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March 2017 Briefing - Emergency Medicine

Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for March 2017. 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.

90 Percent of U.S. Physicians Satisfied With Career Choice

FRIDAY, March 31, 2017 (HealthDay News) -- Nine out of 10 American doctors are happy with their choice of profession, even though they have some challenges, according to an American Medical Association (AMA) survey of 1,200 doctors, residents, and medical students, conducted in February.

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Vertical Integration Insurance Products of Higher Quality

FRIDAY, March 31, 2017 (HealthDay News) -- Insurance products offered by hospitals and health systems, known as vertical integration, are generally of higher quality than other contracts, according to a study published in the March issue of Health Affairs.

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Invasive Heart Center Admission Best for Cardiac Arrest Survival

THURSDAY, March 30, 2017 (HealthDay News) -- Admission to an invasive heart center and regional performance of acute coronary angiography (CAG)/percutaneous coronary intervention (PCI) are associated with improved survival in out-of-hospital cardiac arrest (OHCA) patients, according to a study published online March 29 in the European Heart Journal.

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Increases in Heroin Use in the U.S. Greater Among Whites

THURSDAY, March 30, 2017 (HealthDay News) -- From 2001-2002 to 2012-2013 there was an increase in the prevalence of heroin use and heroin use disorder, according to a study published online March 29 in JAMA Psychiatry.

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Substance Abuse Is a Treatable Chronic Medical Condition

WEDNESDAY, March 29, 2017 (HealthDay News) -- In a position paper published online March 28 in the Annals of Internal Medicine, recommendations are presented for the prevention and treatment of substance use disorders.

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TV Ads for ACA Enrollment Linked to Decline in Uninsured Rates

TUESDAY, March 28, 2017 (HealthDay News) -- The volume of insurance advertisements during the first Affordable Care Act enrollment period correlated with change in uninsurance rates, with a higher volume of television advertisements linked to declines in uninsurance, according to a study published online March 15 in Health Affairs.

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Teens Exposed to Opioid Rx at Risk for Serious Outcomes

TUESDAY, March 28, 2017 (HealthDay News) -- Teenagers with prescription opioid exposures are more likely to have health care facility (HCF) admission and serious medical outcomes than younger children, according to a study published online March 20 in Pediatrics.

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ACP Issues Challenge to Cut Task Burden and Put Patients First

TUESDAY, March 28, 2017 (HealthDay News) -- In a position paper published online March 28 in the Annals of Internal Medicine, recommendations are presented to address the impact of administrative tasks and reduce the administrative burden on clinicians.

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Seventeen States Require AED Installation in Some Schools

TUESDAY, March 28, 2017 (HealthDay News) -- Fewer than half of U.S. states require schools to install automated external defibrillators (AEDs), according to a study published in the April 4 issue of the Journal of the American College of Cardiology.

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Paid Malpractice Claims Cut in Half From 1992 to 2014 in U.S.

MONDAY, March 27, 2017 (HealthDay News) -- From 1992 to 2014 there was a decrease in the rate of malpractice claims paid on behalf of physicians in the United States, but mean compensation amounts increased, according to a study published online March 27 in JAMA Internal Medicine.

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Gender Gap Found in Evaluations of Emergency Medicine Residents

FRIDAY, March 24, 2017 (HealthDay News) -- The rate of milestone attainment is higher for male than female residents throughout training across all emergency medicine (EM) subcompetencies, according to a study published online March 6 in JAMA Internal Medicine.

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30-Day Mortality Down During Joint Commission Survey Weeks

THURSDAY, March 23, 2017 (HealthDay News) -- Patients admitted to the hospital during The Joint Commission on-site inspections (surveys) have reduced mortality compared to that seen during non-survey weeks, according to research published online March 20 in JAMA Internal Medicine.

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C1 Inhibitor Use Reduces Attacks in Hereditary Angioedema

THURSDAY, March 23, 2017 (HealthDay News) -- Prophylactic use of the subcutaneous C1 inhibitor CSL830 is associated with a reduction in the frequency of acute attacks in patients with hereditary angioedema, according to a study published in the March 23 issue of the New England Journal of Medicine.

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Higher Risk of Death From Injury Among Individuals With Autism

WEDNESDAY, March 22, 2017 (HealthDay News) -- Individuals with autism have an increased risk of death from injury, with suffocation, asphyxiation, and drowning identified as the leading causes of injury mortality, according to a study published online March 21 in the American Journal of Public Health.

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Black, Asian Medical Students Less Likely to Be AΩA Members

TUESDAY, March 21, 2017 (HealthDay News) -- Black and Asian medical students are less likely to be members of the Alpha Omega Alpha (AΩA) honor society than white students, according to a study published online March 6 in JAMA Internal Medicine.

