Home Emergency Medicine July 2019 Briefing – Emergency Medicine

July 2019 Briefing – Emergency Medicine

Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for July 2019. 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.

10.6 Percent of Seniors Estimated as Current Binge Drinkers

WEDNESDAY, July 31, 2019 (HealthDay News) — More than 10 percent of U.S. adults aged 65 years and older are estimated to be current binge drinkers, according to a report published online July 31 in the Journal of the American Geriatrics Society.

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Hot Pavement Can Burn Feet in Seconds

WEDNESDAY, July 31, 2019 (HealthDay News) — Hot pavement poses a burn risk, particularly when outside temperatures reach greater than 95 degrees Fahrenheit, according to a study published in the July/August issue of the Journal of Burn Care & Research.

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Burnout Symptoms May Up Racial Bias Among Resident Physicians

WEDNESDAY, July 31, 2019 (HealthDay News) — Symptoms of burnout seem to be associated with greater explicit and implicit racial bias among resident physicians, according to a study published online July 26 in JAMA Network Open.

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$70 Million Settlement Reached in Generic Drug Delay Case

TUESDAY, July 30, 2019 (HealthDay News) — Three drug companies will pay a total of nearly $70 million to California to settle charges of delaying the sale of generic drugs to keep brand-name drug prices high, the state’s attorney general said Monday.

AP News Article

Legionnaires’ Disease Outbreak Linked to Atlanta Hotel

TUESDAY, July 30, 2019 (HealthDay News) — Legionnaires’ disease has been diagnosed in 11 people who stayed at the Sheraton Atlanta, and there have been another 55 probable cases, Georgia health officials say.

CNN Article
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National Norms Developed for Assessing Medical School Empathy

TUESDAY, July 30, 2019 (HealthDay News) — National norms have been developed for assessing empathy among men and women at different levels of medical school education, according to a study published in the August issue of the Journal of the American Osteopathic Association.

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Consumer Products Tied to Three-Fourths of Youth Brain Injuries

MONDAY, July 29, 2019 (HealthDay News) — Nearly three-quarters of traumatic brain injuries (TBI) in children and teens are attributable to consumer products that are regulated by the U.S. Consumer Product Safety Commission, according to a study published online July 29 in the journal Brain Injury.

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Serious Falls Pose Risk to People Living With HIV

MONDAY, July 29, 2019 (HealthDay News) — Benzodiazepines and muscle relaxants are associated with serious falls among people living with HIV in their 50s, according to a study recently published in the Journal of Acquired Immune Deficiency Syndrome.

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Most Pediatric In-Flight Medical Events Handled by Crew

THURSDAY, July 25, 2019 (HealthDay News) — Most pediatric in-flight medical events (IFMEs) are handled by crewmembers, according to a study published online July 25 in the Annals of Emergency Medicine.

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Increase in Rates of Medical Imaging in Pregnancy in U.S., Canada

THURSDAY, July 25, 2019 (HealthDay News) — From 1996 to 2016, the rates of medical imaging among pregnant women increased in the United States and Ontario, Canada, according to a study published online July 24 in JAMA Network Open.

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Senate Bill Would Reduce Drug Costs for Seniors

TUESDAY, July 23, 2019 (HealthDay News) — A bill to reduce prescription drug costs for millions of Medicare recipients and lower federal and state health costs has been introduced by two U.S. senators.

AP News Article

Initiating Stroke Tx 15 Minutes Earlier Can Improve Outcomes

TUESDAY, July 23, 2019 (HealthDay News) — Shorter time to endovascular-reperfusion therapy is associated with improved outcomes among patients with acute ischemic stroke (AIS) due to large vessel occlusion, according to a study published in the July 16 issue of the Journal of the American Medical Association.

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State-Level Firearm Ownership Linked to Domestic Firearm Homicide

MONDAY, July 22, 2019 (HealthDay News) — There is an association for state-level firearm ownership rates with domestic, but not nondomestic, firearm homicide, according to a study published online July 22 in the American Journal of Preventive Medicine.

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Supply of Opioids Predicts Long-Term Use in Injured Workers

FRIDAY, July 19, 2019 (HealthDay News) — The number of days supplied of an initial opioid prescription is the strongest risk factor for developing long-term opioid use among previously opioid-free injured workers, according to a study published online July 17 in JAMA Network Open.

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Transfers Up for Mental Health Disorders in Uninsured Children

THURSDAY, July 18, 2019 (HealthDay News) — For children presenting to the emergency department with a mental health disorder, the likelihood of transfer is increased for those without insurance, according to a study published online July 1 in Pediatric Emergency Care.

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About One in 20 Patients Exposed to Preventable Harm

THURSDAY, July 18, 2019 (HealthDay News) — The pooled prevalence of preventable patient harm is 6 percent across a range of medical settings globally, according to a review published online July 17 in The BMJ.

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Safety Practice Violations ID’d in Septic Arthritis Outbreak

THURSDAY, July 18, 2019 (HealthDay News) — Breaches of recommended infection prevention practices have been identified in an outbreak of septic arthritis cases after intra-articular injections performed in a private outpatient facility, according to a report published online July 17 in Infection Control & Hospital Epidemiology.

