The western journal of emergency medicine
Audio Summaries

De-Labeling of Penicillin Allergy in the Emergency Department at a Veterans Affairs Hospital

Aug 4, 2026

The authors aimed to evaluate the safety and feasibility of a pharmacist-led protocol for de-labeling penicillin allergies in the emergency department (ED) at a Veterans Affairs Hospital. Their study found that nearly half of the patients who underwent an oral amoxicillin challenge had their penicillin allergy removed, with only one mild reaction reported, indicating that such evaluations can enhance patient care and support antimicrobial stewardship without significantly increasing ED length of stay.

Emergency Department Closures and Patient Outcomes: Scoping Review of Impacts on Care, Equity, and System Performance

Aug 4, 2026

This scoping review aims to assess the impacts of emergency department (ED) closures on patient outcomes, healthcare equity, and overall system performance. The authors found that while ED closures generally lead to negative effects on mortality rates for time-sensitive conditions and disproportionately impact equity-deserving populations, the long-term consequences may be less severe in well-resourced systems. The review highlights significant gaps in the literature regarding the effects on non-time-sensitive conditions and marginalized groups, suggesting areas for future research.

The Impact of Urinalysis Turnaround Times on Patient Disposition in the Emergency Department

Aug 4, 2026

The authors aimed to investigate the relationship between urinalysis (UA) turnaround times and patient disposition times in the emergency department, particularly for patients with abdominopelvic complaints. Their retrospective analysis of 6,708 discharged patients revealed a modest positive correlation between UA order-to-result times and time to disposition, suggesting that improving UA processing times could enhance patient throughput in the ED.

Emergency Department-initiated Naltrexone for Alcohol Use Disorder: Association with Recidivism

Aug 4, 2026

The authors aimed to determine whether administering naltrexone in the emergency department (ED) would reduce recidivism rates for alcohol use disorder (AUD) within 30 days post-treatment. While the overall study population showed no change in ED visit rates after naltrexone administration, frequent ED users (those with four or more visits in the preceding 90 days) experienced a significant reduction in visits following treatment. This suggests that naltrexone may be beneficial for high-frequency ED users with AUD.

Unveiling Unwritten Curricula: Enhancing Junior Faculty Development in Academic Emergency Medicine

Aug 4, 2026

The authors aimed to explore how junior faculty in academic emergency medicine perceive and navigate the "unwritten curriculum," which encompasses informal norms and expectations that influence their professional development. Through a survey of 35 junior faculty members, they identified key themes such as the importance of mentorship, implicit expectations regarding productivity and engagement, and challenges related to departmental politics and feedback processes. The findings suggest that addressing these unwritten norms through structured support and clear communication may enhance the transition and growth of junior faculty.

9-1-1 Call Data Modeling to Assess the Influence of a Mass Gathering on Host Community Metrics for Syndromic Surveillance

Aug 4, 2026

This study aims to assess how 9-1-1 emergency medical dispatch data can be modeled to detect changes in health metrics of host communities during mass gatherings, specifically using data from the Super Bowl LIII festivities. The authors analyze call volumes related to hypothermia, traffic incidents, and violence-induced injuries across pre-, during, and post-event periods to enhance syndromic surveillance. The findings suggest that 9-1-1 call data can reveal trends indicative of health risks associated with such large events, thereby improving community health monitoring.

Potentially Avoidable Spine Transfers to a Level I Trauma Center: A Five-Year Retrospective Analysis

Aug 4, 2026

The authors aimed to identify the prevalence of potentially avoidable spine transfers to a Level I trauma center and understand the characteristics of these transfers. Their retrospective analysis revealed that 32.2% of the 1,918 transfers were potentially avoidable, with many patients experiencing lengthy emergency department stays despite not requiring immediate surgical intervention or specialized imaging. The findings suggest a need for further research to develop strategies for managing certain spine conditions in community settings, potentially reducing unnecessary transfers.

Cultivating Environmentally Sustainable Emergency Departments with GreenED

Aug 4, 2026

The authors aimed to evaluate the impact of a sustainability initiative launched by the Royal College of Emergency Medicine, designed to promote environmentally sustainable practices in emergency departments (EDs). Over a two-year period, the study assessed financial and carbon savings from participating sites, revealing significant projected annual savings and carbon reductions. This research represents a pioneering effort to implement a structured and scalable approach to sustainable healthcare in emergency medicine globally.

Comparison of Emergency Department Boarders Managed by a Critical Care Consult Service versus Standard Care

Aug 4, 2026

This study aimed to compare the management of critically ill patients boarding in the emergency department (ED) by a critical care consult team versus standard care, specifically evaluating the rate of downgrades in admission level of care. The findings revealed that patients managed by the consult team had a significantly higher downgrade rate despite presenting with greater acuity, suggesting that ED-based critical care physicians may enhance the identification of patients appropriate for lower levels of care. However, no differences were observed in lengths of stay across ED, ICU, or hospital settings, potentially indicating systemic issues with bed availability.

Association of Pregnancy Documentation with Radiological Imaging in the Emergency Department

Aug 4, 2026

This study investigates the prevalence of missed pregnancy documentation in emergency department encounters and its association with the use of radiological imaging among pregnant individuals. The authors found that 5.9% of encounters lacked pregnancy documentation, which was notably higher among non-Hispanic Black patients, and that such missed documentation was linked to increased odds of receiving radiological imaging. The findings underscore the importance of accurate pregnancy documentation to ensure equitable care and potentially improve maternal outcomes.