Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for September 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.
Physicians Often Don’t Address Their Burnout
FRIDAY, Sept. 28, 2018 (HealthDay News) — More than half of physicians experience burnout, and many do not seek treatment for burnout, according to a report published in the American Medical Association’s AMA Wire.
Prevalence of TBI 2.5 Percent Among U.S. Children
FRIDAY, Sept. 28, 2018 (HealthDay News) — The prevalence of traumatic brain injury (TBI) is 2.5 percent among U.S. children, and TBI is associated with several health conditions, according to a study published online Sept. 24 in JAMA Pediatrics.
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Business Degree Increasingly Useful for Doctors
THURSDAY, Sept. 27, 2018 (HealthDay News) — Having a Master of Business Administration degree (M.B.A.) can help doctors with important, practice-related decisions, according to a report published recently in Physician Practice.
80,000 Americans Died From Influenza Over Last Year
THURSDAY, Sept. 27, 2018 (HealthDay News) — Influenza was deadlier last season than it has been for at least four decades, killing 80,000 Americans. So said the head of the U.S. Centers for Disease Control and Prevention late Tuesday in an interview with the Associated Press.
Opioid Bill Gets Bipartisan Support
THURSDAY, Sept. 27, 2018 (HealthDay News) — In a rare bipartisan move, both the House and Senate have reached a compromise on legislation to address the opioid epidemic.
Final Update on Salmonella-Tainted Honey Smacks Cereal
THURSDAY, Sept. 27, 2018 (HealthDay News) — A total of 135 people across 36 states fell ill with Salmonella after eating Kellogg’s Honey Smacks cereal, according to a final update from the U.S. Centers for Disease Control and Prevention.
Time to Defib Not Linked to Survival in Pediatric IHCA
THURSDAY, Sept. 27, 2018 (HealthDay News) — For pediatric patients with in-hospital cardiac arrest (IHCA), time to first defibrillation attempt is not associated with survival, according to a study published online Sept. 21 in JAMA Network Open.
Practices Should Set Rules for Staff Social Media Use
THURSDAY, Sept. 27, 2018 (HealthDay News) — Medical practices can take steps to avoid problems related to use of social media by staff members, according to an article published in Medical Economics.
Burnout, Career Choice Regret Prevalent in U.S. Residents
WEDNESDAY, Sept. 26, 2018 (HealthDay News) — Symptoms of burnout and career choice regret are prevalent among U.S. resident physicians, according to a study published in the Sept. 18 issue of the Journal of the American Medical Association.
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Lawn-Mower-Related Injuries Are Most Often Lacerations
WEDNESDAY, Sept. 26, 2018 (HealthDay News) — From 2006 through 2013, the weighted estimate of lawn-mower-related injuries was 51,151, with the most common injuries being lacerations, fractures, and amputations, according to a study published online Aug. 1 in Public Health Reports.
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Head CT Decision Aid Ups Parent Knowledge in Child Head Trauma
WEDNESDAY, Sept. 26, 2018 (HealthDay News) — Use of a decision aid can improve parent knowledge for children with minor head injury at intermediate risk of clinically important traumatic brain injury (ciTBI), according to a study published online Sept. 21 in JAMA Network Open.
Initial Abx Feasible Alternative for Uncomplicated Appendicitis
TUESDAY, Sept. 25, 2018 (HealthDay News) — The cumulative incidence of appendicitis recurrence within five years is 39.1 percent among patients with uncomplicated acute appendicitis initially treated with antibiotics, according to research published in the Sept. 25 issue of the Journal of the American Medical Association.
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In 2016, Proportion of Uninsured Americans Down to 10 Percent
TUESDAY, Sept. 25, 2018 (HealthDay News) — From 2013 to 2016 there was a reduction in uninsurance among Americans from 17 to 10 percent, according to a report published in September by the Robert Wood Johnson Foundation (RWJF) and the Urban Institute.
