The role of prescriptive opioid use triggering an opioid use disorder is a target of attention, data, and lore. ED patients often receive an opioid as part of care, but the role of this in later misuse is unclear. One conflating factor when examining initial-to-later opioid use is previous opioid exposure or misuse.  To better understand how often and why new ongoing prescriptive opioid use exists, the authors followed 699 opioid-naïve patients who had been seen for a painful complaint and were exposed to an opioid during or after discharge from two urban EDs. They observed that 2 percent of this cohort had more than one  opioid prescription in the six months after the visit, with amount of early pain (two weeks after visit) being the strongest associated factor, not initial euphoria. These data underscore the realities of ED opioid analgesia and later ongoing use in those without existing opioid use; the frequency of longer use is small and linked to a common feature—continued pain after the initial ED visit.³

Cardiac Arrest Management in United States Emergency Departments During the First Year of the COVID-19 Pandemic, 2020

Choosing a career in the ED exposes physicians, advanced practitioners , nurses, and others to workplace risks, including infections acquired from those being served. The COVID-19 pandemic ushered in a high intensity period where that threat was real and linked to harm. Infectious risk mitigation may happen with protective actions and by changes in patient care that could include forgoing specific therapeutic steps. The authors explored what happened with ED cardiac arrest care during high pandemic periods across 20 sites, seeing this as an event where transmission could be high and basic interventions deemed riskier could be avoided. However, the investigators observed no changes in basic care steps or outcomes in these patients. This observation showed that despite concerns,  ED professionals did their jobs when needed the most,despite being amidst a new and threatening scenario.⁴

ECG Patterns of Occlusion Myocardial Infarction: A Narrative Review

Emergency physicians and others involved in acute care traditionally focus on identifying ST segment elevation as the high priority subset of patients with myocardial ischemia. This review identifies other forms of occlusive myocardial infarction detectable on ECG that can benefit from the same early recognition and reperfusion actions that are now well entrenched with ST elevation myocardial ischemia. These features should be recognized and alter practice to improve patient outcomes.⁵