Category Archives: Emergency Medicine

Emergency Medicine

Just Ask: Patients in the ER Are Willing to Get a Flu Shot – UC San Francisco

Simply asking patients to get the flu vaccine, and combining it with helpful video and print messages, is enough to persuade many who visit emergency departments to roll up their sleeves, according to a new study led by UC San Francisco.

Researchers found a 32% vaccine uptake in patients who were asked if theyd be interested in getting the flu shot and told their health providers would be informed. They saw a 41% uptake for those who were asked about receiving a flu shot and received a pamphlet, watched a three-minute video of a physician with a similar ethnic background discussing the vaccine and were told about the benefits of the vaccine in person.

The study published March 26, 2024 in NEJM Evidence.

The researchers say this type of systematic approach could lead to more underserved people receiving vaccines, especially those whose primary health care occurs in emergency departments.

Flu leads to considerable mortality in the United States annual death rates are typically in the tens of thousands, especially when combined with pneumonia but vaccination is particularly low among underserved populations and those whose primary care occurs in emergency departments. Such patients often face general vaccine hesitancy or a lack of opportunities for the flu shot.

This research arose from our desire to address the health disparities that we see every day in our emergency department, especially among homeless persons, the uninsured and immigrant populations, said first author, Robert M. Rodriguez, MD, a professor of Emergency Medicine with the UCSF School of Medicine.

Investigators in the study created flu vaccine messaging including a brief video, flyer and a scripted health provider question, Would you be willing to accept the influenza vaccine? and assessed their effectiveness among nearly 800 patients in five cities: San Francisco, Houston, Philadelphia, Seattle and Durham, North Carolina. The median age was 46. More than half the participants in the trial were Black or Latino, 16 % lacked health insurance, nearly a third had no primary care and 9% were homeless or living in severely inadequate housing. These demographic characteristics are similar to patient populations often served by urban emergency departments.

The researchers designed the clinical trial to span a single flu season between Oct. 2022 and Feb. 2023.

Overall, our study adds to the growing body of knowledge showing that a number of important public health interventions can and should be delivered to underserved populations in emergency departments, said Rodriguez, whose previous research has found the effectiveness of delivering similar COVID-19 vaccine messaging to emergency department patients.

Co-authors: From UCSF, co-authors are Melanie F. Molina, MD; James Ford, MD; Mireya I. Arreguin; Cecilia Lara Chavez; and Dave V. Glidden, PhD. See paper for other co-authors.

Funding: The study was funded by the National Institute of Allergy and Infectious Diseases (RO1 AII66967-01).

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Just Ask: Patients in the ER Are Willing to Get a Flu Shot - UC San Francisco

Emergency Medicine

Enhancing CT Scanner Efficiency in ED for Trauma Team Activations – Physician’s Weekly

The following is a summary of Improving CT scanner efficiency for trauma team activations in the emergency department, published in the January 2024 issue of Emergency Medicine by Zwank, et al.

Trauma Team Activation (TTA) protocols are crucial for efficiently managing life or limb-threatening injuries in emergency departments (EDs). However, delays in stabilizing patients can lead to idle time for CT scanners, impacting overall patient care. For a quality improvement project, researchers sought to assess the impact of implementing a new policyproviding a 5-min heads-up (5-min HU) notification to CT scanner personnel once a TTA patient was stabilizedon reducing CT scanner idle time.

They conducted a prospective study at a large, urban Level I Trauma Center in November 2022. They tracked incoming TTAs and recorded time points, including TTA notification, 5-minute HU notification, and arrival at the CT scanner. Data were analyzed using a non-parametric comparison test (Mann-Whitney U).

A total of 46 TTAs were included in the analysis, with the majority resulting from blunt trauma (85%) and penetrating trauma (15%). The median time from the initial TTA announcement to CT arrival was 24.0 minutes (IQR: 9.0 min). With the 5-min HU policy, the median time from notification to CT arrival was 5.0 minutes (IQR: 4.0 min), resulting in a median of 19 minutes of CT scanner idle time saved per patient compared to the previous policy (P < 0.0001). Overall, the new policy saved 818 minutes (13.6 hours) of CT scanner time.

Implementing the 5-min HU policy in the ED for TTA patients significantly reduced CT scanner idle time, optimizing resource utilization and potentially improving care for all patients in the ED. It underscored the importance of proactive communication strategies in trauma care protocols to enhance efficiency and patient outcomes.

