November 2014 Briefing - Emergency Medicine

Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for November 2014. 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.

Health Care Organizations See Value of Telemedicine

WEDNESDAY, Nov. 26, 2014 (HealthDay News) -- Health care organizations are developing and implementing telemedicine programs, although many have yet to receive reimbursement, according to a report published by Foley & Lardner.

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NPs, PAs Use More Diagnostic Imaging Compared to Physicians

WEDNESDAY, Nov. 26, 2014 (HealthDay News) -- Advanced practice clinicians (APCs) use more imaging than primary care physicians (PCPs), according to a study published online Nov. 24 in JAMA Internal Medicine.

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Home Visits Can Improve Asthma Control for Low-Income Adults

TUESDAY, Nov. 25, 2014 (HealthDay News) -- For low-income adults with uncontrolled asthma, home visitation by community health workers is associated with improvements in asthma control and quality of life, according to a study published online Nov. 24 in JAMA Internal Medicine.

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Emergency Department Visits on the Rise

TUESDAY, Nov. 25, 2014 (HealthDay News) -- The number of emergency department visits in the United States rose from 129.8 million in 2010 to a record 136.3 million in 2011, according to the U.S. Centers for Disease Control and Prevention.

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More Advanced Emergency Care May Be Worse in Cardiac Arrest

TUESDAY, Nov. 25, 2014 (HealthDay News) -- Advanced life support given by paramedics to cardiac arrest victims may cost lives rather than save them, while the best treatment might just be good cardiopulmonary resuscitation given by paramedics or emergency medical technicians and getting the patient to the hospital as fast as possible. These findings were published online Nov. 24 in JAMA Internal Medicine.

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Special Ambulance Delivers Vital Stroke Care More Quickly

MONDAY, Nov. 24, 2014 (HealthDay News) -- Stroke outcomes are better when patients are treated in an ambulance by a neurologist equipped with a computed tomography scanner and tissue plasminogen activator (tPA), according to a report published online Nov. 17 in JAMA Neurology.

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Strategies Needed to Encourage Appropriate Antibiotic Selection

MONDAY, Nov. 24, 2014 (HealthDay News) -- Although primary care providers are generally familiar with guideline recommendations for antibiotic drug selection, they do not always comply with these guidelines, according to research published in the December issue of the U.S. Centers for Disease Control and Prevention's Emerging Infectious Diseases.

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AMA: Gender Inequality Still Exists in Medicine

FRIDAY, Nov. 21, 2014 (HealthDay News) -- Gender inequality still exists in medicine, according to an article published by the American Medical Association (AMA).

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Structured Education Program Beneficial for Anaphylaxis

FRIDAY, Nov. 21, 2014 (HealthDay News) -- A structured education intervention improves knowledge and emergency management for patients at risk for anaphylaxis and their caregivers, according to a study published online Nov. 19 in Allergy.

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Sickle Cell Trait Tied to Increased Pulmonary Embolism Risk

THURSDAY, Nov. 20, 2014 (HealthDay News) -- For African-Americans, sickle cell trait is associated with an increased risk of pulmonary embolism, but not deep vein thrombosis, according to a study published online Nov. 13 in the Journal of Thrombosis and Haemostasis.

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Number of Pregnant Women on Opioids Doubles

WEDNESDAY, Nov. 19, 2014 (HealthDay News) -- The proportion of women dependent on drugs such as narcotic painkillers or heroin during pregnancy has more than doubled in the past decade and a half, though it still remains below a half-percent of all pregnancies, according to a study published in the December issue of Anesthesiology.

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Trainee-Led Time-Outs Can Improve Antimicrobial Use

WEDNESDAY, Nov. 19, 2014 (HealthDay News) -- Trainee-led time-outs to reevaluate antibiotic use can reduce costs in internal medicine units, according to a study published in a supplement to the Nov. 18 issue of the Annals of Internal Medicine, highlighting the Robert Wood Johnson Foundation Clinical Scholars Program.

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Nearly 3 in 10 Americans With Diabetes Don't Know It

TUESDAY, Nov. 18, 2014 (HealthDay News) -- Almost eight million Americans have diabetes but don't know it, and that's despite the fact that about two-thirds of those with undiagnosed diabetes have seen a doctor two or more times in the past year, according to a study published in the Nov. 18 issue of the Annals of Internal Medicine.

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Head Trauma in Abused Kids Can Have Lifelong Impact

MONDAY, Nov. 17, 2014 (HealthDay News) -- Half of children who experience a severe abusive head trauma before the age of 5 will die before they turn 21, and among those who survive severe injuries, quality of life will be cut in half, according to new research. The findings were published online Nov. 17 in Pediatrics.

