The western journal of emergency medicine
Audio Summaries

From Evaluation to Elevation: Standardized Letter of Evaluation Domains Tied to Future Emergency Medicine Chief Residents

Apr 29, 2026

The authors aimed to determine whether the Standardized Letter of Evaluation (SLOE) can predict future leadership roles, specifically the selection of chief residents in emergency medicine. Their analysis of SLOEs from 243 residents revealed that chief residents scored significantly higher in teamwork, overall comparison to past applicants, and anticipated rank-list placement, suggesting that certain traits may indicate leadership potential. However, the study also highlights that traditional academic metrics alone may not suffice for identifying future leaders, emphasizing the importance of structured leadership development for all residents.

Reducing Emergency Diagnostic Uncertainty with TRACE: Triage and Risk Assessment via Cost Estimation

Apr 29, 2026

The authors aim to address the issue of diagnostic uncertainty in emergency medicine by developing a machine-learning framework called Triage and Risk Assessment via Cost Estimation (TRACE). This framework integrates expected-value calculations and patient similarity metrics to enhance triage accuracy and diagnostic predictions. The results demonstrate that TRACE significantly improves triage prediction accuracy and aligns closely with actual patient outcomes, suggesting its potential as a decision-support tool in clinical settings.

Impact of Artificial Intelligence-supported Triage Systems on Emergency Department Management: A Comparison of Infermedica, Emergency Severity Index, and Manchester Triage System

Apr 29, 2026

This study aimed to evaluate the effectiveness of an artificial intelligence-supported triage system compared to traditional methods, specifically the Emergency Severity Index and the Manchester Triage System, in managing a high-volume emergency department. The findings indicated that the AI-supported system resulted in significantly lower in-ED mortality and complication rates, as well as higher patient satisfaction, although the study's single-center design and short observation period limit the generalizability of the results.

12-Year Case Series of Patients with Heat Illness from an Urban Hospital System in the American Southwest

Apr 29, 2026

The authors aimed to analyze the demographic and clinical characteristics of patients diagnosed with heat-related illness over a 12-year period in an urban hospital system in the American Southwest, in light of increasing heat events due to climate change. They found that affected patients were predominantly older males with significant comorbidities, and highlighted trends in clinical outcomes, including high rates of intensive care admissions. This study provides insights into the vulnerabilities and protective factors associated with heat illness, which can inform local risk stratification and treatment strategies.

Association of Electrocardiogram Abnormalities with Clinical Outcomes in Emergency Department Sepsis Patients

Apr 29, 2026

This study aimed to identify common electrocardiogram (ECG) abnormalities in sepsis patients presenting to the emergency department and analyze their association with poor clinical outcomes, such as ICU admission, prolonged hospital stay, and in-hospital mortality. The findings revealed that certain ECG patterns, including atrial fibrillation/flutter and QT prolongation, were significantly more prevalent in patients with adverse outcomes, suggesting that ECG assessments could enhance early risk identification and management of sepsis in the emergency setting.

Model Resuscitation Leadership Curriculum for Emergency Medicine Residents: Modified Delphi Study

Apr 29, 2026

The authors aimed to establish expert consensus on the essential learning objectives and educational strategies for a resuscitation leadership curriculum tailored for emergency medicine (EM) residents, addressing the unique challenges of EM resuscitations. Through a modified Delphi study involving 12 experts, they identified 28 key learning objectives and 13 educational strategies, culminating in a comprehensive framework designed to enhance structured training and improve team performance in resuscitation scenarios. This curriculum provides EM residency programs with evidence-based guidance for developing effective resuscitation leadership skills.

Clinical Predictors of Intracranial Pathology in Emergency Department Patients with Non-traumatic Headache and No Neurological Deficits: Prospective Study

Apr 29, 2026

This study aimed to identify clinical predictors of intracranial pathology in emergency department patients presenting with non-traumatic headaches and no neurological deficits. The authors found that headache aggravated by physical activity and age over 50 years were significant indicators of intracranial issues, particularly subarachnoid hemorrhage, while traditional symptoms like "sudden onset" and "worst headache ever" did not predict such conditions effectively. These findings could enhance clinical decision-making regarding the need for neuroimaging in this patient group.

Effect of Ice Consistency and Sodium Chloride Additives on Cooling Speed and Final Temperature for Cold Water-Ice Immersion in Heat Stroke

Apr 29, 2026

The authors investigate how different forms of ice (crushed vs. cubed), the addition of sodium chloride, and the initial water temperature affect the cooling speed and final temperature of cold water-ice immersion for treating heat stroke. Their findings indicate that a mixture of crushed ice, cold tap water, and sodium chloride achieves a significantly lower equilibrium temperature and cools more rapidly compared to other combinations. This suggests that optimizing immersion protocols may enhance cooling efficiency, although the impact on patient outcomes remains to be evaluated.

Modified SIRS Criteria for Patients ≥ 65 Years with Addition of Altered Mental Status and Reduced Heart Rate for Atrioventricular Nodal Blockers

Apr 29, 2026

The authors aimed to evaluate a modified systemic inflammatory response syndrome (SIRS) criteria for diagnosing sepsis in patients aged 65 and older, incorporating altered mental status and a reduced heart rate threshold for those on atrioventricular nodal blockers. Their findings indicated that the modified criteria improved sensitivity for identifying sepsis while slightly reducing specificity, ultimately identifying an additional 1.21% of septic patients in this vulnerable population.

Cross-Sectional Examination of Hospital Visits in the Year Prior to Suicide Death in Illinois

Apr 29, 2026

The authors aimed to evaluate the distribution of hospital visits among suicide decedents in Illinois during the year prior to their deaths, focusing on the settings of these visits (emergency departments vs. inpatient units), their timing, and the presence of suicide risk factors. They found that while a lower proportion of decedents had hospital visits compared to other studies, inpatient visits were more closely associated with suicide risk factors and occurred nearer to the time of death. This suggests that inpatient settings may provide more identifiable opportunities for targeted suicide prevention interventions, particularly for individuals with substance use disorders.