Reference: sciencedirect.com/science/article/abs/pii/S073567572300582X

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Enhancing CT Scanner Efficiency in ED for Trauma Team Activations - Physician's Weekly

Emergency Medicine

Awareness of Urgent Care Services Among Primary Healthcare Center Patients in Al-Ahsa, Saudi Arabia – Cureus

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Awareness of Urgent Care Services Among Primary Healthcare Center Patients in Al-Ahsa, Saudi Arabia - Cureus

Emergency Medicine

University Hospitals: New Urgent Care building opens in Medina | wkyc.com – WKYC.com

As of Monday, March 25, the former location at 4001 Carrick Drive is now closed and the new location at 716 North Court Street will serve as the new facility.

MEDINA, Ohio The University Hospitals Urgent Care location in Medina officially made the move to a new location.

As of Monday, March 25, the former location at 4001 Carrick Drive is now closed and the new location at 716 North Court Street will serve as the UH Urgent Care Medina location.

Our UH Urgent Care delivery model aims to provide the most convenient and valuable care for our patients, explained UH Chief Operating Officer Paul Hinchey, MD, MBA. Having easy access to urgent care locations provide a more affordable option than emergency departments for patients who dont have a primary care physician but need immediate, non-life-threating medical attention. By offering more urgent care locations, we can relieve the burden on emergency departments and reduce wait times so our emergency medicine teams can focus on critical cases.

UH says services on site include x-ray, lab, EKG, medication dispensing and more.

The new location's hours are 8 a.m. to 8 p.m. every day. Hours may differ on holidays.

"Our primary goal is to reimagine urgent care for Northeast Ohio by removing obstacles and easing access to care while delivering exceptional patient experiences, Dr. Resnick said. The expansion of UH Urgent Care in Northeast Ohio is a significant step towards fulfilling this commitment. By increasing access to urgent care services, we aim to make a positive impact on the lives of individuals and families throughout the region, providing them with the prompt and effective care they deserve in retail locations where they live, shop and work."

UH says the move to the new building will help reduce travel time of Medina residents thanks to the more centrally located facility.

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University Hospitals: New Urgent Care building opens in Medina | wkyc.com - WKYC.com

Emergency Medicine

Boston Medical Center Establishes Endowed Chair in Emergency Medicine with $4 Million Gift from Philanthropist and … – Boston Medical Center

BOSTON Boston Medical Center (BMC) today announced that William F. Ted and Kathy O. Truscott have donated $4 million to establish the Innovation in Exceptional Care Chair in Emergency Medicine at BMC. Mr. Truscott, the CEO of Columbia Threadneedle Investments, is a Trustee of BMC and Chair of its Philanthropic Trust. BMC Chief of Emergency Medicine Christian Arbelaez, MD, MPH, was named inaugural chair.

Nationwide, emergency departments serve as the front door to societal challenges that impact patients and the healthcare system, including mental illness, substance use disorder, and homelessness, among other conditions plaguing historically underinvested communities. Emergency departments across the country have also seen operational challenges like overcrowding and staff shortages. Addressing these demands will involve an evolved, comprehensive, and holistic approach that includes greater access to timely care, improved healthcare system capacity, and added finances.

The Truscotts gift, funding the first philanthropically endowed chair at BMC, gives current and future endowment recipients the resources to tackle these challenges by innovating and pushing the frontiers of emergency medicine.

This extraordinary gift, along with his service to our Philanthropic Trust and Board of Trustees, exemplifies the dedication and commitment Ted has to BMC. He is truly a champion for our patients and believes deeply in our work and mission, said Alastair Bell, MD, MBA, President & CEO of Boston Medical Center Health System. This gift will further enhance BMCs innovative and equitable approach to emergency medicine, creating new operational and clinical models to meet the most pressing challenges faced by health systems across the nation.

Chief Arbelaez will leverage support to advance clinical care and health equity in emergency departments to continue BMCs work as a national model in emergency medicine.

Arbelaez leads the largest and busiest emergency department in New England, which provides expert emergency medical care to over 130,000 patients each year. In response to rising patient volume since the COVID pandemic, he helped redefine patient care in the emergency department by implementing a Rapid Assessment Zone, a nationally recognized multidisciplinary model to improve patient flow and reduce crowding.

