Here are what the editors at HealthDay consider to be the most important developments in Emergency Medicine for October 2018. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.
Sub-Concussive Hits May Not Be Tied to Neurocognitive Changes
WEDNESDAY, Oct. 31, 2018 (HealthDay News) — Sub-concussive head impacts suffered over the course of a single season of youth tackle football may not be associated with neurocognitive functional outcomes, according to a study published Oct. 12 in the Journal of Head Trauma Rehabilitation.
Abstract/Full Text (subscription or payment may be required)
AMA Announces Initiative to Reinvent Physician Training
TUESDAY, Oct. 30, 2018 (HealthDay News) — The American Medical Association (AMA) today announced a new $15 million competitive grant initiative, the “Reimagining Residency” initiative, aimed at improving residency training.
Many Hospitals Noncompliant With Record Request Regulations
MONDAY, Oct. 29, 2018 (HealthDay News) — Among top-ranked U.S. hospitals, data reveal discrepancies in information provided to patients regarding medical records release processes as well as noncompliance with state and federal regulations, according to a study published online Oct. 5 in JAMA Network Open.
Trump Administration Announces Plan to Cut Drug Prices
FRIDAY, Oct. 26, 2018 (HealthDay News) — In an effort to cut high drug costs, the prices paid by Medicare for certain prescription drugs would be based on those in other advanced industrial nations, according to a proposal announced Oct. 25 by the Trump administration.
HHS Study
New York Times Article
Novel Troponin Assay, hs-cTnI Comparable in Ruling Out AMI
FRIDAY, Oct. 26, 2018 (HealthDay News) — A single point-of-care troponin concentration measured on arrival to the emergency department (ED) with 15-minute turnaround time can accurately rule out acute myocardial infarction (AMI), according to a study published online Oct. 17 in JAMA Cardiology.
Millions of ER Visits for Asthma Due to Air Pollution
FRIDAY, Oct. 26, 2018 (HealthDay News) — Air pollution accounts for millions of emergency room visits for asthma each year, according to a study published Oct. 24 in Environmental Health Perspectives.
No Drop Seen in CT Use for Pediatric Head Trauma
FRIDAY, Oct. 26, 2018 (HealthDay News) — Computed tomography (CT) neuroimaging did not decrease from 2007 to 2015 among pediatric patients evaluated in the emergency department for head injury, according to a study published in the October issue of Pediatrics.
Abstract/Full Text
Editorial (subscription or payment may be required)
Oxygen Saturation Should Not Top 96 Percent in Acutely Ill
THURSDAY, Oct. 25, 2018 (HealthDay News) — For acutely ill patients, an oxygen saturation of no more than 96 percent should be maintained, according to a clinical practice guideline published online Oct. 24 in the BMJ.
HEART Pathway Can Safely Identify Low-Risk ER Patients
THURSDAY, Oct. 25, 2018 (HealthDay News) — Implementation of the HEART Pathway is associated with decreased hospitalizations, increased identification of myocardial infarction (MI) at the index visit, and a very low death and MI rate among low-risk emergency department patients with chest pain, according to a study published online Sept. 28 in Circulation: Cardiovascular Quality and Outcomes.
Pace of Change Has Accelerated in Alternative Payment Models
THURSDAY, Oct. 25, 2018 (HealthDay News) — The impact of alternative payment models (APMs) on physician practices has been described in a study published by the RAND Corp. and the American Medical Association.
Nearly Half of Children Seen in ED for Bronchiolitis Get Radiography
THURSDAY, Oct. 25, 2018 (HealthDay News) — Despite guideline recommendations to the contrary, nearly half of children seen in the emergency department for bronchiolitis receive radiography, according to a research letter published online Oct. 16 in the Journal of the American Medical Association.
Abstract/Full Text (subscription or payment may be required)
7 Children Dead From Adenovirus Outbreak in New Jersey
WEDNESDAY, Oct. 24, 2018 (HealthDay News) — New Jersey health officials on Wednesday confirmed the deaths of seven children after infection with an adenovirus.
More Information
Article from The Record (Bergen County)
FDA Approves First New Influenza Drug in 20 Years
WEDNESDAY, Oct. 24, 2018 (HealthDay News) — For the first time in nearly two decades, the U.S. Food and Drug Administration has approved a new type of antiviral influenza drug.
Almost One in 10 Treated in Hospital for Non-Fatal Injury
WEDNESDAY, Oct. 24, 2018 (HealthDay News) — In 2013, 9.8 per 100 people were treated in the hospital for a non-fatal injury, with costs estimated at $1.853 trillion, according to a study published online Oct. 8 in Injury Epidemiology.
