Costs and effects of interventions targeting frequent presenters to the emergency department: a systematic and narrative review

From BMC Emergency Medicine:


Previous systematic reviews have examined the effectiveness of interventions for frequent presenters to the Emergency Department (ED) but not the costs and cost-effectiveness of such interventions.


A systematic literature review was conducted which screened the following databases: Pubmed, Medline, Embase, Cochrane and Econlit. An inclusion and exclusion criteria were developed following PRISMA guidelines. A narrative review methodology was adopted due to the heterogeneity of the reporting of the costs across the studies.


One thousand three hundred eighty-nine papers were found and 16 were included in the review. All of the interventions were variations of a case management approach. Apart from one study which had mixed results, all of the papers reported a decrease in ED use and costs. There were no cost effectiveness studies.


The majority of interventions for frequent presenters to the ED were found to decrease ED use and cost. Future research should be undertaken to examine the cost effectiveness of these interventions.

Proximity to Retail Clinic Cuts Emergency Department Utilization

From PatientEngagementHIT:

Living close to a retail clinic can curb emergency department (ED) utilization for low-acuity health needs, according to a research note authored by economists from the Federal Reserve Bank of Chicago, Princeton University, and Northwestern University.

This comes as the medical industry rethinks primary and preventive care and how those two factors can cut high healthcare spending for preventable, high-acuity care. When a patient can access affordable, convenient treatment in a primary care setting, it may prevent higher acuity and more expensive health episodes down the road.

An Iowa doctor raises more than $8,000 for pediatric mental health

From CBS2:

Dr. Brown is a doctor of emergency medicine at UnityPoint Hospitals.

After seeing the success of King’s fundraiser, he wanted to do the same, but this time focusing on raising money and awareness for children with psychiatric problems.

“I saw kids waiting days and days for inpatient psychiatric care, often times in a windowless ER, not receiving care while they wait and that was something really heartbreaking for me,” shared Dr. Brown.

What’s inside an airplane’s emergency medical kit?

From The Points Guy:


Emergency rooms expect spike in Christmas present related injuries

(Not humor)

From Fox13:

The most wonderful time of the year can also be one of the most dangerous.

The Consumer Product Safety Commission reports in 2018 there were more than 166,000 toy related emergency department-treated injuries.

And in the 2017 holiday season, about 18,000 people were treated in Emergency Rooms due to holiday decorating-related injuries.

The Emergency Room Medical Director at St. Francis Bartlett said the two main contributing factors are knives and alcohol

ERs Overwhelmed by Life-Threatening, Wrapping Paper-Related Paper Cuts


From the GomerBlog:

What should be a Christmas morning filled with celebration and cheer has turned to horror and bloodshed: life-threatening wrapping paper-related paper cuts have sent millions of Americans to emergency departments, completely overwhelming the health care system this morning.

No deaths have been reported, but at least 20 million are listed in critical condition.

“No money, no problem”: Guaranteeing emergency care for all

From Stanford:

Today if anyone walks into Stanford Hospital’s Marc and Laura Andreessen Emergency Department — or any other emergency department in the United States — they can receive emergency or stabilizing care, even if they have no money.

The law that guaranteed that access — the Emergency Medical Treatment and Labor Act (EMTALA) — passed in 1986. It prevented hospitals from turning away patients in emergencies or transferring unstable patients to other facilities if they couldn’t provide proof of payment.

But that legislation created new problems, problems that Stanford emergency physician Michael Bresler, MD, played a key role in resolving.

Announcing the No Silence on ED Violence Campaign

From ACEP and the ENA:

The statistics are staggering.

According to surveys by the American College of Emergency Physicians and the Emergency Nurses Association, almost half of emergency physicians report being physically assaulted at work, while about 70 percent of emergency nurses report being hit and kicked while on the job. Furthermore, the vast majority – 80 percent – of emergency physicians say violence in the emergency department harms patient care. Similarly, emergency nurses report that the harmful consequences of experiencing a violent event at work interfere with the delivery of high-quality patient care.

The frequency of violent attacks on nurses, physicians and patients in our nation’s emergency departments is unconscionable and unacceptable. For all emergency health care professionals, being assaulted in the emergency department must no longer be tolerated as “part of the job.”

Inspired by the Raise Your Hand movement – which first encouraged emergency nurses in 2018 to share their workplace violence experiences – ACEP and ENA collaborated on an effort to meaningfully minimize the frequency of these attacks, protect emergency department professionals and build a new level of awareness about this crisis.

Launched in 2019, “No Silence on ED Violence” aims to support, empower and provide the resources our respective members need to effect safety improvements at their workplace, while engaging state and federal policymakers, stakeholder organizations and the public at large to generate action to address the problem.

We invite and encourage you to join us in this vital effort. Turn to this website for resources and content that help you support those victimized by workplace violence and explore ways to reduce the frequency of violent incidents. You can join the conversation on social media any time by using #StopEDViolence on Facebook, Twitter and Instagram.

Amid this crisis of violence in emergency departments, the time has come to raise our voices to raise awareness of the dangers faced by all ED staff as they work each day to deliver the best possible care to patients when they need it most.

Patricia Kunz Howard, PhD, RN, CEN, CPEN, TCRN, NE-BC, FAEN, FAAN
ENA President
William Jaquis, MD, FACEP
ACEP President



Drugs Used to Treat Pediatric Emergencies

From the AAP:

This clinical report is a revision of “Preparing for Pediatric Emergencies: Drugs to Consider.” It updates the list, indications, and dosages of medications used to treat pediatric emergencies in the prehospital, pediatric clinic, and emergency department settings. Although it is not an all-inclusive list of medications that may be used in all emergencies, this resource will be helpful when treating a vast majority of pediatric medical emergencies. Dosage recommendations are consistent with current emergency references such as the Advanced Pediatric Life Support and Pediatric Advanced Life Support textbooks and American Heart Association resuscitation guidelines.

Michael Steele: Rural hospitals generate prosperity and are worthy of our protection

From The Hill:

According to the Maryland Department of Health, “the State of Maryland recognizes 18 out of the 24 counties and jurisdictions as rural.” And the 150,816 Marylanders who reside in these rural communities depend on 24 federally qualified health center sites located outside of urbanized areas and 7 short term hospitals located outside of urbanized areas for their care.

Unfortunately, the Centers for Medicaid and Medicare Services (CMS) is seeking to severely underfund these already financially failing facilities through the use of site-neutral payments. This is a reimbursement model that attempts to justify paying hospitals the same amount as single-physician offices.

While I appreciate CMS trying to save American taxpayer dollars, it is outrageous to consider reimbursing hospitals, which have enormous overhead costs, at the same rates as an office with one doctor.