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Medical Marijuana Laws May Not Impact Opioid Use

THURSDAY, July 18, 2019 (HealthDay News) — Medical marijuana laws do not appear to impact nonmedical prescription opioid use or opioid use disorder, according to a study published online July 17 in JAMA Network Open.

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People Living With HIV Have Higher Risk for Cardiovascular Disease

THURSDAY, July 18, 2019 (HealthDay News) — People living with HIV (PLWH) have a higher risk for cardiovascular disease, according to a study published online July 2 in the Journal of the American Heart Association.

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U.S. Drug OD Deaths Fall for First Time in Three Decades

WEDNESDAY, July 17, 2019 (HealthDay News) — For the first time in three decades, drug overdose deaths in the United States fell last year, preliminary federal government data suggest.

AP News Article

Intranasal Sufentanil Cuts Acute Trauma Pain Treated in the ED

WEDNESDAY, July 17, 2019 (HealthDay News) — Intranasal sufentanil (INS) is comparable to intravenous morphine (IVM) for acute severe trauma pain treated in the emergency department, according to a study published online July 16 in PLOS Medicine.

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Subclinical Cardiovascular Dz May Up Fall Risk in Older Adults

WEDNESDAY, July 17, 2019 (HealthDay News) — Subclinical cardiovascular disease (CVD) appears to be an independent risk factor for falls in older adults, according to a study published online July 10 in the Journal of the American Geriatrics Society.

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1999 to 2017 Saw Increase in Unintentional Injury Death Rates

TUESDAY, July 16, 2019 (HealthDay News) — From 1999 to 2017, there was an increase in unintentional injury death rates, with variation in trends by leading causes of unintentional injury death, according to a July data brief published by the U.S. Centers for Disease Control and Prevention National Center for Health Statistics.

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Firearm-Related Pediatric Mortality Down With Stricter Laws

MONDAY, July 15, 2019 (HealthDay News) — States with stricter firearm legislation have lower rates of firearm-related pediatric mortality, according to a study published online July 15 in Pediatrics.

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Opioids Commonly Prescribed in Emergency Department for Gout

MONDAY, July 15, 2019 (HealthDay News) — More than one-fourth of patients with acute gout discharged from the emergency department receive an opioid prescription, according to a study published online July 2 in Arthritis Care & Research.

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Race, Neighborhood Impact Bystander CPR in Pediatric OHCA

MONDAY, July 15, 2019 (HealthDay News) — For pediatric out-of-hospital cardiac arrest (OHCA), racial and neighborhood characteristics are associated with bystander cardiopulmonary resuscitation (BCPR), according to a study published online July 10 in the Journal of the American Heart Association.

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Rabies Warning Issued for Walt Disney World Resort Area

FRIDAY, July 12, 2019 (HealthDay News) — A rabies warning was issued for Walt Disney World Resort and the surrounding area after a rabid cat scratched two employees.

USA Today Article

U.S. Health, Economic Burden of Uncontrolled Asthma Projected

FRIDAY, July 12, 2019 (HealthDay News) — The economic burden of uncontrolled asthma is considerable and is projected to continue increasing, according to a study recently published in the American Journal of Respiratory and Critical Care Medicine.

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Serious Misdiagnosis-Related Harms Mostly Due to ‘Big Three’

FRIDAY, July 12, 2019 (HealthDay News) — Vascular events, infections, and cancers account for about three-quarters of serious misdiagnosis-related harms, according to a study published online July 11 in Diagnosis.

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Kratom Use Associated With Significant Toxicities

FRIDAY, July 12, 2019 (HealthDay News) — The unregulated herbal supplement known as kratom, which is mainly used for self-treating pain or mood disorders in the United States, is associated with significant toxicities, according to a report published in the July issue of Pharmacotherapy.

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CRP-Guided Testing Cuts Antibiotic Use in COPD Exacerbations

FRIDAY, July 12, 2019 (HealthDay News) — For patients with an acute exacerbation of chronic obstructive pulmonary disease (COPD), point-of-care testing of C-reactive protein (CRP) to guide antibiotic prescribing can reduce antibiotic use, according to a study published in the July 11 issue of the New England Journal of Medicine.

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Capping Work Hours in Residency Does Not Impact Outcomes Later

THURSDAY, July 11, 2019 (HealthDay News) — Exposure of U.S. physicians to work-hour reforms during residency training is not associated with post-training differences in patient mortality, readmissions, or costs of care, according to a study published online July 11 in The BMJ.

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PE, Death Not Reduced With Early Vena Cava Filter Placement

THURSDAY, July 11, 2019 (HealthDay News) — Early prophylactic placement of a vena cava filter compared with no placement of a filter after major trauma does not result in a reduced incidence of symptomatic pulmonary embolism or death at 90 days, according to a study published online July 7 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the International Society on Thrombosis and Haemostasis, held from July 6 to 10 in Melbourne, Australia.

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Rimegepant Shows Promise for Relief From Migraine Attacks

THURSDAY, July 11, 2019 (HealthDay News) — Compared with placebo, rimegepant, an orally administered, small-molecule, calcitonin gene-related peptide (CGRP) receptor antagonist, can increase the percentage of patients free of pain and free from their most bothersome symptom during a migraine attack, according to a study published in the July 11 issue of the New England Journal of Medicine.

