Search

Objectives The Global Emergency Medicine Literature Review (GEMLR) conducts a systematic annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most rigorously conducted and widely relevant research in global EM. Methods An electronic search of PubMed, a comprehensive retrieval of articles from specific journals, and search of the gray literature were conducted. Title and abstracts retrieved by these searches were screened by a total of 22 reviewers based on their relevance to the field of global EM, across the domains of disaster and humanitarian response (DHR), emergency care in resource-limited settings (ECRLS), and emergency medicine development (EMD). All articles that were deemed relevant by at least one reviewer, their editor, and the managing editor underwent formal scoring of overall methodologic quality and importance to global EM. Two independent reviewers scored all articles; editors provided a third score in cases of widely discrepant scores. Results A total of 19,102 articles were identified by the searches and, after screening and removal of duplicates, a total of 517 articles underwent full review. Twenty-five percent were categorized as DHR, 61% as ECRLS, and 15% as EMD. Inter-rater reliability testing between the reviewers revealed a Cohen's kappa score of 0.213 when considering the complete score or 0.426 when excluding the more subjective half of the score. A total of 25 articles scored higher than 17.5 of 20; these were selected for a full summary and critique. Conclusions In 2018, the total number of articles relevant to global EM that were identified by our search continued to increase. Studies and reviews focusing on pediatric infections, several new and traditionally underrepresented topics, and landscape reviews that may help guide clinical care in new settings represented the majority of top-scoring articles. A shortage of articles related to the development of EM as a specialty was identified.

Objectives The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a global audience of academics and clinical practitioners. Methods This year 13,890 articles written in four languages were identified by our search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM. An additional two reviewers searched the gray literature. All articles that were deemed appropriate by at least one reviewer and approved by their editor underwent formal scoring of overall quality and importance. Two independent reviewers scored all articles. Results A total of 716 articles met our inclusion criteria and underwent full review. Fifty-nine percent were categorized as emergency care in resource-limited settings, 17% as emergency medicine development, and 24% as disaster and humanitarian response. Nineteen articles received scores of 18.5 or higher out of a maximum score 20 and were selected for formal summary and critique. Inter-rater reliability testing between reviewers revealed Cohen's Kappa of 0.441. Conclusions In 2016, the total number of articles identified by our search continued to increase. The proportion of articles in each of the three categories remained stable. Studies and reviews with a focus on infectious diseases, pediatrics, and the use of ultrasound in resource-limited settings represented the majority of articles selected for final review. This article is protected by copyright. All rights reserved.

Objectives Despite recent strides in the development of global emergency medicine (EM), the field continues to lag in applying a scientific approach to identifying critical knowledge gaps and advancing evidence-based solutions to clinical and public health problems seen in emergency departments (EDs) worldwide. Here, progress on the global EM research agenda created at the 2013 Academic Emergency Medicine Global Health and Emergency Care Consensus Conference is evaluated and critical areas for future development in emergency care research internationally are identified. Methods A retrospective review of all studies compiled in the Global Emergency Medicine Literature Review (GEMLR) database from 2013 through 2015 was conducted. Articles were categorized and analyzed using descriptive quantitative measures and structured data matrices. The Global Emergency Medicine Think Tank Clinical Research Working Group at the Society for Academic Emergency Medicine 2016 Annual Meeting then further conceptualized and defined global EM research priorities utilizing consensus-based decision making. Results Research trends in global EM research published between 2013 and 2015 show a predominance of observational studies relative to interventional or descriptive studies, with the majority of research conducted in the inpatient setting in comparison to the ED or prehospital setting. Studies on communicable diseases and injury were the most prevalent, with a relative dearth of research on chronic noncommunicable diseases. The Global Emergency Medicine Think Tank Clinical Research Working Group identified conceptual frameworks to define high-impact research priorities, including the traditional approach of using global burden of disease to define priorities and the impact of EM on individual clinical care and public health opportunities. EM research is also described through a population lens approach, including gender, pediatrics, and migrant and refugee health. Conclusions Despite recent strides in global EM research and a proliferation of scholarly output in the field, further work is required to advocate for and inform research priorities in global EM. The priorities outlined in this paper aim to guide future research in the field, with the goal of advancing the development of EM worldwide.

