As Medical Editor in Chief of ACEP Now, feedback is never in short supply. When you love something we printed, I hear often about it. When you don’t? Well, I always hear about that. Many of our most popular articles come from your ideas, whether suggested via email or in person. (This is one reason I really miss in-person conferences!) But one thing can’t be denied: people vote with their clicks. The top 10 most read ACEP Now articles this year reflect your needs and interests, and they fall into three categories: COVID-19, equity, and “everything else.”
Explore This IssueACEP Now: Vol 39 – No 12 – December 2020
The four COVID-19 articles trace our collective journey through this crisis. An early article gave background on SARS-CoV-2 itself, and described the initial patients who were considered “persons under investigation.” Highly informative, the article now reads like a historical document; just 10 months later, just about everyone we encounter with symptoms (and even many without symptoms) are now considered at risk. We also contextualized COVID-19 versus previous years’ pneumonia and flu rates, providing an important window into the magnitude of the pandemic. We then covered pros and cons of various types of coronavirus testing. And while we have subsequently covered all manner of COVID-19 treatments, unsurprisingly, our most popular article on the topic described the safety of ibuprofen for children. (Pediatric pieces always get a lot of attention.)
The other major story this year—which would have been the lead story in any other year—was medicine’s reckoning with equity, racism, and sexism in medicine. After I accepted the position as Medical Editor in Chief, the very first thing I did was to create a recurring column called “Equity Equation.” Our article on combatting microagressions in the workplace (written by one of the founding curators of the Equity Equation column, Dr. Uché Blackstock) has quickly become an important online resource.
And while the “Me Too” movement is no longer a new one, our field continues to address those and other systemic issues related to sexism. A powerful piece shining light on the subtle and not-so-subtle disadvantages (entitled “It’s Not a Female Resident Problem”) faced by women in medicine pairs well with the microaggressions article—and both should be required reading.
Then there’s everything else. What could be more representative of emergency medicine as a field than the simple fact that we confronted two major crises and still treated our usual complement of patients and their diverse problems? We have to keep up with new literature and stay fresh on bread-and-butter care that we might encounter on any given shift.
The opioid epidemic rages on. With more overdoses comes more naloxone. And with more naloxone comes more precipitated withdrawal. We covered how to manage it humanely. Meanwhile, the year would not be complete without some new literature to muddy the waters on stroke management. As Dr. Ken Milne showed us, the evidence for alteplase for acute ischemic stroke continues to underwhelm—especially when re-analysis takes into account the baseline differences between patients in the control and intervention arm of the major trials.
The award for “article that taught me the most medicine” goes to Dr. Anton Helman’s “IV vs. PO: Which Antibiotics Are Better for Common ED Infections?” Sure, I knew that oral antibiotics are safe for a wide variety of infections. But bacteremia? You have to be impressed.
And last but not least, just to drive home the point that emergency physicians must be ready for anything, an article on the finer points of managing fibular fractures. I thought I was smart for remembering that we are supposed to get “manual stress views” for assessing ligament stability in Weber B ankle fractures. But it turns out that gravity and weight-bearing stress radiographs are enough!
What will 2021 teach us? You tell me! My ears and inbox are open to your ideas. Send your suggestions to email@example.com.