High-Dose Flu Vaccine May Cut Hospitalization in Dialysis Patients
WEDNESDAY, Oct. 23, 2018 (HealthDay News) — Receipt of the high-dose influenza vaccine in 2016 to 2017 was associated with lower rates of hospitalization among dialysis patients, according to a study published online Oct. 23 in the Clinical Journal of the American Society of Nephrology.
Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)
Deep Neural Network Improves Detection of Wrist Fractures
WEDNESDAY, Oct. 24, 2018 (HealthDay News) — Deep learning methods allow senior medical specialists to deliver their expertise to emergency medicine clinicians via use of a deep neural network, which is associated with considerable improvement in sensitivity and specificity of detecting fractures in wrist radiographs, according to a study published online Oct. 22 in the Proceedings of the National Academy of Sciences.
Most Supplements Contain Prohibited Stimulants
WEDNESDAY, Oct. 24, 2018 (HealthDay News) — Many supplements contain one or more stimulants that have been the subject of U.S. Food and Drug Administration-issued public notices, according to a research letter published online Oct. 22 in JAMA Internal Medicine.
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Editor’s Note (subscription or payment may be required)
Health Enterprise Zone Initiative Cut Hospitalizations, Costs
WEDNESDAY, Oct. 24, 2018 (HealthDay News) — Maryland’s Health Enterprise Zone Initiative reduced hospitalizations and led to net cost savings, according to a study published in the October issue of Health Affairs.
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White House Unveils New Insurance Option for Small Firms
TUESDAY, Oct. 23, 2018 (HealthDay News) — A plan to allow small businesses to use tax-free accounts to provide health coverage for employees was announced today by the Trump administration.
AP News Article
More Information
Policy Denying Coverage for Nonemergent ED Visits Imprecise
TUESDAY, Oct. 23, 2018 (HealthDay News) — A policy retrospectively denying insurance coverage if an emergency department discharge diagnosis is determined to be nonemergent is not associated with accurate identification of unnecessary emergency department visits, according to a study published online Oct. 19 in JAMA Network Open.
Diagnostic Strategy Can Rule Out PE in Pregnant Women
MONDAY, Oct. 22, 2018 (HealthDay News) — A diagnostic strategy based on pretest clinical probability assessment, high-sensitivity D-dimer testing, bilateral lower-limb compression ultrasonography (CUS), and computed tomography pulmonary angiography (CTPA) can safely rule out pulmonary embolism (PE) in pregnant women, according to a study published online Oct. 23 in the Annals of Internal Medicine.
Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)
High Uptake, Acceptability of Rapid Fentanyl Test Strips
MONDAY, Oct. 22, 2018 (HealthDay News) — Young adults who report injecting drugs or using heroin, cocaine, or illicitly obtained prescription pills report high uptake and acceptability of fentanyl test strips to detect illicitly manufactured fentanyl, according to a study published online Oct. 18 in the International Journal of Drug Policy.
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CDC: First U.S. Case of Rat-Borne Andes Virus Diagnosed
FRIDAY, Oct. 19, 2018 (HealthDay News) — The first confirmed U.S. case of a virus carried by South American rodents occurred earlier this year, the U.S. Centers for Disease Control and Prevention says.
Sharp Drop in U.S. Life Expectancy Rankings by 2040
THURSDAY, Oct. 18, 2018 (HealthDay News) — The United States will have the largest drop in life expectancy rankings of all high-income countries by 2040, a new study says.
CNN Article
Abstract/Full Text
Editorial
Procurement Requirements Drive Interoperability in Health Care IT
THURSDAY, Oct. 18, 2018 (HealthDay News) — Interoperability of health care information technology (IT) must be improved to facilitate creation of a fully integrated health care system that can improve health and health care at lower cost, according to a report published by the National Academy of Medicine.
Simple Clinical Assessment in ED Best for Predicting Mortality
THURSDAY, Oct. 18, 2018 (HealthDay News) — A simple clinical assessment seems to be superior to the formalized Danish Emergency Process Triage (DEPT) system for predicting mortality in patients presenting to the emergency department, according to a study published online Oct. 16 in the Emergency Medicine Journal.
CDC Warns of Salmonella Illnesses Linked to Raw Chicken
WEDNESDAY, Oct. 17, 2018 (HealthDay News) — The number of people sickened in a Salmonella outbreak linked to raw chicken products now stands at 92 people in 29 states, U.S. health officials said today.
CDC Warns of Polio-Like Virus Striking More U.S. Children
TUESDAY, Oct. 16, 2018 (HealthDay News) — A rare but devastating polio-like virus appears to have made itself at home in the United States, partially paralyzing hundreds of children.