This is a critical time for emergency medicine, said Christian Arbelaez, MD, MPH, Chief of Emergency Medicine at BMC and Chair of the Department of Emergency Medicine at Boston University Chobanian & Avedisian School of Medicine. As one of the busiest emergency departments in the country caring for patients with a range of needs, innovation is essential to improving care. What we learn and develop here at BMC with support from this gift can be applied to improve care nationwide.

In June 2023, Arbelaez spearheaded the first ever Leaders of Essential Emergency Departments Conference in Boston. The conference brought together leaders of hospitals and emergency medicine departments from across the country for a bold opportunity to reshape and improve emergency care to ensure systems across the nation are poised to provide innovative and equitable care for all.

Kathy and I believe deeply in furthering the mission of BMC and are committed to supporting the essential work that Dr. Arbelaez and his colleagues undertake every day to provide exceptional emergency medical care to all who need it, regardless of their circumstances, Mr. Truscott shares. It is a privilege to make this gift and recognize the critical role that emergency medicine plays at BMC and in our healthcare system.

About William F. Ted Truscott

Ted Truscott is CEO of Columbia Threadneedle Investments, a leading global asset manager headquartered in Boston that provides a broad range of actively managed investment strategies and solutions for individual, institutional, and corporate clients around the world.

Truscott is a corporate leader committed to service and philanthropy. Throughout his career, he has given back to non-profit organizations, both locally and nationally, with his time, expertise and generosity. In addition to his work with BMCs Board of Trustees and Philanthropic Trust, he serves on the Investment Company Institutes Board of Governors, as Chair of the Board of Trustees of Middlebury College, and as Chair of the Board of Directors of The Greater Boston Food Bank.

The Columbia Threadneedle Investments Boston Triathlon annually supports BMCs health equity programs to benefit patients. Over the eight years that Columbia Threadneedle has sponsored the Boston Triathlon, it has raised nearly $500,000 for BMC and hundreds of its employees have participated as athletes and volunteers.

About Boston Medical Center

Boston Medical Centermodels a new kind of excellence in healthcare, where innovative and equitable care empowers all patients to thrive. We combine world-class clinicians, cutting-edge treatments, and advanced technology with compassionate, quality care, that extends beyond our walls. As an award-winning health equity leader, our diverse clinicians and staff interrogate racial disparities in care and partner with our community to dismantle systemic inequities. And as a national leader in research and the teaching affiliate for Boston University Chobanian & Avedisian School of Medicine, were driving the future of care.

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Boston Medical Center Establishes Endowed Chair in Emergency Medicine with $4 Million Gift from Philanthropist and ... - Boston Medical Center

Emergency Medicine

Informed Consent & Use of AI in Emergency Medicine – Physician’s Weekly

Applying artificial intelligence in emergency medicine may lead to advancements in care, but it also poses some ethical and practical concerns.

The application of artificial intelligence (AI) in medicine promises great advancements in care. This new technology, however, poses some ethical and practical concerns for practitioners, specifically in the field of emergency medicine. Kenneth V. Iserson, MD, MBA, explores and addresses these concerns in a guide he developed and published in the American Journal of Emergency Medicine.

Dr. Iserson spoke with Physicians Weekly regarding key concerns about using AI in the emergency medical setting, specifically the importance of informed consent. Dr. Iserson explains, Informed consent is a key element of Western medical practice. It helps preserve patient autonomy.

Applying informed consent appropriately to the application of AI poses some challenges. Dr. Iserson elaborates, To provide this information [informed consent] to patients, physicians first must understand the big picture of how AI systems are developed, function, and integrated into clinical medicine. Key to this is the understanding that due to their source training material and programming, AI may make errors, be biased, may not produce the same answer every time, and not even a systems developers may be able to explain how it came to a decision.

He continues, Physicians must also know where in their practice AI is usedbefore they see the patients (triage), in nursing assessments, evaluation of lab and imaging results, to generate differential diagnoses, etc. Furthermore, a complete understanding of AI includes knowledge of its drawbacks. As Dr. Iserson clarifies, Limitations: A serious limitation is that if AI is baked into the system so that it is so tightly integrated that patients cannot refuse its use, informed consent will be useless. Patients and clinicians will be concerned about privacy and accuracy. Privacy issues come with knowledge about how safe the information that the AI program acquires from the patient is. Will it be used or made available to teach other AI programs or be otherwise accessible?