Physician-Group ACOs Generate Medicare Savings
TUESDAY, Sept. 25, 2018 (HealthDay News) — Physician-group accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) generated significantly more savings for Medicare that grew from 2012 to 2015 compared with hospital-integrated ACOs, according to research published in the Sept. 20 issue of the New England Journal of Medicine.
Interpreter Services Critical for Emergency Care
MONDAY, Sept. 24, 2018 (HealthDay News) — Emergency department interpreters are vital to quality care, according to an article published in the October issue of the Annals of Emergency Medicine.
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Gender Nonconformity Linked to Students’ Mental Distress
MONDAY, Sept. 24, 2018 (HealthDay News) — Gender nonconformity (GNC) is associated with mental distress for female and male students, according to a study published online Sept. 24 in JAMA Pediatrics.
Abstract/Full Text
Editorial (subscription or payment may be required)
Mortality for Unintentional Drug Poisonings Up Since 1979
MONDAY, Sept. 24, 2018 (HealthDay News) — Since at least 1979, there has been an exponential increase in the overall mortality rate for unintentional drug poisonings, according to a research article published online Sept. 21 in Science.
Heart Failure Patients Enrolled in Hospice Use Less Health Care
MONDAY, Sept. 24, 2018 (HealthDay News) — Patients with advanced heart failure enrolled in hospice have fewer emergency department visits, hospital days, and intensive care unit (ICU) stays, according to a study published in the September issue of JACC: Heart Failure.
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Ground Beef Recalled After E. Coli Outbreak
FRIDAY, Sept. 21, 2018 (HealthDay News) — More than 132,000 pounds of ground beef have been recalled by a Colorado company following a suspected outbreak where one person was killed and 17 were sickened by Escherichia coli after eating the meat.
AP News Article
Cargill Statement
Dozens of Medical Groups Join Forces to Improve Diagnoses
FRIDAY, Sept. 21, 2018 (HealthDay News) — Every nine minutes, a patient in a U.S. hospital dies because a diagnosis was wrong or delayed — resulting in 80,000 deaths a year. That sobering estimate comes from the Society to Improve Diagnosis in Medicine (SIDM).
Repeat CT Common in Peds Traumatic Epidural Hematoma
FRIDAY, Sept. 21, 2018 (HealthDay News) — For children with traumatic epidural hematomas (EDHs), repeated computed tomography (CT) imaging is common, but rarely impacts management, according to a study published in the September issue of Pediatrics.
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More Hurt, Killed in Shootings With Semiautomatic Rifles
FRIDAY, Sept. 21, 2018 (HealthDay News) — More people are wounded and killed in active shooter incidents in which semiautomatic rifles are used, according to a research letter published in the Sept. 11 issue of the Journal of the American Medical Association.
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Research Links Doctor Burnout to Patient Safety Incidents
THURSDAY, Sept. 20, 2018 (HealthDay News) — Physician burnout is associated with increased risk of patient safety incidents, poorer quality of care due to low professionalism, and reduced patient satisfaction, according to a review published online Sept. 4 in JAMA Internal Medicine.
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Black Individuals at Highest Risk of Legal Intervention Injury
THURSDAY, Sept. 20, 2018 (HealthDay News) — Black males were at the highest risk of legal intervention injury per capita from 2005 to 2015, according to a study published online Sept. 14 in JAMA Network Open.
Hospitals Charge 479 Percent of Cost of Drugs on Average
THURSDAY, Sept. 20, 2018 (HealthDay News) — On average, hospitals mark up drugs by 479 percent of their cost, according to a report from The Moran Company, commissioned by the Pharmaceutical Research and Manufacturers of America (PhRMA).
Residents Should Take Advantage of Paid Time Off
THURSDAY, Sept. 20, 2018 (HealthDay News) — Although there are many demands on residents, taking advantage of paid vacation time is one of the perks and should be maximized, according to an article published in the American Medical Association’s AMA Wire.