HealthDay Article
More Information: CDC
Change in Shelter Eligibility Policy Tied to More ED Visits
TUESDAY, Oct. 16, 2018 (HealthDay News) — A policy change to Massachusetts’ shelter eligibility was tied to increased pediatric emergency department visits for homelessness and substantial health care costs, according to a study published online Oct. 15 in Pediatrics.
High Risk for Readmission for Takotsubo Syndrome
TUESDAY, Oct. 16, 2018 (HealthDay News) — Patients with Takotsubo syndrome (TTS), which is characterized by transient left ventricular dysfunction with symptoms and electrocardiogram changes mimicking acute myocardial infarction (AMI), have lower mortality during the index admission than AMI patients but are frequently readmitted within 30 days, according to a study published online Sept. 28 in the European Heart Journal – Quality of Care & Clinical Outcomes.
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Without Medicaid Expansion, Poor Patients Forgo Medical Care
MONDAY, Oct. 15, 2018 (HealthDay News) — Doing without medical care is much more common among low-income residents of states that have not expanded Medicaid than among low-income people in other states, according to a Government Accountability Office report.
Active Pharmaceuticals ID’d in >700 Dietary Supplements
MONDAY, Oct. 15, 2018 (HealthDay News) — Dietary supplements often include active pharmaceuticals, even after warnings from the U.S. Food and Drug Administration, according to a study published online Oct. 12 in JAMA Network Open.
FDA Approves New DNA-Based Test to Verify Blood Compatibility
FRIDAY, Oct. 12, 2018 (HealthDay News) — The U.S. Food and Drug Administration has approved the ID CORE XT DNA-based test to help doctors verify blood compatibility before a transfusion.
Eye Trauma Secondary to Falls in Older Adults Increasing
FRIDAY, Oct. 12, 2018 (HealthDay News) — Eye trauma as a secondary admission diagnosis is increasing, largely because of an increased incidence of falls in older individuals, according to a study published online Oct. 4 in JAMA Ophthalmology.
Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)
Nine Cases of Polio-Like Illness Suspected in Children in Illinois
THURSDAY, Oct. 11, 2018 (HealthDay News) — Nine recent cases of a rare, polio-like disorder in children are being investigated in Illinois, health officials said yesterday.
CNN Article
More Information: CDC
Aetna-CVS Merger Approved
WEDNESDAY, Oct. 10, 2018 (HealthDay News) — A $69 billion merger between health insurer Aetna and pharmacy manager CVS Health has been approved, according to the U.S. Justice Department.
Polio-Like Condition in Children on Rise Again in the United States
TUESDAY, Oct. 9, 2018 (HealthDay News) — A rare, polio-like condition in children is on the rise again in the United States, with 38 confirmed cases in 16 states so far this year, the U.S. Centers for Disease Control and Prevention says.
NBC News Article
More Information: CDC
Flea-Borne Typhus Outbreak in Los Angeles County
TUESDAY, Oct. 9, 2018 (HealthDay News) — An outbreak of flea-borne typhus in Los Angeles County has so far resulted in 57 cases, including 20 in Pasadena and nine in downtown Los Angeles, public health officials say.
CNN Article
More Information: CDC
Minority Residents Experience Burdens Linked to Race/Ethnicity
TUESDAY, Oct. 9 2018 (HealthDay News) — Minority residents describe burdens associated with race/ethnicity, including microaggressions and bias on a daily basis, according to a study published online Sept. 28 in JAMA Network Open.
Congress Passes Bill to Fight Opioid Crisis
FRIDAY, Oct. 5, 2018 (HealthDay News) — A bipartisan bill to fight the opioid addiction crisis in the United States has been passed by Congress. President Donald Trump said he would sign the bill into law.
AZ Company Recalls Raw Beef Products Linked to Salmonella
FRIDAY, Oct. 5, 2018 (HealthDay News) — An Arizona company has recalled more than 6.5 million pounds (2.9 million kilograms) of beef linked to a Salmonella outbreak that has sickened 57 people in 16 states. Fourteen people have been hospitalized. No deaths have been reported, according to the U.S. Centers for Disease Control and Prevention.
AP News Article
CDC Food Safety Alert
Industry-Funded Trials Often Involve Employees in Studies
Withdrawal From Medetomidine Increasingly Seen in ICUs 
Multicomponent Interventions Offer Little Impact on Fall Risk 
ED Visits for Gambling Disorder Spike After Canada Liberalizes Online Gambling 
Nearly 2 in 3 Poison Exposures in Young Children May Not Need the ED 
About 1 in 20 Hospitalized U.S. Adults With Firearm Injuries Develop Bacterial Infections 
Unintentional Ingestion of Recreational Drugs Increased, Especially Since 2013 
Emergency Diagnosis Linked to Worse Outcomes for Range of Conditions 
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