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AEMEarlyAccess's podcast

Brown University Emergency Medicine, Academic Emergency Medicine/SAEM

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This is a collaboration between the editors of Academic Emergency Medicine and the Brown University Emergency Medicine Residency Program. Each podcast offers a pre-publication look at a chosen article, with an interview with its corresponding author. Visit www.brownemblog.com (AEM Early Access section) to find the links to each article and other related educational materials.
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In this study, the authors first sought to empirically derive centiles for heart rate (HR), respiratory rate (RR), and systolic blood pressure (SBP) for adults with out-of-hospital emergencies who were transported to an ED. Second, they aimed to evaluate the impact of adjusting for age in the evaluation of centile curves for vital signs to identify…
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Timely reperfusion is necessary to reduce morbidity and mortality in patients with ST-elevation myocardial infarction (STEMI). Initial care by facilities with percutaneous coronary intervention (PCI) capabilities reduces time to reperfusion. The authors sought to examine whether insurance status was associated with initial care at EDs with PCI capa…
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The use of generative artificial intelligence (AI) tools, such as ChatGPT, are gaining popularity for a variety of academic writing tasks and offer an innovative solution to relieve the burden of letter writing. The authors conducted a study aimed at determining whether academic physicians can distinguish between AI and human-generated letters of r…
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Conversations about code status in seriously ill patients at end of life is unfortunately a frequent event in the emergency department. Today we are discussing a paper in AEM entitled The differences in code status conversation approaches reported by emergency medicine and palliative care clinicians: a mixed method study. Lead author Dr. Kei Ouchi …
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Patients with (LEP) have been shown to experience disparities in (ED) care. The objectives of this study were to examine the LEP and irregular ED departures and return ED visits. We interview senior author Dr. Derick Jones about this new AEM paper.By Gita Pensa MD
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Emergency care workforce concerns have gained national prominence given recent data suggesting higher than previously estimated attrition. With little known regarding characteristics of physicians leaving the workforce, this paper sought to investigate the age and number of years since residency graduation at which male and female EM physicians exh…
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General emergency physicians provide most pediatric emergency care in the United States yet report more challenges managing emergencies in children than adults. Recommendations for standardized pediatric emergency medicine (PEM) curricula to address educational gaps due to variations in pediatric exposure during emergency medicine (EM) training lac…
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Dr. Pensa interviews author Dr. Michelle Suh about her teams recent E&T publication, “I’d rather see action”: Application and recruitment experiences of underrepresented in emergency medicine trainees."By Gita Pensa MD
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Amiodarone and lidocaine have not been shown to have a clear survival benefit compared to placebo for out-of-hospital cardiac arrest (OHCA). However, randomized trials may have been impacted by delayed administration of the study drugs. Today we’re talking with Dr. Joshua Lupton, first author on a new AEM paper entitled “ Survival by Time-to-Admini…
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Demographic differences in opioid prescribing by patient race and ethnicity have been widely reported; Black and Hispanic patients receive lower rates and dosages of opioid prescriptions for the same conditions and reported pain level as white patients. At the same time, higher dosage opioid prescriptions have been associated with higher rates of n…
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We speak with lead author Dr. Murdoc Leeies about his team's new AEM paper, "Equity-Relevant Sociodemographic Variable Collection in Emergency Medicine: A Systematic Review, Qualitative Evidence Synthesis & Recommendations for Practice."By Gita Pensa MD
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Delirium, altered mental status or confusion among older adults are common presentations to the emergency department (ED). We discuss this new AEM paper with author Dr. Shan Liu, whose team aimed to report the proportion of older ED patients presenting with delirium who have acute abnormal findings on head imaging. We also assessed whether anticoag…
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Paper abstract: Point-of-care ultrasound (US) has been suggested as the primary imaging in evaluating patients with suspected diverticulitis. Discrimination between simple and complicated diverticulitis may help to expedite emergent surgical consults and determine the risk of complications. This study aimed to: (1) determine the accuracy of an US p…
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The Master Adaptive Learner (MAL) model was developed as an educational framework that teaches learners how to develop adaptive expertise. Dr. Guy Carmelli discusses his recent paper in AEM Education and Training on adapting the EM clerkship to create master adaptive learners.By Gita Pensa MD
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The strengths and weaknesses of virtual and in-person formats within continuing professional development (CPD) are incompletely understood. This study sought to explore attendees’ perspectives across multiple specialties regarding benefits and limitations of conference formats, and strategies for successful virtual and hybrid (i.e., in-person confe…
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Cocaine use results in over 500,000 emergency department (ED) visits annually across the U.S. and ethanol co-ingestion is reported in 34% of these. Commingling cocaine with ethanol results in the metabolite cocaethylene (CE), which is metabolically active for longer than cocaine alone. Current literature on the cardiotoxicity of CE compared to coca…
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Author Dr. Coughlin and Dr. Pensa discuss his team's AEM Education and Training article, "Differences in Faculty Feedback for High, Expected, and Below-Expected Clinically Performing Emergency Medicine Residents."By Gita Pensa MD
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We speak to first author Dr. Marie Jessen about a new paper in AEM entitled "Restrictive Fluids Versus Standard Care in Adults with Sepsis in the Emergency Department (REFACED) – a Multicenter, Randomized Feasibility Trial."