20% of Children, Adolescents Use Prescription Medications
WEDNESDAY, Sept. 19, 2018 (HealthDay News) — Almost 20 percent of children and adolescents used prescription medications in 2013 to 2014, and 8.2 percent of concurrent users of prescription medications in 2009 to 2014 were at risk for a potentially major drug-drug interactions (DDIs), according to a study published in the September issue of Pediatrics.
Patient Health Information Often Shared Electronically
WEDNESDAY, Sept. 19, 2018 (HealthDay News) — The most common electronically sent and received types of patient health information (PHI) include laboratory results and medication lists, according to a report published Aug. 15 by the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics.
Opioid Deaths 1999 to 2015 May Be Dramatically Underestimated
WEDNESDAY, Sept. 19, 2018 (HealthDay News) — States may be greatly underestimating the effect of opioid-related overdose deaths because of incomplete cause-of-death reporting, according to a study recently published in Public Health Reports.
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Global Prevalence of Insufficient Activity 27.5 Percent
WEDNESDAY, Sept. 19, 2018 (HealthDay News) — In 2016 the age-standardized prevalence of insufficient physical activity was 27.5 percent, according to a study published in the October issue of The Lancet Global Health.
U.S. Senate Passes Opioids Bill
TUESDAY, Sept. 18, 2018 (HealthDay News) — The Senate on Monday passed on a 99-1 vote legislation aimed at curbing the nation’s ongoing opioid addiction crisis.
Scribes Improve Physician Workflow, Patient Interaction
TUESDAY, Sept. 18, 2018 (HealthDay News) — Use of medical scribes is associated with decreased physician documentation burden, improved work efficiency, and improved patient interactions, according to a study published online Sept. 17 in JAMA Internal Medicine.
Drug Prices Increase More Than Expected After Shortages
TUESDAY, Sept. 18, 2018 (HealthDay News) — Prices for drugs under shortage increase more than twice as quickly as expected in the absence of a shortage, according to a research letter published online Sept. 18 in the Annals of Internal Medicine.
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Compliance With Requirement to Report Results on EUCTR Is Poor
TUESDAY, Sept. 18, 2018 (HealthDay News) — Half of trials on the European Union Clinical Trials Register (EUCTR) are non-compliant with the European Commission’s requirement that all trials post results to the registry within 12 month of completion, according to a study published online Sept. 13 in The BMJ.
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Decrease in Infant Walker-Related Injuries Since 2010
MONDAY, Sept. 17, 2018 (HealthDay News) — Following implementation of a federal mandatory safety standard on infant walkers in 2010, there was a decrease in the number of infant walker-related injuries, according to a study published online Sept. 17 in Pediatrics.
Mercury in Traditional Tibetan Medicine Could Be Harmful
MONDAY, Sept. 17, 2018 (HealthDay News) — The high mercury (Hg) concentration contained in traditional Tibetan medicine (TTM) could be harmful to humans and contribute to the environmental Hg burden in Tibet, according to a study published in the Aug. 7 issue of Environmental Science & Technology.
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Association Health Plans Can Help Small Businesses Offer Coverage
MONDAY, Sept. 17, 2018 (HealthDay News) — Association health plans (AHPs) will provide small businesses with more choices, access, and coverage options, although critics warn that they may undermine the Affordable Care Act (ACA) marketplace, according to an article published in Managed Healthcare Executive.
Ambient Particulate Matter Linked to Emergency Asthma Care
MONDAY, Sept. 17, 2018 (HealthDay News) — Ambient particulate matter concentrations are associated with emergency/urgent care visits among individuals with asthma, according to a study published in the Aug. 1 issue of the Annals of the American Thoracic Society.
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Final CDC Update on Salmonella Linked to Backyard Poultry
FRIDAY, Sept. 14, 2018 (HealthDay News) — At least 334 people in 47 states have been sickened in Salmonella outbreaks linked to contact with live poultry in backyard flocks, according to the U.S. Centers for Disease Control and Prevention.