The 2014 outbreak of Ebola virus disease (EVD) in West Africa has presented a significant public health crisis to the international health community and challenged U.S. emergency departments (EDs) to prepare for patients with a disease of exceeding rarity in developed nations. With the presentation of patients with Ebola to U.S. acute care facilities, ethical questions have been raised in both the press and medical literature as to how U.S. EDs, emergency physicians (EPs), emergency nurses, and other stakeholders in the health care system should approach the current epidemic and its potential for spread in the domestic environment. To address these concerns, the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine developed this joint position paper to provide guidance to U.S. EPs, emergency nurses, and other stakeholders in the health care system on how to approach the ethical dilemmas posed by the outbreak of EVD. This paper will address areas of immediate and potential ethical concern to U.S. EDs in how they approach preparation for and management of potential patients with EVD.

Global emergency medicine (EM) is a rapidly growing field within EM, as evidenced by the increasing number of trainees and clinicians pursuing additional experiences in global health and emergency care. In particular, many trainees now desire opportunities at the postgraduate level by way of global EM fellowship programs. Despite this growing popularity, little is known of the effects of postgraduate training in global health and emergency care on learners and patients in the United States and abroad. During the 2013 Academic Emergency Medicine consensus conference on global health and emergency care, a group of leading educators at the postgraduate medical education level convened to generate a research agenda of pressing questions to be answered in this area. The consensus-based research agenda is presented in this article. Resumen La medicina de urgencias y emergencias (MUE) global es un campo con un rapido crecimiento dentro de la medicina de urgencias y emergencias, como pone de manifiesto el aumento del numero de estudiantes y clinicos que buscan experiencias adicionales de atencion urgente y salud global. Particularmente, muchos residentes desean ahora oportunidades durante su formacion de postgrado a traves de los programas de postgrado en MUE global. A pesar de esta creciente popularidad, poco se sabe del impacto de la formacion de postgrado en salud global y atencion urgente en los residentes y los pacientes en Estados Unidos y en el extranjero. Durante la Conferencia Consenso de la Academic Emergency Medicine de 2013, un grupo de los principales profesores de medicina de postgrado se reunieron para generar un programa de investigacion con preguntas prioritarias para ser contestadas en esta area. Este programa de investigacion basado en el consenso se presenta en este articulo.

As policy-makers increasingly recognize emergency care to be a global health priority, the need for high-quality clinical and translational research in this area continues to grow. As part of the proceedings of the 2013 Academic Emergency Medicine consensus conference, this article discusses the importance of: 1) including clinical and translational research in the initial emergency care development plan, 2) defining the burden of acute disease and the barriers to conducting research in resource-limited settings, 3) assessing the appropriateness and effectiveness of local and global acute care guidelines within the local context, 4) studying the local research infrastructure needs to understand the best methods to build a sustainable research infrastructure, and 5) studying the long-term effects of clinical research programs on health care systems.

Objectives: The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of published and unpublished articles relevant to global emergency medicine (EM) to identify, review, and disseminate the most important research in this field to a wide audience of academics and practitioners. Methods: This year, 7,924 articles written in seven languages were identified by our search. These articles were divided up among 20 reviewers for initial screening based on their relevance to the field of global EM. An additional two reviewers searched the grey literature. A total of 206 articles were deemed appropriate by at least one reviewer and approved by their editor for formal scoring of their overall quality and importance. Results: Of the 206 articles that met our predetermined inclusion criteria, 24 articles received scores of 17 or higher and were selected for formal summary and critique. Interrater reliability for our scoring system was good with an interclass correlation coefficient of 0.628 (95% confidence interval = 0.51 to 0.72). Conclusions: Compared to previous reviews, there was a significant increase in the number of articles that were devoted to emergency care in resource-limited settings, with fewer articles related to disaster and humanitarian response. The majority of articles that met our selection criteria were reviews that examined the efficacy of particular treatment regimens for diseases that are primarily seen in low- and middle-income countries.

