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June 2018 Briefing – Emergency Medicine

June 2018 Briefing – Emergency Medicine

Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for June 2018. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Practice Management Can Improve Efficiency

FRIDAY, June 29, 2018 — Providers can take practical steps to improve practice efficiency and increase insurance reimbursement, according to an article published in Dermatology Times.

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AMA Calls for Electronic Health Record Training

FRIDAY, June 29, 2018 — The American Medical Association (AMA) is calling on medical schools and residency programs to incorporate electronic health record (EHR) training into their curricula.

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Health Care Technology Impacts Younger Patient Satisfaction

THURSDAY, June 28, 2018 — Health care communication technology is a determinant of patient satisfaction in younger patients, according to a report published by Black Book Market Research LLC.

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Most Bleeding Events in Non-CVD Patients Are GI-Related

WEDNESDAY, June 27, 2018 — Among a cohort of individuals without cardiovascular disease (CVD) not receiving antiplatelet therapy, most major bleeding events involved gastrointestinal bleeding and 7 percent of bleeding events were fatal, according to a study published online June 26 in the Journal of the American Medical Association.

Abstract/Full Text (subscription or payment may be required)

Missed Opportunities for HIV Diagnosis Among Those at Risk

WEDNESDAY, June 27, 2018 — Considerable numbers of men who have sex with men (MSM) and persons who inject drugs (PWID) who are unaware of their HIV infection report missed opportunities for diagnosis, according to a research letter published online June 26 in the Journal of the American Medical Association.

Abstract/Full Text (subscription or payment may be required)

AMA Adopts Ethical Guidance on Medical Tourism

TUESDAY, June 26, 2018 — The American Medical Association (AMA) recently adopted new ethical guidelines on medical tourism to help physicians understand their responsibilities when interacting with patients who seek or have received medical care outside the United States.

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New Hospital-at-Home Care Model Tied to Better Outcomes

TUESDAY, June 26, 2018 — Hospital-at-home (HaH) care, along with 30-day post-acute transitional care, is associated with better patient outcomes and satisfaction with care than inpatient hospitalization, according to a study published online June 25 in JAMA Internal Medicine.

Abstract/Full Text
Editorial

For Pediatric Patients, Wearable Cardioverter Defibrillator Safe

TUESDAY, June 26, 2018 — For pediatric patients with ventricular arrhythmias at risk for sudden cardiac death (SCD), a wearable cardioverter defibrillator (WCD) seems safe and effective, according to a review published online June 26 in Circulation: Arrhythmia and Electrophysiology.

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Cannabis Use Prevalence Up Across Adult Age Groups

TUESDAY, June 26, 2018 — Across adult age categories, there was an increase in the prevalence of daily cannabis use after 2007, according to a study published online June 13 in the Journal of Studies on Alcohol and Drugs.

Abstract/Full Text (subscription or payment may be required)

Parents Urged to Ask Playdates If There Is a Gun in the Home

MONDAY, June 25, 2018 — The American Academy of Pediatrics (AAP) is urging parents to ask a simple question before sending their children over to play at someone’s house: “Is there an unlocked gun in your house?”

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AMA: Docs Declare Drug Shortages Public Health Emergency

MONDAY, June 25, 2018 — At the annual meeting of the American Medical Association (AMA), physicians adopted policy declaring drug shortages an urgent public health crisis.

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Stress Echo Safe for ER Triage of Patients With Chest Pain

MONDAY, June 25, 2018 — For patients presenting to the emergency department with chest pain, a smaller proportion are hospitalized after undergoing stress echocardiography (SE) versus coronary computed tomography angiography (CCTA), according to a study published online June 13 in JACC: Cardiovascular Imaging.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Poison Control Center Data Detail Peds Exposure to Buprenorphine

MONDAY, June 25, 2018 — Pediatric exposure to buprenorphine can result in serious adverse outcomes, especially among children aged younger than 6 years, according to a study published online June 25 in Pediatrics.

