for ED patients with hip fractures. Our secondary aims were to study the demographic and clinical characteristics of patients who received and did not receive a nerve block.

Pharmacogenomic-assisted prescribing of medications uses individual genetic information to identify drug-gene interactions. We aimed to assess potential pharmacogenomic drug-gene interactions in geriatric emergency department (ED) patients who sustained a fall.

Advanced practice clinician (APC) presence has increased in emergency departments (ED), leading to increased exposure to higher acuity patient conditions. Relatively few APCs have completed formalized postgraduate emergency medicine (EM)-specific training, creating uncertainty around how well prepared APCs are in identifying and treating life-threatening conditions. Foundations of Emergency Medicine (FoEM) offers free open-access curricula, including Foundations I (F1), a flipped-classroom course targeting fundamental knowledge for resident physicians. We sought to use F1 for APC learners to improve their knowledge in identifying and treating emergent conditions.

Hypertension and diabetes are common cardiovascular disease risk factors among emergency department observation unit (EDOU) patients evaluated for acute coronary syndrome (ACS). Our primary aim was to determine rates of untreated hypertension and diabetes in the EDOU. Our secondary aim was to identify rates of glycemic control assessment among patients with diabetes.

Core faculty are key to supporting the educational mission in emergency medicine (EM). Changes in the Accreditation Council for Graduate Medical Education (ACGME) requirements for minimum protected time for core faculty may no longer guarantee adequate support. We sought to assess EM core faculty characteristics, support, and the impact of the 2019 revisions to ACGME regulations. We explored the influence of individual and institutional characteristics on support and the impact of the regulatory changes.

Topical salicylates are commonly found in over-the-counter medications and are applied for pain relief or to treat dermatologic conditions. While generally considered safe, they can cause systemic toxicity under certain conditions. We conducted a systematic review of topical salicylate toxicity. This comprehensive review of previously reported cases highlights the risks, clinical presentations, and management considerations of systemic toxicity from topical salicylates.

Ambulances are often left to idle, which may contribute to maintenance costs, environmental harm, and resource inefficiencies. Engine idling affects the health of first responders due to the consequences of exhaust. Our study objective was to gain understanding of current emergency medical services (EMS) policies and perspectives on ambulance engine idling.

Black and Hispanic patients, and patients with a preferred language other than English experience longer emergency department (ED) wait times and delays in treatment. We aimed to evaluate racial, ethnic, and language-based differences in wait times to see a physician and get a disposition, as well as in the rates of objective vs subjective urgent evaluations.

Rib fractures are common in patients with blunt thoracic trauma, and their associated pain causes significant morbidity and mortality. Adequate analgesia is crucial to prevent rib fracture-associated pulmonary complications. However, current analgesic modalities have drawbacks, and the optimal analgesia protocol remains elusive. Intravenous (IV) lidocaine infusions have a well-established safety profile and efficacy in other patient populations and may benefit patients with traumatic rib fractures. To better understand current practices and to inform the design of a multi-centre trial, we believe that a study to determine Canadian trauma centres' current analgesic practices is warranted. This study describes the current familiarity and use of IV lidocaine infusions for management of rib fracture pain. Secondary outcomes included the identification of common Canadian analgesic protocols for rib fractures and willingness to participate in a future multi-centre trial of lidocaine for these traumatic injuries.

Patients with respiratory distress are frequently encountered in the emergency department (ED). Efforts to assess, initiate treatments, and stabilize these patients require a systematic and rapid response. Emergency physicians need a comprehensive and efficient approach for evaluating, treating, and managing patients presenting to the ED with moderate respiratory distress.

The global incidence and severity of severe heat illness is on the rise. The increasing number of summer heatwaves in Phoenix, Arizona, gave us a distinctive opportunity to better understand the impact on the clinical presentation and management of acute heatstroke. Our primary objective in this study was to describe the prehospital and emergency department (ED) clinical presentation, treatment, and outcomes of patients with acute heatstroke at a single hospital system during the summers of 2021 and 2022 in Phoenix.

Out-of-hospital cardiac arrest remains a leading cause of death and significantly impacts global health outcomes. International guidelines emphasize the importance of high-quality CPR (cardiopulmonary resuscitation).

The emergency department (ED) serves as an entry point to the healthcare system for many patients, and the increased use of advanced imaging has resulted in identification of masses of unclear significance. We describe patients presenting to an ED who were referred to an undiagnosed mass clinic (UMC).

Throughout graduate medical education (GME), it is crucial for learners to not only develop the skills necessary to manage a wide variety of medical conditions, but also to foster personal development and to gain a deeper understanding of the complex and multifaceted needs of our patients. We often refer patients to community sites to address needs such as homelessness, hunger, and domestic violence; however, we frequently make these referrals with only a superficial understanding of what each resource entails.

Violence-related injuries (VRI) such as interpersonal violence, intimate-partner violence, and self-harm injuries present a significant public health challenge in the United States. We aimed to explore interpersonal-violence and self-harm injuries, focusing on demographic disparities (age and sex) and mechanisms of injury, including firearm-related violence.

Clear communication is essential for emergency medical services (EMS) clinicians to assess a situation and make appropriate transport decisions. When barriers are present that impede communication between emergency responders and patients, EMS clinicians report difficulty navigating these encounters. As communication barriers potentially delay definitive care, it remains unclear the amount of time that EMS clinicians spend on scene during these encounters and how often they result in non-transport. In this study we sought to characterize the association between the presence of communication barriers, time spent on scene, and non-transport.

On August 3, 2019, a mass casualty incident (MCI)/active shooter event in El Paso, TX, left 21 people dead on scene and 27 transported. Our main objective in this article was to describe trauma center responses to a sudden patient influx after a MCI/active shooter event. We hypothesized that a triage practice in which two physicians providing care while simultaneously triaging would be equivalent to triage with a single physician providing triage only. The secondary objective was to describe patient injuries and treatment. Our third objective was to describe how a large, multidisciplinary team of hospital personnel were rapidly notified and arrived at the trauma center. Finally, we describe how the problems identified in a review of hospital response led to better results after implementing new practices in a 2023 MCI/active shooter event.