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Health Care Professionals Exhibit Gender Bias

THURSDAY, July 11, 2019 (HealthDay News) — Survey results show that health care professionals have implicit and explicit gender bias, according to a study published online July 5 in JAMA Network Open.

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About 12 Percent With Ankle Sprain Fill Opioid Prescriptions

WEDNESDAY, July 10, 2019 (HealthDay News) — Overall, 11.9 percent of patients diagnosed with an ankle sprain fill an opioid prescription within seven days of diagnosis, according to a research letter published online July 9 in the Annals of Internal Medicine.

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High Incarceration Rates Tied to More Drug-Related Deaths

WEDNESDAY, July 10, 2019 (HealthDay News) — Reduced household income and high incarceration rates are associated with drug-related deaths, according to a study published in the July issue of The Lancet Public Health.

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CDC Updates Data on Cases Meeting Criterion for Acute Flaccid Myelitis

TUESDAY, July 9, 2019 (HealthDay News) — Clinical and laboratory data have been updated for cases that met the clinical criterion for acute flaccid myelitis (AFM) in the United States during 2018, according to a Vital Signs report published in the July 9 early-release issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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EHR System-Generated In-Basket Messages Linked to Burnout

TUESDAY, July 9, 2019 (HealthDay News) — Receipt of more than the average number of electronic health record (EHR) system-generated in-basket messages is associated with an increased probability of physician burnout, according to a study published in the July 1 issue of Health Affairs.

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Neuropsychiatric Morbidity Up With Synthetic Cannabinoid Use in Teens

MONDAY, July 8, 2019 (HealthDay News) — Synthetic cannabinoid (SC) exposure is associated with increased odds of neuropsychiatric morbidity versus cannabis exposure among adolescents presenting to the emergency department, according to a study published online July 8 in Pediatrics.

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IL-6 Level May Predict Symptom Duration in Concussed Athletes

WEDNESDAY, July 3, 2019 (HealthDay News) — For concussed athletes, interleukin (IL)-6 and IL-1 receptor antagonist (IL-1RA) are significantly elevated at six hours after concussion, and IL-6 levels are associated with symptom duration, according to a study published online July 3 in Neurology.

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DOJ Asks Congress to Permanently Classify Fentanyl-Like Drugs

WEDNESDAY, July 3, 2019 (HealthDay News) — A temporary order classifying fentanyl-like drugs as controlled substances should be enacted into law, the U.S. Department of Justice is telling Congress.

CBS News Article

Lack of Evidence for Treating Chronic Pain in Children

WEDNESDAY, July 3, 2019 (HealthDay News) — There is a lack of evidence on the efficacy and safety of pharmacological treatments for chronic pain in children, according to research published online June 19 in PAIN.

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Interventions Linked to Drop in Unvaccinated Kindergartners

WEDNESDAY, July 3, 2019 (HealthDay News) — Statewide legislative and educational interventions are associated with a reduction in the yearly rates of kindergartners without up-to-date vaccination status, according to a study published in the July 2 issue of the Journal of the American Medical Association.

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Most U.S. Adults Are Concerned About Antibiotic Resistance

WEDNESDAY, July 3, 2019 (HealthDay News) — Most U.S. adults have heard of and are concerned about antibiotic resistance, but 45 percent report having not taken antibiotics as prescribed, according to a report published online June 21 by the Kaiser Family Foundation.

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Flesh-Eating Bacteria Claims Life of Florida Woman

TUESDAY, July 2, 2019 (HealthDay News) — A Florida woman died late last week from flesh-eating bacteria two weeks after cutting her leg while walking along the coast.

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Combo of Mental Disorders and Physical Illness Ups ED Visits

TUESDAY, July 2, 2019 (HealthDay News) — Mental disorders and physical multimorbidity interact to increase the odds of frequent visits to the emergency department, according to a study published in the July 2 issue of CMAJ, the Journal of the Canadian Medical Association.

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Considerable Number of Patients Receive Surprise Hospital Charges

TUESDAY, July 2, 2019 (HealthDay News) — Eighteen percent of all emergency department visits and 16 percent of in-network hospital stays have at least one out-of-network charge, according to a report published June 20 by the Kaiser Family Foundation.

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Stewardship Intervention Can Cut Inappropriate Rx by a Third

MONDAY, July 1, 2019 (HealthDay News) — Antibiotic stewardship interventions for acute respiratory infection (ARI) can significantly reduce overuse in emergency departments and urgent care centers, according to a study published online June 19 in Academic Emergency Medicine.

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High-Sensitivity Troponin Levels Can Predict MI Risk

MONDAY, July 1, 2019 (HealthDay News) — For patients presenting to the emergency department with symptoms suggestive of myocardial infarction, a tool developed to integrate high-sensitivity troponin I or T concentrations and dynamic change during serial sampling can estimate the probability of myocardial infarction and 30-day outcomes, according to a study published in the June 27 issue of the New England Journal of Medicine.

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