CDC: Some Sexual Minorities Have Higher Sexual Risk Behaviors
FRIDAY, Sept. 14, 2018 (HealthDay News) — Bisexual females and “not sure” male students report higher prevalences for many sexual risk behaviors than heterosexual students, according to research published in the Sept. 14 issue of the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.
Extreme Flooding Can Up Exposure to Pathogens
FRIDAY, Sept. 14, 2018 (HealthDay News) — Extreme flooding, such as was seen in Hurricane Harvey, can increase exposure to pathogens, according to a research letter published recently in Environmental Science & Technology.
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Situation Framing, Language Can Influence Decision-Making
FRIDAY, Sept. 14, 2018 (HealthDay News) — How a situation is framed and the language used to describe risks can influence patients’ decision-making, according to an article published in Physicians Practice.
Firearm Deaths Up Globally From 1990 to 2016
THURSDAY, Sept. 13, 2018 (HealthDay News) — Firearm deaths increased globally between 1990 and 2016, according to a study published in the Aug. 28 issue of the Journal of the American Medical Association.
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New Risk Score Promising for Predicting MI, Death
THURSDAY, Sept. 13, 2018 (HealthDay News) — A score based on the results of three laboratory tests has higher sensitivity and specificity than cardiac troponin alone for stratifying patients presenting with suspected acute coronary syndrome, according to a study published online Aug. 19 in CMAJ, the journal of the Canadian Medical Association.
Physicians Need Training for Mass Casualty Incidents
THURSDAY, Sept. 13, 2018 (HealthDay News) — Proper training and post-incident steps can help lessen the secondary trauma health professionals experience providing care during mass casualty incidents (MCIs), according to an article published in the American Medical Association’s AMA Wire.
AHA: Resistant Hypertension Diagnosis, Tx Guidelines Updated
THURSDAY, Sept. 13, 2018 (HealthDay News) — A correct diagnosis of resistant hypertension is necessary to avoid overmedicating, according to a scientific statement from the American Heart Association published online Sept. 13 in Hypertension.
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Gains in Insurance Coverage Seen for Lesbian, Gay, Bisexual Adults
THURSDAY, Sept. 13, 2018 (HealthDay News) — Lesbian, gay, and bisexual (LGB) adults report continued problems affording care despite coverage gains offered by the Affordable Care Act, according to a study published in the August issue of Health Affairs.
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Highest Opioid-Related Mortality Seen in Construction Jobs
WEDNESDAY, Sept. 12, 2018 (HealthDay News) — Proportional mortality ratios (PMRs) for heroin-related overdose deaths and methadone-related overdose deaths from 2007 to 2012 were highest among construction workers, according to research published in the Aug. 24 issue of the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.
Residents Working Long Hours Can Increase Alertness
WEDNESDAY, Sept. 12, 2018 (HealthDay News) — Medical residents can take steps to maintain their energy and alertness during long shifts, according to an article published in the American Medical Association’s AMA Wire.
Six-Step Analysis Can Help Improve Practice Logistics
WEDNESDAY, Sept. 12, 2018 (HealthDay News) — A six-step analysis can help redesign and improve the outpatient health care process, according to a study recently published in the Journal of Evaluation in Clinical Practice.
Chest Radiograph Effective for Excluding Pediatric Pneumonia
TUESDAY, Sept. 11, 2018 (HealthDay News) — A negative chest radiograph (CXR) accurately excludes pneumonia in the majority of children, according to a study published in the September issue of Pediatrics.
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One in Five Pot Products Fails Potency, Purity Tests in California
TUESDAY, Sept. 11, 2018 (HealthDay News) — Close to 20 percent of marijuana products in California have failed to pass tests for potency or purity since the state began mandating such testing July 1, a new report finds.
Tai Chi Effective at Reducing Number of Falls in Older Adults
TUESDAY, Sept. 11, 2018 (HealthDay News) — Tai chi is more effective than conventional exercise at preventing falls among high-risk, older adults, according to a study published online Sept. 10 in JAMA Internal Medicine.
