Journal Club - Racism is a Public Health Problem

Journal Club - Racism is a Public Health Problem

In the United States, racism is a critical public health problem, permeating everyday systems including educational and health care systems; criminal justice and legal systems; financial, housing, and economic systems; environmental issues and beyond to create differential health outcomes that adversely affect Black, Indigenous, and other people of color. This pervasive system of power is based on the socio-politically constructed notion that non-Hispanic white people are inherently superior to people of color (Black, African American, Indigenous, Native American, Alaska Native, Native Hawaiian, Pacific Islander, Asian, Latine, Hispanic) and this ideology operates across multiple levels (individual, interpersonal, institutional) to unjustly advantage non-Hispanic white people, unjustly disadvantaging people of color. We recognize that racism is an important cause of health disparities and that, as health care providers, we have a responsibility to educate ourselves about racism so that we will be prepared to acknowledge the impact of racism on our patients’ health and work towards more equitable systems in support of health equity. One important component of that education is learning how to engage in productive conversations about race and racism. In service of that goal, we chose Ijeoma Oluo’s book, So you want to talk about race, as our common read for this special Journal Club session.

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Journal Club - Emergency Department Initiated Buprenorphine for Opioid Use Disorder

Journal Club - Emergency Department Initiated Buprenorphine for Opioid Use Disorder

Recent data from the National Center for Health Statistics reveal that in the 12-month period ending in April 2021, more than 100,000 Americans died of an overdose, a staggering increase of nearly 30% the prior year. While the ongoing COVID-19 pandemic has contributed to overdose deaths and taxed constrained ED resources, it has also clarified the important role that emergency physicians have in expanding access to life-saving medications to treat opioid use disorder. In this journal club, we review the evidence on ED-initiated buprenorphine, including barriers to implementing ED-buprenorphine here in rural Maine.

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Journal Club - Vasopressor use in Cardiac Arrest

Journal Club - Vasopressor use in Cardiac Arrest

Vasopressors are used in Emergency Medicine to treat cardiac arrest, hypotension, and shock. Recent studies have sought to investigate questions around timing, medication choices, and administration of these medications in varying clinical scenarios. The emergency provider must be familiar with the properties of, and indications for, vasopressors in the ED setting. In this journal club summary, we review the evidence on the impact vasopressors have on clinical outcomes.

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Journal Club July 2017 - Risk Stratification of Acute Heart Failure

Journal Club July 2017 - Risk Stratification of Acute Heart Failure

With nearly 1 million US emergency department (ED) visits attributed to acute heart failure (AHF) annually, heart failure is a serious illness frequently managed by emergency physicians. More than 80% of visits result in hospital admission, and readmission rates may range from 30-60% within 3 to 6 months of initial discharge. ED visits related to AHF are expected to continue to rise with the aging population and improved survival rates in patients with chronic heart failure and acute coronary syndromes. One critical issue facing emergency physicians caring for AHF patients is deciding upon disposition: admission (with or without monitoring) or discharge (with or without early follow-up). Consensus guidelines are available to support decision-making around diagnosis and treatment; however, no current guidelines provide an evidence-based approach to disposition. For this month’s journal club, we reviewed three papers examining decision aids developed to assist emergency physicians in determining risk in AHF patients.

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