Abstract:
STUDY OBJECTIVE:Postoverdose interventions that deploy peer recovery support specialists to emergency departments (EDs) are a promising response to opioid overdoses among patients presenting in EDs. The objective of this study was to elicit patients' perspectives regarding the feasibility and acceptability of such an intervention and to ensure that their perspectives are represented in intervention design, implementation, and evaluation. METHOD:In 2019 the study investigators conducted focus groups with people who use opioids to elicit perspectives about a postoverdose intervention delivered in the ED by using a semistructured interview guide that asked about feasibility, acceptability, perceived benefits, and concerns. Focus groups were digitally recorded, transcribed, and analyzed for emerging themes. RESULTS:Nine focus groups with 30 people who use opioids were conducted. Key findings that could improve feasibility and acceptability of the intervention include the following: the importance of balancing the urgency of seeing patients quickly with a need to accommodate the experience of precipitated withdrawal symptoms; the need to address privacy concerns; and the need to address concerns related to cost, insurance coverage, and sustainability. Perceived benefits of the intervention included the ability of the peer recovery support specialist to provide advocacy and support, serve as a model of hope and encouragement for behavior change, and fill key service gaps. CONCLUSION:Postoverdose interventions in the ED provide the opportunity to integrate harm reduction-based interventions into traditional biomedical care facilities. These interventions can fill gaps in services and provide additional care and comfort for people who use opioids, but design, implementation, and evaluation should be informed by a patient-centered care perspective.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Wagner KD,Mittal ML,Harding RW,Smith KP,Dawkins AD,Wei X,Woodard S,Roget NA,Oman RFdoi
10.1016/j.annemergmed.2020.06.003subject
Has Abstractpub_date
2020-12-01 00:00:00pages
717-727issue
6eissn
0196-0644issn
1097-6760pii
S0196-0644(20)30442-Xjournal_volume
76pub_type
杂志文章abstract:STUDY OBJECTIVE:Previous studies have demonstrated that a sex disparity exists in the editorial boards of select specialties. However, there are limited data with respect to emergency medicine. We seek to determine the sex distribution of editors in chief and editorial board members among emergency medicine journals. ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2020.03.027
更新日期:2021-01-01 00:00:00
abstract::Venomous bites and stings are numerous but severe local tissue damage is uncommon. Venoms may be simple substances or complex mixtures of many poorly characterized components whose interactions are still not fully understood. The best studied example of a dermonecrotic venom is that produced by the brown recluse spide...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(88)80360-3
更新日期:1988-12-01 00:00:00
abstract::Gifts to physicians by the pharmaceutical industry pose numerous ethical questions. Although individual patients and physicians may benefit financially and educationally from certain gifts, the risk of bias resulting from such gifts makes them ethically challenging. After a brief description of the nature and scope of...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2005.12.013
更新日期:2006-11-01 00:00:00
abstract::A retrospective review of all patients admitted to an urban teaching hospital emergency department with the complaint of overdose, poisoning, or ingestion during a 10-month period was conducted. Analysis of these 82 episodes involving 69 individuals revealed: 1) a preponderance of women in the 20- to 40-year old range...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(81)80453-2
更新日期:1981-01-01 00:00:00
abstract::Irukandji syndrome is a constellation of delayed severe local and systemic symptoms occurring after a Carukia barnesi box jellyfish sting involving any exposed skin. These cases are limited to Australia, the habitat of that animal. Numerous other cases of an Irukandji-like syndrome after other small Carybdeid genus en...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(03)00513-4
更新日期:2003-12-01 00:00:00
abstract::A 57-year-old woman presented in severe respiratory distress 30 minutes after ingesting hydrochlorothiazide. Pulmonary edema was evident clinically and radiographically. A noncardiogenic etiology was suggested by the lack of jugular venous distention, S3 gallop, or pedal edema, and the presence of a normal cardiac sil...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(87)80531-0
更新日期:1987-08-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the usefulness of the alveolar-arterial oxygen gradient for detecting pulmonary embolism in elderly patients presenting to the emergency department. DESIGN:Retrospective cohort analysis. SETTING:Two university-affiliated community hospitals. TYPE OF PARTICIPANTS:Consecutive patients more...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)80985-0