Shift Seen From EDs to Urgent Care for Low-Acuity, Acute Care
TUESDAY, Sept. 11, 2018 (HealthDay News) — From 2008 through 2015, there was a substantial shift in venue in which acute care for low-acuity conditions was sought, according to a study published online Sept. 4 in JAMA Internal Medicine.
Medicaid Work Requirements Don’t Impact Many Enrollees
TUESDAY, Sept. 11, 2018 (HealthDay News) — Medicaid work requirements will only impact a small proportion of persons and may only generate minimal savings, according to two research letters published online Sept. 10 in JAMA Internal Medicine.
Abstract/Full Text – Goldman
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Editorial
Data Age in Clinical Trials Is About Three Years at Publication
TUESDAY, Sept. 11, 2018 (HealthDay News) — The median data age in clinical trials in journals with a high impact factor is about three years at publication, according to a study published in the Aug. 10 issue of JAMA Network Open.
Many Opportunities for Doctors Using Twitter
MONDAY, Sept. 10, 2018 (HealthDay News) — Doctors can use Twitter to build networks and learn more about research in real time, according to a blog post published by Penn Medicine News.
Nurse-Led Call After Discharge Doesn’t Cut Peds Urgent Care
MONDAY, Sept. 10, 2018 (HealthDay News) — A one-time nurse-led telephone call does not decrease the 30-day reutilization rate of urgent health care services in children discharged from the hospital, according to a study published in the Sept. 4 issue of JAMA: Pediatrics.
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Naloxone Rarely Administered by Layperson in Opioid Deaths
MONDAY, Sept. 10, 2018 (HealthDay News) — From July 2016 to June 2017, bystanders were documented in 44 percent of opioid overdose deaths, but naloxone was rarely administered by a layperson, according to a study published Aug. 31 in Morbidity and Mortality Weekly Report.
Docs, Consumers Agree on Benefits of Virtual Care
MONDAY, Sept. 10, 2018 (HealthDay News) — Physicians and consumers agree on the benefits of virtual care, but physician adoption of virtual care technologies is low, according to a report on the Deloitte 2018 Survey of U.S. Physicians.
Physician Burnout Rates Vary by Medical Specialty
MONDAY, Sept. 10, 2018 (HealthDay News) — Nearly half of physicians report being burned out, but rates vary substantially by medical specialty, according to an article published in AMA Wire.
Influenza Caused Emirates Flight to Be Briefly Quarantined at JFK
FRIDAY, Sept. 7, 2018 (HealthDay News) — The mysterious illness that kept a plane away from the terminal after some passengers reported feeling sick has been confirmed as the flu, according to the New York City Department of Health and Mental Hygiene.
With New Persistent Opioid Use, Most Early Scripts From Surgeons
FRIDAY, Sept. 7, 2018 (HealthDay News) — Among surgical patients who develop new persistent opioid use, surgeons provide the majority of opioid prescriptions in the first few months after surgery, but by nine to 12 months post-surgery, most prescriptions are from primary care providers, according to a study recently published in the Journal of General Internal Medicine.
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Greater CAD Incidence, Heart Mass in Firefighter Cardiac Arrests
FRIDAY, Sept. 7, 2018 (HealthDay News) — Most cardiac fatalities among firefighters have evidence of coronary heart disease and increased heart mass, according to a study published online Sept. 5 in the Journal of the American Heart Association.
X-Rays, Blood Tests Not Advised for Children’s Concussions
FRIDAY, Sept. 7, 2018 (HealthDay News) — Routine X-rays and blood tests should not be used to diagnose children’s concussions, new U.S. government guidelines say. The guidelines were published online Sept. 4 in JAMA Pediatrics.
CDC Guideline
Evidence Review (subscription or payment may be required)
Editorial (subscription or payment may be required)
CDC Press Release
Personalized Weighting Could Enhance Hospital Rating Tools
FRIDAY, Sept. 7, 2018 (HealthDay News) — The weighting systems that underlie hospital performance rating tools should incorporate the needs, values, and preferences of patients, according to a perspective article published in the Aug. 30 issue of the New England Journal of Medicine.