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Impaired Orthostatic BP Recovery Linked to Falls in Older Adults

MONDAY, March 20, 2017 (HealthDay News) -- Delayed recovery orthostatic hypotension (OH) and sustained OH are associated with increased risk of falls among community-dwelling older adults, according to a study published in the March issue of the Journal of the American Geriatrics Society.

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Initial Rx Can Affect Likelihood of Long-Term Opioid Use

FRIDAY, March 17, 2017 (HealthDay News) -- Doctors who limit the supply of opioids they prescribe to three days or less may help patients reduce their risk of dependence and addiction, according to research published in the March 17 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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CDC: Suicide Rates Up in Less Urban Regions of United States

FRIDAY, March 17, 2017 (HealthDay News) -- Although the U.S. suicide rate has been rising gradually since 2000, suicides in less urban areas are outpacing those in more urban areas, according to research published in the March 17 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Foreign Body Ingestion Can Result in Movement Disorder

THURSDAY, March 16, 2017 (HealthDay News) -- Ingestion of a foreign body can result in sudden onset of movement disorder in young children, according to a case report published online March 15 in Pediatrics.

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Clinical Decision Support System Use Tied to Fewer VTE Events

THURSDAY, March 16, 2017 (HealthDay News) -- Use of computerized clinical decision support systems (CCDSSs) among surgical patients is associated with an increase in the rate of appropriate ordering of venous thromboembolism (VTE) prophylaxis and a decrease in the risk of VTE events, according to a review published online March 15 in JAMA Surgery.

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Catastrophic Neonatal Outcome Ups Unscheduled C-Section Rates

THURSDAY, March 16, 2017 (HealthDay News) -- Catastrophic neonatal outcome is associated with a transient increase in the rate of unscheduled cesarean deliveries, according to research published in the April issue of Obstetrics & Gynecology.

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Supervised Self-Injection Ups Teens' Comfort With Approach

THURSDAY, March 16, 2017 (HealthDay News) -- For food-allergic adolescents at risk for anaphylaxis, supervised self-infection with an empty syringe is associated with improved comfort levels with self-injection, according to a study published in the March-April issue of the Journal of Allergy and Clinical Immunology: In Practice.

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Women Underrepresented Among Grand Rounds Speakers

WEDNESDAY, March 15, 2017 (HealthDay News) -- Women seem to be underrepresented among academic grand rounds (GR) speakers, according to a research letter published online March 6 in JAMA Internal Medicine.

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Concurrent Benzodiazepine, Opioid Use Up Significantly

WEDNESDAY, March 15, 2017 (HealthDay News) -- From 2001 to 2013, concurrent benzodiazepine/opioid use significantly increased in privately-insured patients in the United States, according to a report published online March 14 in The BMJ.

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Many A-Fib Patients Not Getting Appropriate Anticoagulation Rx

TUESDAY, March 14, 2017 (HealthDay News) -- Many patients with atrial fibrillation who experience a stroke may not have been on appropriate anticoagulation therapy, according to a study published in the March 14 issue of the Journal of the American Medical Association.

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Support for Health Law Up to 48 Percent in February

TUESDAY, March 14, 2017 (HealthDay News) -- Support for the health law is increasing, with most Americans feeling that Medicaid should continue as it is today, according to a report published by Kaiser Health News.

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Synthetic Cannabinoids Tied to High-Risk Behavior in Adolescents

MONDAY, March 13, 2017 (HealthDay News) -- Adolescents who use synthetic cannabinoids are at a heightened risk for violent behavior, high-risk sexual activity, and abuse of other drugs, according to research published online March 13 in Pediatrics.

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Higher Spending by Physicians Not Tied to Better Outcomes

MONDAY, March 13, 2017 (HealthDay News) -- Medicare patients treated by higher-spending physicians are just as likely to be readmitted or die within 30 days of being admitted to the hospital as patients treated by doctors who order fewer or less-expensive tests and treatments, according to a study published online March 13 in JAMA Internal Medicine.

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Nursery Items Contribute to Increased Infant Injury Rates

MONDAY, March 13, 2017 (HealthDay News) -- Emergency department visits for injuries related to strollers, cribs, and other nursery products rose nearly 24 percent between 2003 and 2011, after more than a decade of decline, according to a report published online March 13 in Pediatrics.

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Chorioretinal Lesions Secondary to Zika Virus Observed

MONDAY, March 13, 2017 (HealthDay News) -- Acute-onset, self-resolving, placoid or multifocal non-necrotizing chorioretinal lesions may be caused by Zika virus infection, according to a case report published online March 9 in JAMA Ophthalmology.

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QI Project Ups Jet Injection of Lidocaine in IV Placements

FRIDAY, March 10, 2017 (HealthDay News) -- A quality improvement project can increase jet injection of lidocaine (JIL) use with intravenous (IV) placements in the emergency department, according to a quality report published online March 9 in Pediatrics.

