Emergency Medicine

Achievable benchmarks reveal wide pediatric ED practice variation and worsening throughput.

This PECARN cross-sectional study of 5,302,587 visits across 12 EDs established achievable benchmarks of care (ABCs) for pediatric management, readiness, and quality. Key quality measures varied widely: vital-sign documentation ranged 56.8%–99.3%, 2-point pain reduction for long-bone fractures 61.4%–92.6%, and steroid use for asthma 93.1%–99.2% across sites. Throughput metrics (time-to-clinician and length-of-stay) showed substantial site-to-site variation and worsened over time. ABCs highlighted larger gaps for clinician-controlled processes, suggesting targets for local quality improvement and peer benchmarking. 1

Danish drowning registry has high prehospital data completeness but misses some Utstein variables.

The nationwide Danish Drowning Cohort analysed 1,664 drowning events and reported a median data availability of 100% for cohort variables. Among 22 Utstein variables included, overall availability was 95%, but 21 of 79 (26%) Utstein variables were unavailable in the Danish setting. Availability was similar between patients with and without out-of-hospital cardiac arrest. High completeness supports robust epidemiologic and quality work, but be aware some Utstein items may be systematically missing. 2

CSRS and FAINT validate as low-risk syncope tools; FAINT better for cardiac outcomes than physicians.

Prospective multicenter cohort of 1,263 ED patients aged ≥40 found CSRS AUROC 0.72 for any serious outcome and FAINT AUROC 0.76 for serious cardiac outcomes. A CSRS <0 had sensitivity 91.9% and NPV 97.5% for 30-day serious outcomes, supporting low-risk identification. A FAINT score of 0 had sensitivity 96.7% and NPV 98.8% for serious cardiac events and outperformed physician-estimated risk. Consider incorporating these scores to augment discharge decisions while accounting for local resources and patient context. 3