Better Training Needed to Boost LGBTQ Patient Health Care
THURSDAY, Sept. 6, 2018 (HealthDay News) — High-quality health care needs to be provided to lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients, and improved training is necessary to deliver that care, according to a report published in the American Medical Association’s AMA Wire.
Opioid Maker to Pay for Overdose Antidote Development
THURSDAY, Sept. 6, 2018 (HealthDay News) — A $3.4 million grant to help a non-profit company develop a less expensive opioid overdose antidote was announced by Purdue Pharma, which makes the opioid painkiller OxyContin.
AP News Article
Purdue Pharma News Release
Hospital Groups Launch Own Generic Drug Company
THURSDAY, Sept. 6, 2018 (HealthDay News) — Three U.S. health care foundations and seven hospital groups have formed a generic drug company to combat high prices and chronic shortages of medicines.
Widespread Statin Use Not Recommended in Old, Very Old
THURSDAY, Sept. 6, 2018 (HealthDay News) — Statin use is not associated with reduced risk of atherosclerotic cardiovascular disease (CVD) or all-cause mortality among older adults without type 2 diabetes, according to a study published online Sept. 5 in The BMJ.
CDC Issues Recs on Diagnosis, Management of Pediatric mTBI
THURSDAY, Sept. 6, 2018 (HealthDay News) — The U.S. Centers for Disease Control and Prevention has established an evidence-based guideline for diagnosis and management of pediatric mild traumatic brain injury (mTBI). The guideline was published online Sept. 4 in JAMA Pediatrics.
CDC Guideline
Evidence Review (subscription or payment may be required)
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Baloxavir Superior to Placebo for Alleviating Flu Symptoms
WEDNESDAY, Sept. 5, 2018 (HealthDay News) — The selective inhibitor of influenza cap-dependent endonuclease, baloxavir marboxil, is superior to placebo for alleviating influenza symptoms, according to a study published in the Sept. 6 issue of the New England Journal of Medicine.
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130 Now Sickened by Salmonella-Tainted Honey Smacks Cereal
WEDNESDAY, Sept. 5, 2018 (HealthDay News) — One hundred thirty people across 36 states have now fallen ill with Salmonella after eating Kellogg’s Honey Smacks cereal, according to the U.S. Centers for Disease Control and Prevention.
FDA Outbreak Alert
CDC Press Release
ED Plays Critical Role in Caring for Patients With Opioid Use Disorder
WEDNESDAY, Sept. 5, 2018 (HealthDay News) — Emergency department providers need evidence-based strategies to identify and manage patients with opioid use disorder, according to a review published in the Annals of Emergency Medicine.
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~3,000 Excess Deaths Estimated Due to Hurricane Maria
WEDNESDAY, Sept. 5, 2018 (HealthDay News) — The total excess mortality attributed to Hurricane Maria is estimated at 2,975 deaths, according to a report issued by George Washington University.
Public Service Loan Forgiveness Program Has Uncertain Future
WEDNESDAY, Sept. 5, 2018 (HealthDay News) — Uncertainty surrounds the future of the Public Service Loan Forgiveness (PSLF) program, according to an Ideas and Opinions article published online Aug. 28 in the Annals of Internal Medicine.
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Enrollment in High-Deductible Health Plans Up From ’07 to ’17
TUESDAY, Sept. 4, 2018 (HealthDay News) — Enrollment in high-deductible health plans (HDHPs) has increased among adults with employment-based insurance coverage, according to an August data brief published by the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics.
CDC: Increase in Rate of STDs for Fourth Consecutive Year in U.S.
TUESDAY, Sept. 4, 2018 (HealthDay News) — Nearly 2.3 million cases of chlamydia, gonorrhea, and syphilis were diagnosed in the United States in 2017, marking a fourth consecutive year of sharp increases in these sexually transmitted diseases (STDs), according to a report published by the U.S. Centers for Disease Control and Prevention.
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