In addition to privacy concerns, Dr. Iserson also discussed an understanding of AIs precision, As for accuracy, they [practitioners] will need to be able to explain their system (and, of course, have a system) for resolving discrepancies between the physicians plan/diagnosis and that recommended by AI. The article suggests several that are currently in use.

Perhaps the greatest challenge in integrating AI into emergency medicine is its ever-evolving nature and the administrators involvement in its execution. Dr. Iserson addresses these concerns: Lastly, this is a rapidly developing area. Lots of money is being made, and administrators who often will decide whether to use AI may be more concerned with their own and the institutions bottom line than the efficacy and accuracy of the AI system, its applicability, the purpose for which it is being used, and the physician and patients autonomy and welfare.

When asked about the future of AI and its use in emergency medicine, Dr. Iserson shared, In the future, I see the need for incorporating honest, factual training about AI into every part of the physicians educationfrom medical school to CME. The field will constantly change, and the big players will lure medical institutions and physicians to use (sometimes inappropriately) their AI systems, probably using the same sales techniques now used by the pharmaceutical and medical equipment industries.

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Informed Consent & Use of AI in Emergency Medicine - Physician's Weekly

Emergency Medicine

Omaha emergency medicine doctor uses drug in new way to treat anxiety and depression – KETV Omaha

An Omaha doctor who served in the battlefield is now helping patients battle anxiety and depression. Dr Leslie Koenig opened Waybridge Clinic in October. The people who walk in there are not the people we see three weeks later. Theyre entirely different smiling and laughing, said Koenig, an emergency medicine physician. Koenig is a U.S. military veteran who served as a Navy doctor in Afghanistan where she used ketamine as a sedative to treat people on the battlefield. Later, in emergency rooms, she encountered mental health crises, daily.If someone is suicidal, a panic attack, where do they go: the emergency room. That was me, said Koenig.With additional training, shes now administering low dose Ketamine infusions to treat people with medication resistant anxiety, depression, chronic pain, PTSD and OCD. Each patients vital signs are monitored during the intravenous infusion and they must continue seeing their therapist and family practice doctor. Koenig is also a meditation coach and takes a holistic approach to health, encouraging people to continue seeing their therapist, eating healthy food and taking part in exercise.The clinic is located in west Omaha: Waybridge Clinic.I liken it to a gym session. You come here and do some serious work, but then you have to go and support that gym session after. You need sleep and you need the nutrition, she said. Low dose Ketamine infusions are considered an off-label use for mental health. A handful of clinics in the Omaha area offer the treatments.There are so many medications used off label. Its totally safe. Ketamine is an old medication with a new purpose. When it was first FDA approved, it was for anesthesia and what were finding out is that in low doses, it has neuroplastic benefits where you can grow new brain connections, said Koenig. With new connections, Koenig said perspective changes. "You can change your thinking," she said. She said Ketamine works on different receptors in the brain than traditional meds which are used to treat anxiety and depression. She said the new connections created by Ketamine help the brain bypass prior triggers to mental health issues, so that they no longer impact an individual. Jay Allen visited Koenig recently to talk about his life-changing recovery. He jokingly told her his face now hurts from smiling so much.I missed feeling happy. I missed laughing with my friends. I missed the positive person I used to be, said Allen, who recalls that he started feeling better after the second treatment.Allen is a military veteran and mechanical engineer who said hes excited to live again, instead of just existing from day to day. Now I can look forward and see hope, said Allen.His positive recovery and story is repeated by Jack Christian, a husband and father of three who loves creating music with his two local bands.He believes his life-long anxiety was rooted in childhood.I pretty much exhausted all my options, said Christian, who tried many prescription medications over the years and nothing seemed to pull him out of the funk.Hes had 7 low dose Ketamine treatments and after the baseline 6 treatments, some patients never need another dose. Some have an occasional booster dose. To me, its ground-breaking. Its been a godsend for me, said Christian, who now journals and practices yoga. Patients describe the infusion itself as calming and they find themselves in a place between wakefulness and sleep as the drug helps them sort through issues in their mind.Youre conscious, but youre watching your subconscious open up to you like a movie, said Christian. Allen describes the infusion as surreal.I liken it to being in a rowboat in the ocean. You can change the direction but at the end of the day, youre at the mercy of the medicine, said Allen.Both said they noticed positive changes days and weeks after the infusion and the changes are lasting. Koenig is working on trying to get health insurance companies to pay for the treatments and shes considering options for employers and non-profits to chip in. Right now, infusions are $500 a treatment, with a baseline program of 6 infusions, or $3,000.We need to destigmatize this and really make lasting change happen, said Koenig. Allen said hes forever grateful that his mom found the clinic and got him in for a consult.Im excited for whats next and I cant thank you guys enough for that, he said, hugging Koenig in her office lobby. Click here for the latest headlines from KETV NewsWatch 7

An Omaha doctor who served in the battlefield is now helping patients battle anxiety and depression. Dr Leslie Koenig opened Waybridge Clinic in October.