Abstract/Full Text (subscription or payment may be required)

U.S. High School Students Report Sport-Linked Concussion

MONDAY, June 25, 2018 — The prevalence of concussion among U.S. high school students related to playing a sport or being physically active is 15.1 percent per year, according to research published in the June 22 issue of the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

Abstract/Full Text

Some California Mosquitoes Can Carry Zika Virus

FRIDAY, June 22, 2018 — Aedes mosquitoes in California can spread the Zika virus, according to a study published online June 21 in PLOS Neglected Tropical Diseases.

Abstract/Full Text

Risk of OD Highest for First Days of Opioid + Benzodiazepine Use

FRIDAY, June 22, 2018 — Concurrent benzodiazepine use is associated with increased risk of opioid-related overdose, with the risk highest on the first days of concurrent use, according to a study published online June 22 in JAMA Network Open.

Abstract/Full Text

Outpatient Care Less Efficient for Neonatal Abstinence Syndrome

FRIDAY, June 22, 2018 — In infants with neonatal abstinence syndrome (NAS) outpatient pharmacotherapy is associated with longer length of therapy and higher rates of emergency department utilization than exclusive inpatient treatment, according to a study published online May 10 in The Journal of Pediatrics.

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More Cash-Pay Patients Means Docs Need Billing Strategies

THURSDAY, June 21, 2018 — More patients are paying for health care services with cash, and this means physician practices need a comprehensive billing policy, according to an article published in Medical Economics.

Abstract/Full Text

ACA Provisions Tied to Change in Profile of Frequent ER Users

THURSDAY, June 21, 2018 — Following implementation of several major coverage expansion provisions in the Affordable Care Act (ACA), the profile of frequent emergency department users changed, according to a study published in the June issue of Health Affairs.

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Educational Strategies Could Improve Cardiac Arrest Outcomes

THURSDAY, June 21, 2018 — Addressing shortcomings in resuscitation educational efficiency and local implementation could improve outcomes after cardiac arrest, according to a scientific statement published online June 21 in Circulation.

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Florida Teen First Human Case of Another Mosquito-Borne Virus

WEDNESDAY, June 20, 2018 — The first confirmed human case of Keystone virus — named after the location in the Tampa Bay area where it was first identified in 1964 — has been diagnosed in a Florida teen, but it’s likely that infection with the mosquito-borne disease is common among state residents, researchers report.

Abstract/Full Text (subscription or payment may be required)
Press Release

70 Sickened So Far in Salmonella-Tainted Melon Outbreak

WEDNESDAY, June 20, 2018 — A salmonella outbreak linked to melons and fruit salad mixes continues to expand, say officials at the U.S. Centers for Disease Control and Prevention.

FDA Recall Notice
CDC Press Release

Considerable Costs Associated With Switching EHR

TUESDAY, June 19, 2018 — Switching electronic health record (EHR) systems can result in increased efficiency and productivity gains, but there are significant costs associated with the switch, according to an article published in Medical Economics.

Abstract/Full Text

Tattoo-Linked Complications ID’d in Immunosuppressed Female

TUESDAY, June 19, 2018 — In a case report published online June 18 in BMJ Case Reports, a tattoo-related complication causing an inflammatory myopathy is described in an immunosuppressed patient.

Abstract/Full Text (subscription or payment may be required)

Increased Risk of MI, Ischemic Stroke After COPD Exacerbation

TUESDAY, June 19, 2018 — For adults with chronic obstructive pulmonary disease (COPD), acute exacerbations are associated with increased risk of myocardial infarction and ischemic stroke, according to a study published online May 3 in the Annals of the American Thoracic Society.

Abstract/Full Text (subscription or payment may be required)

Meds for Opioid Use Disorder May Reduce Mortality in OD Survivors

MONDAY, June 18, 2018 — Use of medications for opioid use disorder (MOUD) is associated with a reduction in all-cause and opioid-related mortality after opioid overdose, according to a study published online June 19 in the Annals of Internal Medicine.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

AMA Vows to Improve Access for Docs Seeking Mental Health Care

MONDAY, June 18, 2018 — The American Medical Association (AMA) recently adopted a policy aimed at improving physician access to mental health care in response to physician depression, burnout, and suicide.