更新日期:1993-07-01 00:00:00
abstract:STUDY OBJECTIVE:Methanol poisoning outbreaks are a global public health issue, with delayed treatment causing poor outcomes. Out-of-hospital ethanol administration may improve outcome, but the difficulty of conducting research in outbreaks has meant that its effects have never been assessed. We study the effect of out-...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2016.01.010
更新日期:2016-07-01 00:00:00
abstract:STUDY OBJECTIVE:The study was designed to determine if open peritoneal lavage is superior to closed peritoneal lavage. DESIGN AND PARTICIPANTS:Patients who were admitted to a trauma center and needed peritoneal lavage were assigned to alternate trauma teams. Team 1 performed only open lavages one month and then switch...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0196-0644(05)81067-4
更新日期:1991-12-01 00:00:00
abstract:STUDY OBJECTIVES:To determine if the use of verapamil in patients with contraindications is associated with adverse sequelae, thereby assessing whether process measures of the quality of care are correlated with patient outcomes. DESIGN:Retrospective chart review comparing the incidence of adverse outcomes and drug fa...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81382-4
更新日期:1991-10-01 00:00:00
abstract:STUDY OBJECTIVE:The optimal ratio of chest compressions to ventilations during cardiopulmonary resuscitation (CPR) is unknown. We determine 24-hour survival and neurologic outcome, comparing 4 different chest compression-ventilation CPR ratios in a porcine model of prolonged cardiac arrest and bystander CPR. METHODS:F...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2002.129507
更新日期:2002-12-01 00:00:00
abstract:STUDY OBJECTIVE:Preoxygenation is important to prevent oxygen desaturation during emergency airway management. The purpose of this study is to describe the use of end tidal oxygen (eto2) during rapid sequence intubation in the emergency department. METHODS:This study was carried out in 2 academic centers in Sydney, Au...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/j.annemergmed.2019.01.038
更新日期:2019-09-01 00:00:00
abstract::The ingestion of iron-containing products is a potential toxicologic emergency. The total iron binding capacity (TIBC) has been used widely as a predictor of end-organ toxicity and a guide to the need for deferoxamine therapy. When the TIBC is greater than the serum iron concentration (SIC), it is held that no free ir...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(99)70420-8
更新日期:1999-01-01 00:00:00
abstract:STUDY OBJECTIVE:We evaluate associations between pairs of discordant cardiac biomarkers (positive MB band of creatine kinase [CKMB] with negative creatine kinase, positive CKMB with negative cardiac troponin, and positive troponin with negative CKMB) and the presence of acute coronary syndromes in emergency department ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2006.05.016
更新日期:2006-12-01 00:00:00
abstract:STUDY OBJECTIVE:To test the hypothesis that intersystem variation in initial rhythm among EMS-witnessed arrests is of sufficient magnitude to warrant standardization of survival by creation of an Utstein-style denominator of EMS-witnessed ventricular fibrillation (VF). METHODS:We conducted a planned subset analysis of...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(97)70115-x
更新日期:1997-07-01 00:00:00
abstract::The sudden emergence of 2009 H1N1 influenza in the spring of that year sparked a surge in visits to emergency departments in New York City and other communities. A larger, second wave of cases was anticipated the following autumn. To reduce a potential surge of health system utilization without denying needed care, we...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2010.04.005
更新日期:2010-09-01 00:00:00
abstract:STUDY OBJECTIVE:To examine community changes in self-reported CPR training and use from 1980-82 to 1985-87 using data obtained from the Minnesota Heart Survey. A comparative investigation of CPR training among blacks and whites in 1985-86 also was completed. DESIGN:Data were obtained in 1980-81, 1981-82, 1985-86, and ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)82782-9
更新日期:1992-06-01 00:00:00
abstract:STUDY OBJECTIVE:Frequent emergency department (ED) users have been the targets of health care reform proposals and hospital crowding interventions, but it is not clear that common assumptions about this group are supported by data. We review the literature pertaining to frequent ED users, their demographics, acuity of ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/j.annemergmed.2010.01.032
更新日期:2010-07-01 00:00:00