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Fluid, Electrolyte Replacement Successful in Two Cases of EVD

FRIDAY, Nov. 14, 2014 (HealthDay News) -- Aggressive fluid and electrolyte replacement successfully improved the condition of two patients with Ebola virus disease (EVD), according to case reports published online Nov. 12 in the New England Journal of Medicine.

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Improper Contact Lens Use Causes Millions of Eye Infections

FRIDAY, Nov. 14, 2014 (HealthDay News) -- Millions of Americans misuse contact lenses -- wearing them too long, not cleaning them properly -- and that causes almost a million cases of keratitis in the United States annually, according to research published in the Nov. 14 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Triple Aim Should Be Expanded to Address Physician Burnout

FRIDAY, Nov. 14, 2014 (HealthDay News) -- Expanding the Triple Aim approach -- which includes enhancing patient experience, improving population health, and reducing costs -- to the Quadruple Aim by adding the goal of improving health care provider work life is recommended, according to the authors of an article published in the November/December issue of the Annals of Family Medicine.

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Hospital Workers Wash Hands Less at End of Shift

THURSDAY, Nov. 13, 2014 (HealthDay News) -- Health workers in hospitals wash their hands less often as they near the end of their shift, and this lapse -- likely due to mental fatigue -- could contribute to hundreds of thousands of patient infections a year in the United States, according to a study published online Nov. 3 in the Journal of Applied Psychology.

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Falls Leading Cause of Serious Head Trauma for Children

THURSDAY, Nov. 13, 2014 (HealthDay News) -- For children under the age of 2, falls account for 77 percent of head injuries, and for children aged 2 to 12, falls cause 38 percent of head injuries. Among teens aged 13 to 17, head injuries are most often caused by assaults, sports, and car crashes. These findings were published in the Nov. 13 issue of the New England Journal of Medicine.

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U.S. Prices Soaring for Some Generic Drugs

THURSDAY, Nov. 13, 2014 (HealthDay News) -- Market forces are dramatically driving up the cost of some generic drugs, prompting U.S. investigations into the pricing of what should be cheap alternatives to brand-name medications.

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Laundry Detergent Pods Pose Poisoning Risk to Children

MONDAY, Nov. 10, 2014 (HealthDay News) -- Laundry detergent "pods," an alternative to traditional liquid and powder detergents, pose a serious health risk to children, especially those under age 3, according to a report published online Nov. 10 and in Pediatrics.

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Review: Point-of-Care Biomarker May Help Cut Antibiotic Use

MONDAY, Nov. 10, 2014 (HealthDay News) -- The point-of-care C-reactive protein biomarker test of infection can reduce antibiotic use, although it does not affect clinical recovery, according to a review published online Nov. 6 in The Cochrane Library.

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Preventable Hospitalizations ID'd in Pediatric Medical Complexity

MONDAY, Nov. 10, 2014 (HealthDay News) -- A review published online Nov. 10 in Pediatrics identifies the characteristics of preventable hospitalizations for children with medical complexity (CMC), and offers strategies for the prevention of these hospitalizations.

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CDC Spends $2.7 Million on Ebola Hospital Kits

FRIDAY, Nov. 7, 2014 (HealthDay News) -- About $2.7 million in personal protective gear has been ordered for health care workers at U.S. hospitals treating Ebola patients, the federal Centers for Disease Control and Prevention said Friday.

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Want to Be a Leader? Cultivate a Healthy Look

FRIDAY, Nov. 7, 2014 (HealthDay News) -- It's more important for potential business or political leaders to look healthy than intelligent, according to a study published online Nov. 5 in Frontiers in Human Neuroscience.

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Climate Change Will Boost Grass Pollen Production

FRIDAY, Nov. 7, 2014 (HealthDay News) -- Climate change will boost levels of grass pollen in the air in the next 100 years, resulting in more allergen exposure, according to a study published online Nov. 5 in PLOS ONE.

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Better Physician Communication at Shift Change Reduces Errors

FRIDAY, Nov. 7, 2014 (HealthDay News) -- Changing how doctors communicate during shift changes in hospitals reduces the risk of adverse events in patients by 30 percent, according to a study published in the Nov. 6 issue of the New England Journal of Medicine.

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Docs Spend ~16.6 Percent of Their Time on Administration

FRIDAY, Nov. 7, 2014 (HealthDay News) -- About 16.6 percent of doctors' working hours are spent on administrative work, according to a study published recently in the International Journal of Health Services.

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ACOG Issues Guidance for Care of Pregnant Women With Ebola

THURSDAY, Nov. 6, 2014 (HealthDay News) -- Guidelines have been developed for the care of pregnant women at risk of or with suspected Ebola virus disease (EVD), according to a practice advisory published online Nov. 3 by the American College of Obstetricians and Gynecologists (ACOG).