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One-Third of U.S. Children, Teens Use Dietary Supplements

MONDAY, June 18, 2018 — Approximately one-third of U.S. children and adolescents use dietary supplements, according to a research letter published online June 18 in JAMA Pediatrics.

Abstract/Full Text

CDC: Many High School Students Engage in Health-Risk Behaviors

MONDAY, June 18, 2018 — Many high school students are engaged in health-risk behaviors, according to research published June 15 in the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

Abstract/Full Text

Increase in VA Legionnaires’ Disease Rates From 2014 to 2016

MONDAY, June 18, 2018 — There was an increase in Legionnaires’ Disease (LD) from 2014 to 2016, according to a study published online June 15 in JAMA Network Open.

Abstract/Full Text
Editorial

FDA Approves First Generic Under-the-Tongue Suboxone

FRIDAY, June 15, 2018 — The first generic version of an under-the-tongue film to treat opioid addiction has been approved by the U.S. Food and Drug Administration.

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Kellogg’s Honey Smacks Cereal Recalled Due to Salmonella Risk

FRIDAY, June 15, 2018 — The Kellogg Company has announced it is recalling certain boxes of Honey Smacks cereal due to the possibility of contamination with Salmonella.

FDA Recall Notice
CDC Press Release

AMA President Calls Physicians to Lead in Addressing Gun Violence

THURSDAY, June 14, 2018 — The issue of gun violence must be addressed by the physician leadership scientifically, in an evidence-based manner, according to remarks issued by the president of the American Medical Association (AMA) at the organization’s annual meeting.

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Children Can Drink Clear Fluids Until One Hour Before Anesthesia

THURSDAY, June 14, 2018 — On the day of surgery it is practical to allow children to drink until one hour before anesthesia, according to a special interest article published online April 27 in Pediatric Anesthesia.

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Illicit Opioid Trade Up With Restrictions on Hydrocodone

THURSDAY, June 14, 2018 — The U.S. Drug Enforcement Administration’s 2014 ruling to reschedule hydrocodone combination products coincided with an increase in illicit trading of opioids through online illicit markets (cryptomarkets), according to a study published online June 13 in The BMJ.

Abstract/Full Text
Editorial

IV Fluid Specs Do Not Influence Neuro Outcomes in Kids w/DKA

WEDNESDAY, June 13, 2018 — Neurologic outcomes in children with diabetic ketoacidosis are similar regardless of the rate of administration or the sodium chloride content of intravenous fluids, according to a study published in the June 14 issue of the New England Journal of Medicine.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

APA: Suicide Prevention Should Be a Public Health Priority

WEDNESDAY, June 13, 2018 — Suicide prevention needs to be a public health priority, according to the American Psychological Association (APA).

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60 Sickened So Far in Salmonella-Tainted Melon Outbreak

WEDNESDAY, June 13, 2018 — Federal, state, and local health officials are investigating a Salmonella outbreak linked to fruit salad mixes that has sickened 60 people in five U.S. states. The fruit salad mixes included precut watermelon, honeydew melon, cantaloupe, and cut fruit medley products from the Caito Foods facility in Indianapolis. The company has recalled the products.

FDA Recall Notice
CDC Press Release

USPSTF: No to ECG Screening to Prevent CVD in Low-Risk Adults

TUESDAY, June 12, 2018 — The U.S. Preventive Services Task Force (USPSTF) recommends against screening with resting or exercise electrocardiography (ECG) to prevent cardiovascular disease (CVD) events in low-risk asymptomatic adults. This final recommendation statement has been published in the June 12 issue of the Journal of the American Medical Association.

Evidence Review
Final Recommendation Statement
Editorial

How Do Business Partner Data Breaches Affect Your Practice?