abstract::Single-dose antibiotic therapy for urinary tract infections in which no underlying structural or neurologic lesions are present holds the promise of greater patient compliance and convenience. We present the results of a study comparing a single intramuscular dose of a long-acting, third-generation cephalosporin, ceft...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0196-0644(85)80239-0
更新日期:1985-10-01 00:00:00
abstract::To define the usefulness of the lumbar spine x-ray series in the emergency department and to generate clinical criteria for optimizing its application, we retrospectively studied 552 consecutive emergency department patients for whom lumbar spine x-rays were ordered. Patients were divided into traumatic (47.6%) and no...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(83)80378-3
更新日期:1983-02-01 00:00:00
abstract:STUDY OBJECTIVE:Although adjunctive intravenous bicarbonate therapy is commonly recommended for children with severe diabetic ketoacidosis (DKA), no studies assessing clinical outcome with this therapy have ever been performed. Our objective was to determine whether bicarbonate therapy influenced outcome for pediatric ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(98)70279-3
更新日期:1998-01-01 00:00:00
abstract:STUDY OBJECTIVE:The prevalence of agitation among emergency department (ED) patients is increasing. Physical restraints are routinely used to prevent self-harm and to protect staff, but are associated with serious safety risks. To date, characterization of physical restraint use in the emergency setting has been limite...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2018.06.020
更新日期:2019-02-01 00:00:00
abstract:STUDY OBJECTIVE:Disposition decision for patients with possible acute coronary syndrome in the emergency department (ED) is driven primarily by perception of short-term risks. We sought to evaluate communication between patient and physician about these risks by ascertaining the content of discussions surrounding dispo...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2015.01.027
更新日期:2015-07-01 00:00:00
abstract::Strokes in the vertebrobasilar arterial distribution may result in a variety of physical findings and can be challenging to diagnose. We report a case of a 60-year-old woman with infarction of the left midbrain, right pons, and bilateral thalami with physical findings resembling transtentorial herniation. ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(98)70212-4
更新日期:1998-05-01 00:00:00
abstract:STUDY OBJECTIVE:There has been increasing attention to screening for health-related social needs. However, little is known about the screening practices of emergency departments (EDs). Within New England, we seek to identify the prevalence of ED screening for health-related social needs, understand the factors associat...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2020.08.010
更新日期:2021-01-01 00:00:00
abstract:STUDY OBJECTIVES:To develop a practical procedure for producing a nomogram describing the relationship between the osmolality gap and serum ethanol concentrations that is appropriate for the formulas and analytical methodologies in use at any laboratory. DESIGN:Retrospective review of serum sodium, glucose, urea nitro...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81899-2
更新日期:1992-11-01 00:00:00
abstract::A case is presented of a vaginal foreign body. A drinking glass was inserted in the vagina of an intoxicated patient by her irate lover. Infection followed. The emergency care is described, including the method of extraction of the object, along with discussion of the principles involved and associated complications. ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(81)80287-9
更新日期:1981-09-01 00:00:00
abstract::Significant toxicity can result from ingestion of certain species of the Zigadenus plant, an herb occasionally confused with nontoxic wild onions. A 50-year-old man inadvertently ingested Z paniculatus and presented to the emergency department with profound gastrointestinal toxicity, hypotension, and bradycardia. The ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(95)70336-5
更新日期:1995-02-01 00:00:00
abstract::Acute ischemic stroke is the third leading cause of death in the United States and the leading cause of adult disability. The direct and indirect costs of stroke care exceed $51 billion annually. In 1996, the US Food and Drug Administration approved the first treatment for acute ischemic stroke, intravenous tissue pla...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1067/mem.2001.111573
更新日期:2001-02-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate the ability of laypeople to apply basic CPR techniques after recent training. DESIGN:Cross-sectional assessment of practical CPR skills. TYPE OF PARTICIPANTS:151 laypeople who were trained twice in the preceding 20 to 24 months. MEASUREMENTS AND MAIN RESULTS:Practical skills were teste...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70094-x
更新日期:1994-05-01 00:00:00