May 2018 Briefing - Emergency Medicine

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

Comprehensive Primary Care Initiative Improves Care Delivery

THURSDAY, May 31, 2018 (HealthDay News) -- Introducing the Comprehensive Primary Care Initiative (CPC), a health care delivery model developed by the Centers for Medicare and Medicaid Services (CMS), improves primary care delivery but does not reduce Medicare spending enough to cover care management fees, according to a study published online May 23 in Health Affairs.

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ASHP: SVP, Injectable Opioid Shortages Threaten Patient Care

THURSDAY, May 31, 2018 (HealthDay News) -- The widespread shortages of injectable opioids and small-volume parenteral (SVP) solutions are jeopardizing patient care and placing a strain on hospital operations, according to a report published by the American Society of Health-System Pharmacists (ASHP).

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Tighter Alcohol Policies Cut Alcohol-Related Crash Deaths

WEDNESDAY, May 30, 2018 (HealthDay News) -- Strengthening state alcohol policies can reduce alcohol-related crash fatalities, according to a study published online May 29 in JAMA Internal Medicine.

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Parents Have Concerns Over Food Allergy Precautions at Schools

WEDNESDAY, May 30, 2018 (HealthDay News) -- A substantial portion of parents whose children have food allergies have concerns over the safety of their child at school, according to a study published online May 12 in BMC Pediatrics.

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Severe Hyponatremia Described After Drinking Horsetail Juice

TUESDAY, May 29, 2018 (HealthDay News) -- Severe hyponatremia has been described after drinking horsetail (Equisetum) juice in a case report published online May 29 in the Annals of Internal Medicine.

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Babies of Adolescents in CPS Care More Likely to Be Taken Into Care

TUESDAY, May 29, 2018 (HealthDay News) -- Teen mothers who are in the care of child protection services (CPS) when they gave birth have more than a seven times higher likelihood that their child will be taken into care before age 2 years, compared to teen mothers not in CPS, according to a study published online May 29 in Pediatrics.

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Gaps in Care Post Discharge for Mild Traumatic Brain Injury

TUESDAY, May 29, 2018 (HealthDay News) -- There are considerable gaps in follow-up care for patients with mild traumatic brain injury (mTBI) who have been discharged from the hospital, according to a study published online May 25 in JAMA Network Open.

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CDC IDs Outbreak Trends Tied to Treated Recreational Water

FRIDAY, May 25, 2018 (HealthDay News) -- Outbreaks associated with treated recreational water with confirmed infectious etiology are usually caused by Cryptosporidium, Legionella, or Pseudomonas, according to research published in the May 18 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Mortality Still High After Surgery for Congenital Heart Defects

FRIDAY, May 25, 2018 (HealthDay News) -- Long-term mortality after congenital heart surgery is higher than that of the general population for all forms of congenital heart defects (CHDs), according to a study published in the May 29 issue of the Journal of the American College of Cardiology.

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Congress Approves Bill Expanding Private Care for VA Patients

THURSDAY, May 24, 2018 (HealthDay News) -- Patients served by the beleaguered Veterans Affairs health system may have wider access to private care, thanks to a bill approved Wednesday by the Senate. President Donald Trump is known to support the bill, which now awaits his signature.

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Delay of Lactate Draws in Sepsis Ups Risk of In-Hospital Death

THURSDAY, May 24, 2018 (HealthDay News) -- Each hour of delay in detecting abnormal lactates in patients with sepsis increases the odds of in-hospital death, according to a study published online May 24 in CHEST.

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Social Isolation Tied to Worse Heart Failure Outcomes

THURSDAY, May 24, 2018 (HealthDay News) -- Greater perceived social isolation is associated with an increased risk of death and health care use among patients with heart failure, according to a study published online May 23 in the Journal of the American Heart Association.

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Rising Fatal Drug Overdoses Linked to Years of Life Lost

THURSDAY, May 24, 2018 (HealthDay News) -- For non-Hispanic whites, rising fatal drug overdose rates are associated with increases in the mortality rate and years of potential life lost from 1999 to 2015, according to a study published online May 22 in the American Journal of Preventive Medicine.

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Global Variation in Personal Health Care Access and Quality

THURSDAY, May 24, 2018 (HealthDay News) -- There is considerable global variation in personal health care access and quality, according to a study published online May 23 in The Lancet.

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AAP: Congress Urged to Act to Prevent Firearm Deaths

WEDNESDAY, May 23, 2018 (HealthDay News) -- Pediatricians are joining the call for action to prevent firearm deaths and injuries, according to a letter published by the American Academy of Pediatrics.

Letter

Pediatricians Should Advocate for Life Support Training

WEDNESDAY, May 23, 2018 (HealthDay News) -- Pediatricians should advocate for life support training for children, parents, caregivers, school personnel, and the public, according to a technical report and policy statement published online May 23 in Pediatrics.

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Post-Surgical Readmissions Higher Among Homeless Veterans

TUESDAY, May 22, 2018 (HealthDay News) -- Readmissions are higher in homeless veterans discharged to the community after surgery, compared to housed veterans, according to a study published in the June issue of Medical Care.