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Bone Health After Fracture May Be Overlooked in Men

THURSDAY, Nov. 6, 2014 (HealthDay News) -- Older men are much less likely than women to receive osteoporosis screening and treatment after suffering a wrist fracture, according to a study published in the Nov. 1 issue of The Journal of Bone & Joint Surgery.

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Google Glass Might Adversely Affect Vision

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- Since its initial launch in 2013, Google Glass has been touted as a revolutionary entry into the world of "smart" eyewear. The promise: a broadly expanded visual experience with on-the-move, hands-free access to photos, videos, messaging, web-surfing, and apps. The catch: a small new study suggests that the structure of the glasses (rather than the software) may curtail natural peripheral vision, creating blind spots that undermine safety while engaging in routine tasks, such as driving or walking.

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Hospitalizations for Pulmonary Embolism Vary by Season

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- Hospitalizations for pulmonary embolism (PE) are higher in the winter and lower in the summer, according to a study published online Oct. 31 in the Journal of Thrombosis and Homeostasis.

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Even Early Signs of Plaque in Arteries Signal Heart Risk

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- Even the earlier signs of coronary artery disease significantly increase the risk of myocardial infarction (MI) and early death, according to a new study published in the Nov. 5 issue of the Journal of the American Medical Association.

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Hospital MRSA Traced to U.K. Livestock

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- A strain of methicillin-resistant Staphylococcus aureus (MRSA) in hospitals can be traced back to livestock, and the strain's resistance to antibiotics is likely due to the widespread use of antibiotics on farms, according to a study published in the December issue of Applied and Environmental Microbiology.

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AMA: New Mapping Tool IDs Areas in Need of Physicians

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- A new interactive mapping tool can help physicians and their staff determine locations to establish or expand their practice, according to a report published by the American Medical Association (AMA).

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Ambulance Use With MI Tied to Higher Mortality

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- Using an ambulance for hospital transport of patients with ST-segment elevation myocardial infarction (MI) is associated with higher mortality, according to a study published in the Nov. 1 issue of The American Journal of Cardiology.

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Nearly 75% of Patients With No CAD Have Persistent Symptoms

TUESDAY, Nov. 4, 2014 (HealthDay News) -- Nearly three-quarters of people whose hearts are found to be healthy after being checked for coronary artery disease continue to have persistent symptoms such as chest pain, according to research published online Nov. 3 in Open Heart.

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Atrial Fibrillation May Double Risk for 'Silent Strokes'

TUESDAY, Nov. 4, 2014 (HealthDay News) -- Atrial fibrillation (AF) may more than double the risk of silent cerebral infarction (SCI), a new review suggests. The report was published in the Nov. 4 issue of the Annals of Internal Medicine.

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Long-Term Shift Work May Drain the Brain

TUESDAY, Nov. 4, 2014 (HealthDay News) -- Working non-standard hours -- "shift work" -- for many years is not only hard on the body, but may also dull the mind, new research suggests. According to the study, published online Nov. 3 in Occupational & Environmental Medicine, those who do shift work for more than 10 years seem to have the equivalent of an extra 6.5 years of age-related decline in memory and thinking skills.

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ACP Issues Recurrent Kidney Stone Prevention Guidelines

MONDAY, Nov. 3, 2014 (HealthDay News) -- Increased fluid intake is recommended to prevent recurrent nephrolithiasis, with pharmacological monotherapy suggested for patients in whom increased fluid intake fails to reduce stone formation. These clinical practice guidelines were developed by the American College of Physicians (ACP) and published in the Nov. 4 issue of the Annals of Internal Medicine.

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Ebola Elimination Possible With Early Patient Isolation

MONDAY, Nov. 3, 2014 (HealthDay News) -- Isolation of patients with Ebola in critical condition within days of symptom onset is likely to have a high chance of eliminating the disease, according to a study published online Oct. 28 in the Annals of Internal Medicine.

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Rate of PCI for Coronary Artery Disease Drops in the U.S.

MONDAY, Nov. 3, 2014 (HealthDay News) -- In the past several years, the rate of percutaneous coronary intervention (PCI) for coronary artery disease (CAD) has decreased in the United States, according to research published in the Oct. 1 issue of The American Journal of Cardiology.

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CT Findings ID Tx Effectiveness in Small-Bowel Obstruction

MONDAY, Nov. 3, 2014 (HealthDay News) -- Computed tomographic (CT) findings can predict the effectiveness of nonsurgical treatment in patients with adhesive small-bowel obstruction (SBO), according to a study published in the November issue of Radiology.

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AMA: Absence of Health Insurer Competition in Many Areas

MONDAY, Nov. 3, 2014 (HealthDay News) -- In most metropolitan areas, there is a significant absence of health insurer competition, according to a report published by the American Medical Association (AMA).

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Physician's Briefing