A new Annals of Emergency Medicine retrospective study assessed data from more than 77,000 adults who were discharged after coming to the emergency department with dizziness. Researchers tracked these patients for 30 days after discharge to see how many were later hospitalized with a stroke that caused disability or death.

The researchers found that only 0.12% were hospitalized for any stroke (about 1 in 830), and only 0.04% had a stroke resulting in disability or death (about 1 in 2,500). Of those who had strokes, very few required major acute stroke care interventions, and it might be surprising to some that the location of the stroke was not typically in the posterior fossa.

The results indicate that from the perspective of emergency physicians discharging patients with dizziness, the incidence of missed stroke, and particularly missed stroke that results in disability or death, is rare.

New Annals of Emergency Medicine Article Provides Model for Integrating Advocacy into EM Education and Practice 

Since emergency physicians care for all patients regardless of demographics, insurance status, or ability to pay, advocacy is a cornerstone of emergency medicine (EM) and a critical means of ensuring that the voices of patients and physicians alike are heard. 

A new article in Annals of Emergency Medicine shows how an academic children’s hospital established a formal “advocacy pillar” within their EM emergency medicine division to transform advocacy from an individual effort into a sustainable domain.  

The team worked to codify specific advocacy objectives and initiatives spanning division, hospital, community, national, and global levels to reflect the reality that many problems seen in the ED emergency department cannot be solved at the bedside alone. The division also established new leadership roles, dedicated committees, administrative support, and financial incentives to make the value of advocacy clear. Advocacy was deeply integrated into the division’s strategic plan alongside traditional pillars such as clinical operations, education, and research; as such, it was positioned as a core professional activity aligned with the mission and goals of EM . 

“Given that advocacy is a cornerstone of emergency medicine and that more physicians are investing time and energy into social emergency medicine, impacting patient care beyond the bedside, we hope that this work can act as a framework for other groups, divisions, and systems to integrate advocacy into their strategic plans and support physician-advocates’ passions and pursuits to better the practice of medicine and patient care,” said lead study author Matthew E. Lecuyer, MD, MPH.

The work offers a practical roadmap, demonstrating that advocacy can be measured and sustained. As emergency departments continue to serve as the front line for public health crises, the framework reinforces that supporting physician-advocates is essential to the sustainability of EM.