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Increase in Pediatric ADHD Meds Exposures from 2000 to 2011

TUESDAY, May 22, 2018 (HealthDay News) -- From 2000 through 2011 there was an increase in pediatric attention-deficit/hyperactivity disorder (ADHD) medication exposures reported to U.S. poison control centers, according to a study published online May 21 in Pediatrics.

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2003 to 2014 Saw Rise in Diabetic Ketoacidosis Admissions

TUESDAY, May 22, 2018 (HealthDay News) -- The incidence of hospitalization for diabetic ketoacidosis (DKA) and associated costs increased from 2003 to 2014, according to a study published online May 17 in Diabetes Care.

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Moral Distress for Docs Providing Emergency-Only Hemodialysis

TUESDAY, May 22, 2018 (HealthDay News) -- Clinicians who provide emergency-only hemodialysis (EOHD) to undocumented immigrants experience moral distress and professional burnout, according to a study published online May 22 in the Annals of Internal Medicine.

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CDC: No Change in Level of Uninsured in U.S. in 2017

TUESDAY, May 22, 2018 (HealthDay News) -- Overall, 9.1 percent of individuals in the United States were uninsured in 2017, which was not significantly different from the level in 2016, according to a report published online May 22 by the U.S. Centers for Disease Control and Prevention's National Centers for Health Statistics.

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Patterns of Potential Misuse Help Assess Risk of Opioid Overdose

MONDAY, May 21, 2018 (HealthDay News) -- Patterns of potential opioid misuse are positively associated with subsequent opioid overdose, according to a study published online May 22 in the Annals of Internal Medicine.

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Rivaroxaban Linked to Low VTE Recurrence in Active Cancer

MONDAY, May 21, 2018 (HealthDay News) -- For patients with active cancer and venous thromboembolism (VTE), rivaroxaban is associated with lower VTE recurrence compared with dalteparin, but with elevated clinically relevant non-major bleeding (CRNMB), according to a study published online May 10 in the Journal of Clinical Oncology.

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Language Used in Medical Record Can Affect Patient Care

FRIDAY, May 18, 2018 (HealthDay News) -- Stigmatizing language used in medical records to describe patients can influence medical students and residents in terms of their attitudes towards the patient and their clinical decision-making, according to a study published in the May issue of the Journal of General Internal Medicine.

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Adding Chiropractic to Usual Care Beneficial for Low Back Pain

FRIDAY, May 18, 2018 (HealthDay News) -- For active-duty military personnel, the addition of chiropractic care to usual medical care is associated with improvements in low back pain intensity and disability, according to a study published online May 18 in JAMA Network Open.

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Confirmatory Testing Follows ER Use of Ultrasound

THURSDAY, May 17, 2018 (HealthDay News) -- Emergency room physicians report that their use of point-of-care ultrasound (POCUS) is usually followed by confirmatory testing, according to a study published online May 8 in the Journal of Clinical Ultrasound.

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Budesonide-Formoterol Used As Needed Beneficial in Mild Asthma

THURSDAY, May 17, 2018 (HealthDay News) -- Inhaled combined budesonide-formoterol used as needed is beneficial for mild asthma, according to two studies published in the May 17 issue of the New England Journal of Medicine.

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New Rabies Test Could Radically Change Testing, Treatment

WEDNESDAY, May 16, 2018 (HealthDay News) -- A new rapid rabies test for animals could revolutionize screening and spare humans unnecessary painful treatment, according to a U.S. Centers for Disease Control and Prevention study published online May 16 in PLOS ONE.

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Nonprofit Manufacturer Could Keep Generic Drug Costs Down

WEDNESDAY, May 16, 2018 (HealthDay News) -- A nonprofit manufacturer could help keep generic drug prices down and maintain their supply, according to a perspective piece published in the May 17 issue of the New England Journal of Medicine.

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Suicide Ideation, Attempts Increasing Among U.S. Children

WEDNESDAY, May 16, 2018 (HealthDay News) -- From 2008 to 2015 there was an increase in encounters for suicide ideation (SI) and suicide attempts (SAs) among U.S. children, according to a study published online May 16 in Pediatrics.

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Asthma Mortality Inversely Tied to Deprivation in English Young

TUESDAY, May 15, 2018 (HealthDay News) -- For children and younger adults with asthma, prevalence and admissions increase with deprivation, while mortality is inversely associated with deprivation, according to a study published online May 14 in Thorax.

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Hyoscyamine Helps in A-Fib With Slow Ventricular Response

TUESDAY, May 15, 2018 (HealthDay News) -- Hyoscyamine can prevent pacemaker placement in a patient with symptoms caused by a slow ventricular response during atrial fibrillation, according to a case study published online May 15 in the Annals of Internal Medicine.