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ACA's Medicaid Expansion May Pose Challenges to Timely Care

THURSDAY, March 9, 2017 (HealthDay News) -- People living in states that expanded Medicaid under the Affordable Care Act (ACA) are less likely to be uninsured or struggling with the strain of unpaid medical bills, but they also seem to have increased difficulty receiving timely care, according to research published in the March 9 issue of the New England Journal of Medicine.

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Nonclinical Factors Drive Antibiotic Choice in Pediatric CAP

THURSDAY, March 9, 2017 (HealthDay News) -- For children with community-acquired pneumonia (CAP), patient and nonclinical characteristics are associated with receipt of macrolides and broad-spectrum antibiotics versus amoxicillin, according to a study published online March 7 in Pediatrics.

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Migraine Consistently Tied to Cervical Artery Dissection

TUESDAY, March 7, 2017 (HealthDay News) -- Cervical arterial dissection (CEAD) increases risk of ischemic stroke (IS), and appears related to history of migraine headaches in some younger adults, according to a study published online March 6 in JAMA Neurology.

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Republicans Introduce Affordable Care Act Replacement

TUESDAY, March 7, 2017 (HealthDay News) -- An initial Republican replacement for the Affordable Care Act was formally introduced in the House of Representatives on Monday.

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Watchful Waiting Cost-Effective for Pediatric Acute Otitis Media

TUESDAY, March 7, 2017 (HealthDay News) -- Implementation of the American Academy of Pediatrics guidelines of watchful waiting (WW) for acute otitis media (AOM) is cost-effective, according to research published online March 3 in Pediatrics.

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Most Health Care Providers Can Offer Cost Estimate

MONDAY, March 6, 2017 (HealthDay News) -- Most provider organizations can offer a cost estimate, although few patients request one, according to a report published by Becker's Hospital CFO.

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Guidelines Updated for Benign Paroxysmal Positional Vertigo

MONDAY, March 6, 2017 (HealthDay News) -- In a clinical practice guideline published in the March issue of Otolaryngology-Head and Neck Surgery, updated recommendations are presented for the diagnosis and management of benign paroxysmal positional vertigo (BPPV).

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Quality Improvement Project Can Reduce Pediatric Head CT Use

MONDAY, March 6, 2017 (HealthDay News) -- A quality improvement (QI) project can decrease use of computed tomography (CT) in the emergency department for children with head injury, according to a study published online March 2 in Pediatrics.

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Tolerance Develops in NSAID-Induced Urticaria/Angioedema

FRIDAY, March 3, 2017 (HealthDay News) -- Patients with nonsteroidal anti-inflammatory drug (NSAID)-induced urticaria/angioedema (NIUA) may develop tolerance to NSAIDs over time, according to a study published online Feb. 22 in Allergy.

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Judgement Bias in Medical Device Recall Decisions

FRIDAY, March 3, 2017 (HealthDay News) -- The characteristics of the signal in user feedback of adverse events associated with medical devices and the situated context of decision makers correlate with judgement bias in reacting to these adverse events, according to research published online Jan. 29 in Production and Operations Management.

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Hospital Floors May Be Breeding Ground for Superbugs

FRIDAY, March 3, 2017 (HealthDay News) -- Hospital room floors may be more of an infection threat than many hospital staffers realize, according to a study published in the March 1 issue of the American Journal of Infection Control.

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CDC: Children Getting Ill From Ingesting Gel Hand Sanitizer

FRIDAY, March 3, 2017 (HealthDay News) -- A rising number of children are becoming ill from ingesting gel hand sanitizer, according to research published in the March 3 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Wide Variation Found for Amount of Melatonin in Supplements

THURSDAY, March 2, 2017 (HealthDay News) -- Many over-the-counter melatonin products are inaccurately labeled, according to a study published in the Feb. 15 issue of the Journal of Clinical Sleep Medicine.

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Overall, 8.8 Percent of U.S. Population Uninsured in 2016

THURSDAY, March 2, 2017 (HealthDay News) -- Overall, 8.8 percent of individuals of all ages were uninsured in the first nine months of 2016, which marked a nonsignificant reduction from 2015, according to a Feb. 14 report from the National Center for Health Statistics.

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Subdural Hematomas Rising Alongside Antithrombotic Use

WEDNESDAY, March 1, 2017 (HealthDay News) -- Antithrombotic drug use is associated with increased risk of subdural hematoma, according to a study published in the Feb. 28 issue of the Journal of the American Medical Association.

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Exposure to Neuraminidase Inhibitors in Utero Not Harmful

WEDNESDAY, March 1, 2017 (HealthDay News) -- Exposure to neuraminidase inhibitors during pregnancy is not associated with adverse neonatal outcomes or congenital malformations, according to a study published online Feb. 28 in The BMJ.

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Physician's Briefing
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