The people who walk in there are not the people we see three weeks later. Theyre entirely different smiling and laughing, said Koenig, an emergency medicine physician.

Koenig is a U.S. military veteran who served as a Navy doctor in Afghanistan where she used ketamine as a sedative to treat people on the battlefield. Later, in emergency rooms, she encountered mental health crises, daily.

If someone is suicidal, a panic attack, where do they go: the emergency room. That was me, said Koenig.

With additional training, shes now administering low dose Ketamine infusions to treat people with medication resistant anxiety, depression, chronic pain, PTSD and OCD. Each patients vital signs are monitored during the intravenous infusion and they must continue seeing their therapist and family practice doctor.

Koenig is also a meditation coach and takes a holistic approach to health, encouraging people to continue seeing their therapist, eating healthy food and taking part in exercise.

The clinic is located in west Omaha: Waybridge Clinic.

I liken it to a gym session. You come here and do some serious work, but then you have to go and support that gym session after. You need sleep and you need the nutrition, she said.

Low dose Ketamine infusions are considered an off-label use for mental health. A handful of clinics in the Omaha area offer the treatments.

There are so many medications used off label. Its totally safe. Ketamine is an old medication with a new purpose. When it was first FDA approved, it was for anesthesia and what were finding out is that in low doses, it has neuroplastic benefits where you can grow new brain connections, said Koenig.

With new connections, Koenig said perspective changes. "You can change your thinking," she said.

She said Ketamine works on different receptors in the brain than traditional meds which are used to treat anxiety and depression. She said the new connections created by Ketamine help the brain bypass prior triggers to mental health issues, so that they no longer impact an individual.

Jay Allen visited Koenig recently to talk about his life-changing recovery. He jokingly told her his face now hurts from smiling so much.

I missed feeling happy. I missed laughing with my friends. I missed the positive person I used to be, said Allen, who recalls that he started feeling better after the second treatment.

Allen is a military veteran and mechanical engineer who said hes excited to live again, instead of just existing from day to day.

Now I can look forward and see hope, said Allen.

His positive recovery and story is repeated by Jack Christian, a husband and father of three who loves creating music with his two local bands.

He believes his life-long anxiety was rooted in childhood.

I pretty much exhausted all my options, said Christian, who tried many prescription medications over the years and nothing seemed to pull him out of the funk.

Hes had 7 low dose Ketamine treatments and after the baseline 6 treatments, some patients never need another dose. Some have an occasional booster dose.

To me, its ground-breaking. Its been a godsend for me, said Christian, who now journals and practices yoga.

Patients describe the infusion itself as calming and they find themselves in a place between wakefulness and sleep as the drug helps them sort through issues in their mind.

Youre conscious, but youre watching your subconscious open up to you like a movie, said Christian.

Allen describes the infusion as surreal.

I liken it to being in a rowboat in the ocean. You can change the direction but at the end of the day, youre at the mercy of the medicine, said Allen.

Both said they noticed positive changes days and weeks after the infusion and the changes are lasting.

Koenig is working on trying to get health insurance companies to pay for the treatments and shes considering options for employers and non-profits to chip in. Right now, infusions are $500 a treatment, with a baseline program of 6 infusions, or $3,000.

We need to destigmatize this and really make lasting change happen, said Koenig.

Allen said hes forever grateful that his mom found the clinic and got him in for a consult.

Im excited for whats next and I cant thank you guys enough for that, he said, hugging Koenig in her office lobby.

Click here for the latest headlines from KETV NewsWatch 7

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Omaha emergency medicine doctor uses drug in new way to treat anxiety and depression - KETV Omaha

Emergency Medicine

Concerns over public health heighten as trainee doctors walk off job for 2nd day –

An emergency room at a military hospital in Pohang, 262 kilometers southeast of Seoul, Feb. 20. Yonhap

Surgeries have been canceled and some patients were forced to be transferred to other hospitals as trainee doctors stopped working for the second day in a row Wednesday in protest of the government's plan to boost the number of medical students.

