The western journal of emergency medicine
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Changes in THC Positivity Rates in Adolescents Corresponding to Legalization of Recreational Marijuana in Illinois

Jun 8, 2026

The authors aimed to determine whether the legalization of recreational marijuana in Illinois in 2020 led to an increase in THC positivity rates among adolescents presenting to the emergency department, as well as any changes in co-ingestion rates of other substances. Their retrospective cohort study found no significant increase in THC-positive urine drug screens or co-ingestion rates in pediatric patients post-legalization compared to pre-legalization data. These results suggest that legalization did not impact the incidence of THC use in this population, providing insights for healthcare planning and policy considerations.

Climate Change and Emergency Medicine: A Scoping Review Across Emergency Medicine Subspecialties

Jun 8, 2026

This scoping review aims to synthesize existing literature on the impacts of climate change across various emergency medicine (EM) subspecialties and identify key findings, knowledge gaps, and priorities for enhancing climate-resilient emergency care systems. The study reveals that climate change significantly strains EM systems, particularly through temperature-related exposures and extreme weather events, disproportionately affecting socially marginalized populations. The authors highlight the need for improved geographic representation, intervention evaluations, and integration of climate projections in health system planning to address these challenges effectively.

Mechanisms and Intervention Strategies for Heat Stroke-Associated Myocardial Dysfunction: A Narrative Review

Jun 8, 2026

This narrative review explores the mechanisms and intervention strategies for myocardial dysfunction associated with heatstroke, a severe condition characterized by elevated body temperature and central nervous system impairment. The authors aim to elucidate the multifactorial pathophysiology of this dysfunction, which includes direct thermal damage and systemic inflammation, and emphasize the importance of early diagnosis and management strategies such as rapid cooling and hemodynamic support. The review highlights the need for further research into targeted therapies and risk stratification for effective treatment of this potentially reversible complication.

Pilot Simulation Task Trainer for Prehospital Management of Neck Hemorrhage

Jun 8, 2026

The authors aimed to address the lack of guidance and training for first responders in the prehospital management of penetrating neck injuries (PNI), which are critical due to their potential for fatal hemorrhage. They developed a novel training curriculum and synthetic medical simulator to enhance the skills of athletic trainers and physicians, specifically targeting the identification of bleeding patterns, hemorrhage control, and patient transfer. The pilot implementation demonstrated positive feedback from participants, indicating the effectiveness of simulation-based training in improving response to these high-risk injuries.

Impact of Bystander Naloxone on Emergency Medical Transport Refusal After Opioid Overdose: A Statewide Retrospective Analysis

Jun 8, 2026

This study investigates how bystander administration of naloxone impacts the likelihood of patients refusing emergency medical transport after an opioid overdose. The authors found that transport refusal was significantly higher when naloxone was administered by bystanders compared to first responders, with bystander administration increasing over time. The findings suggest that while refusal may not always lead to negative outcomes, it presents missed opportunities for critical follow-up care and interventions for opioid use disorder.

Clinical Insights and Case Analysis of Disorders Attributed to Cicadas in the Emergency Department

Jun 8, 2026

The authors aimed to characterize the impact of the 2024 co-emergence of cicada broods on emergency department and urgent care visits in the United States. Through a retrospective chart review, they identified 42 cicada-related cases among over 1.3 million visits, primarily involving trauma and allergic reactions. The findings highlight the need for public education and preparedness for future cicada emergences, despite the overall limited health system impact.

Emergency Department Boarding for Psychiatric Hospitalization in Older Adults: Placement Challenges and Associated Risks

Jun 8, 2026

The authors aimed to quantify the duration of emergency department (ED) boarding for older adults awaiting psychiatric hospitalization and to assess its association with functional decline and the use of physical restraints. Their study found that over half of the older adults boarded for more than 24 hours, with significant rates of functional decline and restraint episodes occurring primarily in this group, particularly among those with neurocognitive disorders. The findings highlight the challenges and risks associated with prolonged ED boarding in this vulnerable population.

Clinician-documented Firearm Access and Safety Interventions for Veterans Receiving Suicide Risk Evaluation in VA Emergency Care Settings

Jun 8, 2026

The authors aimed to assess the frequency of clinician documentation regarding firearm access and the implementation of safety interventions among veterans undergoing suicide risk evaluations in Veterans Health Administration emergency and urgent care settings. They found that while only 15.2% of patients were documented as having firearm access, a significant majority (80.6%) of those with access received at least one safety intervention. The study highlights the need for improved documentation practices and system-wide strategies to enhance the delivery of safety interventions for at-risk patients.

Contraception in the ED: Understanding Education and Opportunities for Clinicians to Advise Patients

Jun 8, 2026

This study aimed to assess emergency clinicians' comfort levels in prescribing contraceptives and educating patients about their use, as well as their interest in receiving targeted education on contraceptive care. The findings revealed that while many clinicians are willing to offer contraceptive services, a lack of education serves as a significant barrier, with a strong interest in educational sessions noted, particularly among younger clinicians and residents. The authors suggest that enhancing education could improve clinicians' confidence and ultimately increase access to contraceptive services in emergency departments.

Worth the Wait? Comparison of Emergency Department Patients' Waiting Room Tolerance for Real Patient Care vs Training/Simulation Scenarios

Jun 8, 2026

The authors aimed to determine whether patients in an emergency department waiting room would be willing to accept delays in their care for in-situ simulation training scenarios compared to real patient care scenarios. The study found that while patients showed lower tolerance for delays associated with simulation training, a significant portion (around 40%) were still willing to wait over 40 minutes for these scenarios, suggesting that in-situ simulation is generally acceptable to patients in clinical settings.