Emergency Medicine

Sex differences in EMS-attended atrial fibrillation: less prehospital treatment for women.

In 16,415 EMS attendances for atrial fibrillation, women comprised 56.8% and had higher age-standardized attendance rates than men. Women had lower odds of prehospital treatment (56% vs 62%; aOR 0.85) and fewer cardioversions (aOR 0.79). Women experienced higher 30-day and 6-month EMS reattendance (aHRs 1.29 and 1.35) but lower short- and long-term mortality (aHRs 0.83 and 0.71). Findings support implementing standardized prehospital AF pathways and rapid-access postdischarge follow-up to address sex differences. 1

LLMs for screening missed ED diagnoses: variable sensitivity–specificity by model and cohort.

Among 288 ED encounters with 39 adjudicated missed opportunities for diagnosis, models showed similar discrimination but different tradeoffs. In the 72-hour return cohort, sensitivity ranged from 42.9% to 85.7% and specificity from 55.9% to 82.9% across models. In the floor-to-ICU cohort, sensitivity fell as low as 5.6% and AUCs spanned 0.57–0.82, showing cohort-dependent performance. LLMs may aid eTrigger case selection but require clinician review and local threshold tuning before deployment. 2

Quicker benzodiazepine delivery shortens pediatric seizures and lowers ICU transfers.

In 371 pediatric acute seizure episodes, median time to benzodiazepine was 6 minutes, with 74% treated within 10 minutes. Faster treatment occurred when nurses made the decision, intranasal routes were used, or prior rescue medication given. Intranasal midazolam was associated with shorter seizure duration versus IV lorazepam and with fewer ICU transfers (OR 0.3). Address modifiable workflow drivers to reduce delays and ICU transfers in pediatric seizure care. 3