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We discuss a new article in AEM Education and Training called “Coaching models, theories, and structures: an overview for teaching faculty in the emergency department and educators in the offices” with lead author Dr. Nicole Deiorio.
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Appropriate triage of patients in the ED is sometimes challenging, and today we’re discussing a new article in AEM entitled “Physician Gestalt for Emergency Department Triage: A Prospective Videotaped Study.” This paper from an academic ED in Taiwan compared physician gestalt versus the Taiwan Triage and Acuity Scale (TTAS), which is standard compu…
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Although more guideline-adherent care has been described in pediatric compared to adult trauma centers, we aimed to provide a more detailed characterization of management and resource utilization of children with intra-abdominal injury (IAI) within pediatric centers. Our primary objective was to describe the epidemiology, diagnostic evaluation, and…
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Competency-based medical education (CBME) is a topic we have discussed often on this podcast series, and today we are discussing a critical part of it; direct observation of trainees. But as most of us know, direct observation also has its challenges in a busy ED. Today we’re discussing a new paper in AEM Education and Training entitled "Does direc…
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Most emergency medicine educators are familiar with the Milestones, the current evaluation system for emergency medicine residents, and these have been shown to be imperfect and highly subjective. Ath the same time, EM residents need to achieve competency in patient safety and quality improvement processes, Today we’re talking about a recent paper …
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The ACGME requires residents to participate in scholarship, and programs are required to provide an environment conducive to the production of scholarship and acquiring the necessary skills involved. Today we are talking to Dr Kraftin Schreyer about a recent paper in AEM Education and Training entitled “The Content Expert Program: A Structured Appr…
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The American College of Surgeons requires trauma centers to use six minimum criteria (ACS-6) for full trauma team activation: hypotension, gunshot wound to the neck or torso, Glasgow Coma Scale (GCS) score < 9, respiratory compromise, transfers receiving blood transfusion, or physician discretion. Our goal was to evaluate the effect of adding varyi…
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Gender disparities in medicine are well documented; however, little qualitative data exist. This study sought to provide a qualitative assessment of harassment and discrimination experienced by female physicians in emergency medicine (EM) specifically by colleagues or supervisors.
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The journal club is a ubiquitous and time-honored tradition within medical education. However, in recent years, open educational resources (OERs) have become increasingly influential in how physicians interact with the medical literature across multiple specialties. The authors sought to explore how emergency medicine (EM) resident physicians recon…
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Tracheal intubation (TI) practice across pediatric emergency departments (EDs) has not been comprehensively reported. We aim to describe TI practice and outcomes in pediatric EDs in contrast to those in intensive are units (ICUs) and use the data to identify quality improvement targets.By Gita Pensa MD
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Patient-centered care is concordant with patient values and preferences. There is a lack of research on patient values and preferences for pulmonary embolism (PE) testing in the emergency department (ED), and a poor physician understanding of patient-specific goals. Our aim was to map patient-specific values, preferences, and expectations regarding…
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In 2017, the Accreditation Council for Graduate Medical Education (ACGME) revised its Common Program Requirements to support trainees and faculty by mandating programs to provide dedicated wellness resources and education. Emergency medicine may benefit from this change due to high burnout rates within the specialty. However, the current state of w…
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Prior studies have demonstrated that EM applicants consider geography as well as modifiable/non- modifiable program factors. Less attention, however, has been paid to underrepresented groups. Additionally, the prevalence and characteristics of “red flags,” or factors that may lead an applicant to lower a program’s rank or not rank it at all, remain…
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Delayed diagnosis of cerebrovascular disease (CVD) among patients can result in substantial harm. If diagnostic process failures can be identified at emergency department (ED) visits that precede CVD hospitalization, interventions to improve diagnostic accuracy can be developed.By Gita Pensa MD
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Emergency medicine clinicians are excellent at identifying and treating physical trauma as a chief complaint, but are often unaware of patients’ previous experiences of trauma. The purpose of this study was to describe emergency department (ED) patients’ lifetime experiences of trauma.By Gita Pensa MD
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Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first-line medication for acute low back pain (LBP). It is unclear if the choice of NSAID impacts outcomes. We compared ibuprofen, ketorolac, and diclofenac for the treatment of acute, nonradicular LBP.By Gita Pensa MD
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