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Rate of Deaths From Falls in Seniors Up From 2007 to 2016

MONDAY, May 14, 2018 (HealthDay News) -- From 2007 to 2016, the rate of deaths from falls among older adults increased by an average of 3.0 percent per year, according to research published in the May 11 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Initiative Cuts Overuse of Tests, Treatments for Bronchiolitis

FRIDAY, May 11, 2018 (HealthDay News) -- A multidisciplinary improvement initiative can reduce overuse of interventions for bronchiolitis, according to a study published online May 11 in Pediatrics.

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Hemorrhage Control Training Is Beneficial for Laypersons

FRIDAY, May 11, 2018 (HealthDay News) -- Hemorrhage control training for laypersons is the most efficacious method for controlling hemorrhaging, according to a study published online May 9 in JAMA Surgery.

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Recent Oral Antibiotics Use Tied to Higher Risk of Nephrolithiasis

THURSDAY, May 10, 2018 (HealthDay News) -- Recent use of oral antibiotics is associated with increased odds of nephrolithiasis, according to a study published online May 10 in the Journal of the American Society of Nephrology.

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Peds Fasting Duration Not Tied to Adverse Sedation Outcomes

WEDNESDAY, May 9, 2018 (HealthDay News) -- For children undergoing procedural sedation for a painful procedure, fasting duration is not associated with adverse events, according to a study published online May 7 in JAMA Pediatrics.

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Regulatory Requirements Drive Dissatisfaction With EHRs

TUESDAY, May 8, 2018 (HealthDay News) -- Regulatory requirements are likely to be an important aspect of physician dissatisfaction with electronic health records (EHRs) that is driving burnout, according to an Ideas and Opinions piece published online May 8 in the Annals of Internal Medicine.

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Evidence Lacking for Impact of PDMPs on Drug Overdoses

TUESDAY, May 8, 2018 (HealthDay News) -- There is insufficient evidence available for examining the correlation between prescription drug monitoring programs (PDMPs) and non-fatal or fatal overdoses, according to a review published online May 8 in the Annals of Internal Medicine.

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High Number of Years of Life Lost Due to Police Violence in U.S.

TUESDAY, May 8, 2018 (HealthDay News) -- The number of years of life lost (YLLs) due to police violence in the United States is substantial and disproportionately impacts young people of color, according to a study published online May 7 in the Journal of Epidemiology & Community Health.

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Low Neighborhood Walkability Increases Risk of Asthma in Kids

FRIDAY, May 4, 2018 (HealthDay News) -- Children living in neighborhoods with low walkability are at increased risk of asthma, according to a study published online April 17 in the Annals of the American Thoracic Society.

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Many Organizations Not Meeting Trial Reporting Requirements

FRIDAY, May 4, 2018 (HealthDay News) -- Many organizations are not meeting the trial registration and results reporting requirements clarified by "The Final Rule," which had a compliance date of April 18, 2017, according to a study published online May 1 in BMC Medicine.

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High Incidence of Sudden and/or Arrhythmic Death in CHD

FRIDAY, May 4, 2018 (HealthDay News) -- Among patients with coronary heart disease without severe systolic dysfunction, sudden and/or arrhythmic deaths (SAD) account for a considerable proportion of deaths, according to a study published online May 2 in JAMA Cardiology.

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Five Strategies to Reduce Acute Care for Cancer Patients ID'd

THURSDAY, May 3, 2018 (HealthDay News) -- Five major strategies exist for reducing acute care for patients with cancer, according to a review published online April 17 in the Journal of Oncology Practice.

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Unit-Dose Packaging Cuts Accidental Peds Opioid Exposures

THURSDAY, May 3, 2018 (HealthDay News) -- The transition to use of buprenorphine products with unit-dose packaging (UDP) starting in 2010 correlated with a reduction in unintentional pediatric exposures to buprenorphine-naloxone, according to a study published online May 3 in Pediatrics.

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Health Care for Undocumented Immigrants Is Complex

WEDNESDAY, May 2, 2018 (HealthDay News) -- In a perspective piece published in the May 2 issue of the New England Journal of Medicine, health care for undocumented immigrants is addressed in the context of an anti-immigration federal policy environment.

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Synthetic Opioid Involvement in Opioid-Related Deaths Up

TUESDAY, May 1, 2018 (HealthDay News) -- Synthetic opioid involvement in opioid-related overdose deaths increased significantly from 2010 to 2016, according to a research letter published in the May 1 issue of the Journal of the American Medical Association.

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Practices Should Be Aware of Correct Way to Fire Employees

TUESDAY, May 1, 2018 (HealthDay News) -- Physicians should be aware of the correct protocol for, as well as the laws involved in, firing employees, according to a report published in Medical Economics.

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Timely Receipt of PCI in STEMI Up With Hospital Bypass Policy

TUESDAY, May 1, 2018 (HealthDay News) -- Adoption of policies allowing emergency medical services (EMS) to bypass non-percutaneous coronary intervention (PCI) capable hospitals for patients with ST-segment elevation myocardial infarction (STEMI) is associated with increased receipt of timely PCI, according to a study published online May 1 in Circulation: Cardiovascular Interventions.

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