Annals of emergency medicine
Audio Summaries

Palliative Care in Emergency Medicine: A Perspective from a Trainee

Jun 18, 2026

The authors aim to address the misconception that palliative care is solely a late intervention, advocating for its integration into emergency medicine as a proactive approach to patient needs amidst uncertainty. They emphasize the importance of early recognition, effective communication, and a supportive clinical presence in emergency settings, drawing on the experiences of a palliative care trainee to illustrate how these practices enhance patient care and decision-making.

Accuracy of Point-of-Care Ultrasound Versus Consultative Echocardiography to Identify Right Ventricular Dysfunction in Emergency Department Patients With Pulmonary Embolism

Jun 18, 2026

The authors aimed to evaluate the accuracy of emergency physician-interpreted point-of-care ultrasound (POCUS) in identifying right ventricular dysfunction in emergency department patients with pulmonary embolism, compared to cardiologist-interpreted consultative echocardiography. They found that POCUS demonstrated a sensitivity of 76.8% and specificity of 85.9%, with moderate agreement between the two modalities, particularly improving when right ventricular dysfunction was categorized as moderate to severe. The study highlights the potential of POCUS as a reliable tool for risk stratification in this patient population.

Improving End-of-Life Screening in the Emergency Department With Collaborative Artificial Intelligence

Jun 18, 2026

The authors aimed to compare the effectiveness of the physician-answered surprise question (SQ) and the Geriatric End-of-Life Screening Tool (GEST), as well as a combined GEST+SQ model, in predicting 6-month mortality among older patients in the emergency department. Their findings indicated that while GEST outperformed SQ in terms of specificity and sensitivity, the combined model did not significantly enhance predictive discrimination but did improve calibration. The study suggests that a sequential screening approach could substantially reduce the screening burden on physicians while maintaining effective mortality risk assessment.

Computable Structured Phenotype Versus Large Language Model Identification of Opioid Use Disorder Using Electronic Health Record Data

Jun 13, 2026

The authors aimed to compare the effectiveness of a rule-based computable phenotype and a large language model in identifying opioid use disorder among patients in the emergency department, using expert physician review as the reference standard. Their findings indicated that while both methods demonstrated strong diagnostic performance, the large language model had significantly higher specificity and positive predictive value, suggesting it may be more effective in minimizing false-positive alerts in clinical settings. Further validation in diverse populations is recommended to confirm these results.

Pharmacy Interventions on Medication Orders Increase With Emergency Medicine Clinician Time-on-Shift

Jun 13, 2026

The authors aimed to evaluate the relationship between clinician time-on-shift and the rate of pharmacist interventions on medication orders in emergency departments. Their study found that as clinician time-on-shift increased, the likelihood of pharmacist interventions also rose, indicating that decision fatigue may impact medication safety and appropriateness. This effect varied by clinician type and was site-dependent, suggesting that addressing clinician fatigue could enhance patient care quality.

Medical Scribe and Ambient Artificial Intelligence Impact on Emergency Physician Documentation Burden and Clinical Productivity

Jun 12, 2026

The authors aimed to evaluate the impact of ambient artificial intelligence (AI) scribes and human scribes on emergency physicians' documentation burden and clinical productivity compared to encounters with no scribe. Their findings indicated that both ambient AI and human scribes significantly reduced documentation time, with AI scribes leading to a 1.6-minute reduction and human scribes a 3.3-minute reduction, while clinical productivity, measured as work relative value units per shift hour, remained unchanged across all groups.

Defining Diagnostic Excellence and Missed Diagnostic Opportunity for the Emergency Department Setting

Jun 11, 2026

The authors aimed to define "diagnostic excellence" and "missed diagnostic opportunity" within the emergency department (ED) setting to enhance research and quality improvement initiatives. Through a modified Delphi panel involving multidisciplinary experts, they established that diagnostic excellence involves optimal, evidence-based practices leading to accurate and timely patient explanations, while a missed diagnostic opportunity refers to deviations from these practices that can result in misdiagnosis or poor communication. The study emphasizes the need for further research on implementing these definitions in ED diagnostic processes.

Emergency Medical Services Equipment Use in the Emergency Department and Time to Care for Those With Out-of-Hospital Cardiac Arrest

Jun 11, 2026

The authors investigate whether the use of emergency medical services (EMS) equipment for initial rhythm analysis in the emergency department (ED) leads to faster time to defibrillation for patients experiencing out-of-hospital cardiac arrest (OHCA). Their findings indicate that patients analyzed with EMS equipment had significantly shorter times to both rhythm analysis and defibrillation compared to those using ED equipment, suggesting that EMS equipment may enhance early intervention in OHCA cases.

Medical Screening of Adult Psychiatric Patients Presenting to the Emergency Department

Jun 3, 2026

The authors aim to evaluate and categorize the existing literature on medical screening practices for adult psychiatric patients presenting to emergency departments. Through a scoping review of 145 publications, they identified eight key themes in medical screening, with a notable emphasis on laboratory testing, history taking, and vital sign assessment. The findings highlight the need for high-quality prospective studies to better assess the diagnostic accuracy of these practices, as current recommendations largely discourage routine laboratory testing.

A Randomized Controlled Trial of a Digital Patient Decision Tool to Increase Sexually Transmitted Infection Testing in the Emergency Department

May 15, 2026

The authors aimed to evaluate the effectiveness of a digital patient decision aid, STIckER, in increasing sexually transmitted infection (STI) testing among adolescents and young adults in emergency departments. The randomized controlled trial found that participants using the STIckER tool were significantly more likely to receive gonorrhea/chlamydia testing and reported higher satisfaction and clarity regarding their testing options. The study suggests that STIckER is a feasible and scalable approach to enhance STI screening in acute care settings.