TUESDAY, June 12, 2018 — Data breaches affecting health care systems or their partners need to be addressed quickly, according to an article published in Medical Economics.

Abstract/Full Text

Active Failures Seen in Proper Use of Personal Protective Equipment

TUESDAY, June 12, 2018 — Active failures frequently occur in infectious agent transmission-based precautions, including personal protective equipment (PPE) use, according to a study published online June 11 in JAMA Internal Medicine.

Abstract/Full Text
Editorial

CDC: Invasive MRSA More Likely Among Injection Drug Users

MONDAY, June 11, 2018 — Injection drug users are more than 16-fold more likely to develop invasive methicillin-resistant Staphylococcus aureus (MRSA) infections, according to research published in the June 8 issue of the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

Abstract/Full Text

Public Support Only Moderate for Opioid Harm Reduction Strategies

MONDAY, June 11, 2018 — Stigmatizing attitudes toward those who use opioids are associated with lower support for two evidence-based opioid harm reduction strategies, according to a study published in the June issue of Preventive Medicine.

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Erectile Dysfunction Independently Tied to CV Events

MONDAY, June 11, 2018 — Erectile dysfunction (ED) is independently associated with cardiovascular disease (CVD), according to a research letter published online June 11 in Circulation.

Abstract/Full Text (subscription or payment may be required)

Synthetic Cannabis May Increase Ischemic Cardiomyopathy Risk

FRIDAY, June 8, 2018 — A case of severe ischemic cardiomyopathy in the absence of traditional risk factors and attributed to synthetic cannabinoid use is described in a report published online June 7 in BMJ Case Reports.

Abstract/Full Text (subscription or payment may be required)

1999 to 2016 Saw Increase in Suicide Rates Across Most States

THURSDAY, June 7, 2018 — From 1999 to 2016 there was a significant increase in suicide rates across 44 states, according to research published in the June 8 issue of the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

Abstract/Full Text

Respiratory Pathogens May Up Treatment Failure Risk in Asthma

THURSDAY, June 7, 2018 — Respiratory pathogens are associated with increased risk of treatment failure in children with asthma exacerbations, according to a study published online June 4 in Pediatrics.

Abstract/Full Text

Online Consumer Ratings of Physicians Tend to Be Skewed

WEDNESDAY, June 6, 2018 — Online physician reviews tend to be skewed positively, according to a study published in the May issue of the Journal of Medical Internet Research.

Abstract/Full Text

CDC: Prevalence of No Insurance Varies by Occupational Groups

WEDNESDAY, June 6, 2018 — The prevalence of being uninsured varies by occupational groups, according to research published in the June 1 issue of the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

Abstract/Full Text

FDA: Opioid Antidote Naloxone Recalled

TUESDAY, June 5, 2018 — A recall of the opioid overdose antidote Naloxone was announced Monday. The U.S. Food and Drug Administration said the recall was triggered by the possibility of “loose particulate matter on the syringe plunger” that could pose a number of health risks, CNN reported.

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Post-Hurricane Deaths in Puerto Rico Underestimated

TUESDAY, June 5, 2018 — The actual number of deaths related to Hurricane Maria in Puerto Rico in 2016 is likely more than 70 times the official government estimate of 64, according to a study published online May 29 in the New England Journal of Medicine.

Abstract/Full Text

Studies ID Impact of U.S. Opioid-Related Mortality, Rx Patterns

FRIDAY, June 1, 2018 — From 2001 to 2016 there was an increase in the number and percentage of opioid-related deaths; in addition, most patients receiving opioids receive immediate-release (IR) formulations, according to two studies published online June 1 in JAMA Network Open.

Abstract/Full Text – Gomes
Abstract/Full Text – Hwang
Editorial

CDC Says E. Coli Outbreak Tied to Romaine Lettuce Is Over

FRIDAY, June 1, 2018 — This spring’s outbreak of Escherichia coli illness tied to tainted Arizona romaine lettuce is likely over, U.S. health officials say, but not before claiming five lives.

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Posted: July 2018

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