More than 6,400 trainee doctors nationwide, about 55 percent of the junior doctors, have submitted their resignations en masse so far, with about 1,600 of them walking off the job, according to the health ministry.

Medical services at the five biggest general hospitals in Seoul suffered partial disruptions Tuesday after interns and resident doctors did not show up for work following collective resignations as they protested the plan to raise the medical school admission quota by 2,000 seats next year.

To cope with a potential disruption to medical services, the government has extended operating hours at 97 public hospitals and opened emergency rooms at 12 military hospitals to the public.

"We are deeply disappointed and concerned that the collective action by trainee doctors has led to a disruption in medical services, such as the cancellation of surgeries," Second Vice Health Minister Park Min-soo told reporters.

"We cannot give justification to the actions of the doctors leaving their patients behind to protest a policy despite knowing what the collective action could result in," Park said.

Despite the government's back-to-work order, trainee doctors have shown no sign of backing down.

In a statement, the Korean Intern Resident Association, a major organization of trainee doctors, demanded the government withdraw the plan to increase the number of medical students.

Describing the plan as "ridiculous," the association criticized the government for treating trainee doctors as "criminals by overusing extrajudicial executive orders."

The government says the increase in the admission quota is needed to address a shortage of doctors, particularly in rural areas and essential medical fields, such as high-risk surgeries, pediatrics, obstetrics and emergency medicine.

The number of doctors in South Korea relative to the size of the population is among the lowest in the developed world, according to health authorities.

But doctors have claimed that the government has not had full consultations on the matter and that the move will compromise the quality of medical education and services. (Yonhap)

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Concerns over public health heighten as trainee doctors walk off job for 2nd day -

Emergency Medicine

LifeFlight makes significant investment in strengthening EMS and hospital partnerships – Boothbay Register

LifeFlight of Maine has launched a significant new initiative to bolster its relationships with hospitals, first responders, emergency medical services (EMS), 911 centers, and other stakeholders that rely on LifeFlight to deliver critical care quickly and reliably for patients facing a life-threatening medical emergency.

This initiative will be led by Kyle Madigan, director of client relations at LifeFlight of Maine, who began in this newly created role in January 2024. Madigan brings decades of experience as a flight nurse and critical care provider, an educator, and an air medical program administrator. Most recently, he led the Dartmouth Hitchcock Advanced Response Team (DHART), LifeFlight of Maines peer service based in Lebanon, New Hampshire.

Under Madigans leadership, LifeFlight is working to expand its outreach and education efforts across all 16 counties in Maine, as well as parts of New Hampshire along the border with Maine, an area in which LifeFlight of Maines Sanford-based team provides service when needed. These efforts include expanding offerings of LifeFlights Ground Safety and User Course, which trains partner agencies on how to identify when a patient needs a LifeFlight transport, how to make a transport request, how to safely secure a landing zone, and how to transfer the patient into LifeFlights care.

Madigan, in concert with LifeFlight of Maine CEO Joe Kellner, is also leading efforts to strengthen operational collaboration between LifeFlight and Maines hospitals. The majority of calls to LifeFlight come from a hospital requesting to transfer an acutely ill patient to a facility that offers a higher level of care. This is a critically important service for Maines geographically dispersed system of community hospitals. The smooth, reliable, and rapid movement of these patients in a LifeFlight vehicle is critical both to the patients outcomes and to the capacity of the emergency medical system statewide to ensure all patients can access the care they need. Madigan will work with leaders and clinicians in emergency departments and intensive care units to improve coordination and logistics for the care teams interfacing with LifeFlight crews.

Additionally, LifeFlight is working with communities, first responders, and private citizens to establish additional helicopter landing zones in rural areas. LifeFlight maintains a database of thousands of landing zones across Maine and parts of New Hampshire, which LifeFlight crews utilize to respond to medical emergencies. Many of these landing zones are a local ball field or parking lot. Others are a clearing deep in the Maine woods. By working with communities to expand this database, which is available both to LifeFlight and to 911 dispatchers statewide, LifeFlight is creating more critical healthcare access points across Maine.

