Background and Objectives
We sought to understand the impact of COVID‐19 on emergency department (ED) overdoses and county coroner verified overdose deaths.
Methods
Electronic medical health record and county coroner data were gathered and comparisons were made between three 16‐week time periods. In the three time periods, 873 individuals had an overdose diagnosis in the ED and 440 individuals in the county died of drug overdose.
Results
While total ED patient volume decreased substantially, the number of ED overdose patients increased between March 6 and June 25, 2020. Furthermore, during this same period, coroner data revealed an increase in overdose deaths.
Conclusion and Scientific Significance
This preliminary evidence provides a key insight into the impact of COVID‐19 on both overdose presentations to the ED and county overdose deaths. These results emphasize the critical need for increasing vigilance to prevent overdose by continuously developing and optimizing both accessible and quality treatment as we navigate through this pandemic and its ongoing effects on persons with substance use disorder. (Am J Addict 2021;00:00–00)
We present the case of a 33-year-old male with end stage renal disease presenting to the emergency department (ED) with headache, dizziness, and unilateral weakness. Initial concern was for ischemic or hemorrhagic stroke. Magnetic resonance imaging confirmed posterior reversible encephalopathy syndrome (PRES). The patient was treated appropriately and made a full neurologic recovery. PRES is an under-recognized diagnosis in the ED. As a stroke mimic, PRES can lead the clinician on an incorrect diagnostic pathway with potential for iatrogenic harm.
Objective Sleep deprivation decreases work performance and predisposes workers to deleterious health outcomes. We sought to evaluate sleep hygiene and fatigue among emergency physicians. Methods In March–June 2016, physicians and residents at an academic emergency medicine program were invited to complete a survey evaluating sleep and alertness. Results Six attending physicians and 26 residents completed the survey. Among six personal priorities, sleep ranked fourth behind family, work, and leisure. 75% stated poor sleep impedes effectiveness as a physician while 53% noted difficulty falling asleep before a night shift. In the last three months, 39% of subjects forgot driving home from a shift, and 34% had fallen asleep while driving. 34% used medications to assist with sleep (including melatonin (36%), alcohol (27%), and prescription drugs (9%)). Most providers attested to phone (88%) and television exposure (69%) immediately prior to goal sleep onset. Conclusion Despite sleep being identified as a priority among EM physicians, deleterious habits remain. Poor sleep affects perceived effectiveness and personal safety, as evidenced by a significant portion of providers falling asleep on the commute home. Night shift is the chief obstacle to optimal sleep hygiene.
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