At LifeFlight of Maine, we hold ourselves to uncompromising standards of excellence. This is what has inspired this organization for two and a half decades, and what continues to drive us as one of the premier nonprofit air ambulance and critical care services in the country. We are continually looking for ways to elevate the level of care we provide to our patients, and to improve the reliability and speed of the service we offer to every community here in Maine. This new initiative continues our longstanding commitment to excellence, said Joe Kellner, CEO, LifeFlight of Maine.

Kyle Madigans experience and expertise in the delivery of critical care emergency medicine is formidable. The work he is doing to strengthen collaboration between LifeFlight and our EMS and hospital partners is a tremendous asset both to this organization and to the entire Maine EMS system, fundamentally because this initiative will improve patient care and save lives, said Bill Cyr, COO, LifeFlight of Maine.

I have dedicated my career to nonprofit, critical care emergency medicine, because I firmly believe that this is the best delivery model for patients in Maine, northern New England, and beyond. I have worked in collaboration with my colleagues at LifeFlight of Maine for years, and Im pleased to now have the opportunity to serve alongside them. Maine is fortunate to have an air medical provider as well-regarded as LifeFlight, and I look forward to contributing my skills to this team and to the State of Maine, said Kyle Madigan, director of client relations, LifeFlight of Maine.

LifeFlight of Maine is a nonprofit and the states only air ambulance service. Since 1998, LifeFlight has transported more than 38,000 patients, one life at a time, from every community in Maine. LifeFlights mission is to transform the critical care transport medicine system into an integrated, high-quality, patient-centered system worthy of the publics trust. LifeFlights airplane and five helicopters are based in Bangor, Lewiston, and Sanford. Along with dedicated ground ambulances, these vehicles cover the entire state and offshore islands. LifeFlight complements and supports the work of local EMS and hospital personnel in caring for the critically ill or injured. Each LifeFlight base is staffed by a highly qualified team of pilots, flight nurses and flight paramedics, EMT vehicle operators, aviation maintenance technicians, and communications specialists. LifeFlight of Maine is a joint venture partnership of Central Maine Healthcare and Northern Light Health. LifeFlight was fully re-accredited by the Commission on Accreditation of Medical Transport Systems in 2022. More information about LifeFlight of Maine is available at LifeFlightMaine.org.

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LifeFlight makes significant investment in strengthening EMS and hospital partnerships - Boothbay Register

Emergency Medicine

Analyzing the Gender’s Impact on ED HEART Scores – Physician’s Weekly

The following is a summary of Influence of Patient and Clinician Gender on Emergency Department HEART Scores: A Secondary Analysis of a Prospective Observational Trial, published in the February 2024 issue of Emergency Medicine by Barron, et al.

Healthcare gaps can be reduced with the help of clinical decision tools. However, many clinical decision tools have subjective factors that could bring bias from the doctor. The HEART score is a clinical decision that helps doctors tell how likely a patient in the emergency department (ED) will have a heart attack.

For a study, researchers sought to find out how gender affects HEART scores for both patients and clinicians.

They looked at a random group of adult ED patients at one hospital who came in with signs of acute cardiac syndrome in this secondary analysis of a prospective observational study. They looked at HEART scores made by ED clinicians and scores made by researchers who didnt know what gender the patient was. The main result was whether the HEART numbers given by the physician and researcher were the same for each patients gender and each therapists gender. They used difference-in-difference (DiD) to compare continuous scores and prevalence-adjusted, bias-adjusted Kappa (PABAK) to compare binary scores (low risk vs. moderate/high risk). All 336 pairs of clinicians and patients from the original study were considered. 47% of the patients were women (158/336), and 52% were handled by women clinicians (174/336).

The difference between the doctors and researchers HEART scores for male and female patients was 0.24 (95% CI 0.01 to 0.48). They found that male clinicians gave male patients a higher score than female patients (DiD 0.51 [95% CI 0.16 to 0.87]), but female clinicians did not (DiD 0.00 [95% CI 0.33 to 0.33]). It was most agreed upon between female clinicians (PABAK 0.72; 95% CI 0.61 to 0.81) and least agreed upon between male clinicians evaluating male patients (PABAK 0.47; 95% CI 0.29 to 0.66). The gender of the patient and the doctor may affect the HEART score. When this and other professional decision aids are being made and used, researchers should try to understand these factors.

Source: sciencedirect.com/science/article/abs/pii/S0196064423001993

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Analyzing the Gender's Impact on ED HEART Scores - Physician's Weekly