The International Emergency Medicine (IEM) Literature Review aims to highlight and disseminate high-quality global EM research in the fields of EM development, disaster and humanitarian response, and emergency care in resource-limited settings. For this review, we conducted a Medline search for articles published between January 1 and December 31, 2010, using a set of international and EM search terms and a manual search of journals that have produced large numbers of IEM articles for past reviews. This search produced 6,936 articles, which were divided among 20 reviewers who screened them using established inclusion and exclusion criteria to select articles relevant to the field of IEM. Two-hundred articles were selected by at least one reviewer and approved by an editor for scoring. Two independent reviewers using a standardized and predetermined set of criteria then scored each of the 200 articles. The 27 top-scoring articles were chosen for full review. The articles this year trended toward evidence-based research for treatment and care options in resource-limited settings, with an emphasis on childhood illness and obstetric care. These articles represent examples of high-quality inter- national emergency research that is currently ongoing in high-, middle-, and low-income countries alike. This article is not intended to serve as a systematic review or clinical guideline but is instead meant to be a selection of current high-quality IEM literature, with the hope that it will foster further growth in the field, highlight evidence-based practice, and encourage discourse. ACADEMIC EMERGENCY MEDICINE 2011; 18:872-879 a 2011 by the Society for Academic Emergency Medicine

ACADEMIC EMERGENCY MEDICINE 2011; 18:86–92 © 2011 by the Society for Academic Emergency Medicine Abstract As the specialty of emergency medicine evolves in countries around the world, and as interest in international emergency medicine (IEM) grows within the United States, the IEM Literature Review Group recognizes an ongoing need for a high-quality, consolidated, and easily accessible evidence base of literature. The IEM Literature Review Group produces an annual publication that strives to provide readers with access to the highest quality and most relevant IEM research from the previous year. This publication represents our fifth annual review, covering the top 24 IEM research articles published in 2009. Articles were selected for the review according to explicit, predetermined criteria that emphasize both methodologic quality and impact of the research. It is our hope that this annual review acts as a forum for disseminating best practices, while also stimulating further research in the field of IEM.

Objectives: The objective of this study was to determine the test characteristics for two different ultrasound (US) measures of severe dehydration in children (aorta to inferior vena cava [IVC] ratio and IVC inspiratory collapse) and one clinical measure of severe dehydration (the World Health Organization [WHO] dehydration scale). Methods: The authors enrolled a prospective cohort of children presenting with diarrhea and/or vomiting to three rural Rwandan hospitals. Children were assessed clinically using the WHO scale and then underwent US of the IVC by a second clinician. All children were weighed on admission and then fluid-resuscitated according to standard hospital protocols. A percent weight change between admission and discharge of greater than 10% was considered the criterion standard for severe dehydration. Receiver operating characteristic (ROC) curves were created for each of the three tests of severe dehydration compared to the criterion standard. Results: Children ranged in age from 1 month to 10 years; 29% of the children had severe dehydration according to the criterion standard. Of the three different measures of dehydration tested, only US assessment of the aorta/IVC ratio had an area under the ROC curve statistically different from the reference line. At its best cut-point, the aorta/IVC ratio had a sensitivity of 93% and specificity of 59%, compared with 93% and 35% for IVC inspiratory collapse and 73% and 43% for the WHO scale. Conclusions: Ultrasound of the aorta/IVC ratio can be used to identify severe dehydration in children presenting with acute diarrhea and may be helpful in guiding clinical management. ACADEMIC EMERGENCY MEDICINE 2010; 17:1035–1041 © 2010 by the Society for Academic Emergency Medicine

As the specialty of emergency medicine (EM) continues to evolve in countries around the world, and as interest in international emergency medicine (IEM) continues to grow within the United States, the IEM Literature Review Group recognizes a need for a high-quality, consolidated, and easily accessible evidence base of literature. In response to that need, the group created an annual publication that strives to provide readers with access to the highest quality and most relevant IEM research. This publication represents our fourth annual review, covering the top 26 IEM research articles published in 2008. Articles were selected for the review according to explicit, predetermined criteria that include both methodologic quality and perceived impact of the research. It is our hope that this annual review will act as a forum for disseminating best practices while also stimulating further research in the field of IEM.

Background Acute diarrhea remains both common and deadly in children worldwide. Proper treatment depends on accurately assessing dehydration status. Current World Health Organization (WHO) guidelines include an algorithm for classifying children as having no, some, or severe dehydration, which has never been properly validated. The Dehydration: Assessing Kids Accurately (DHAKA) study recently derived a new scoring system for dehydration in children, but it requires external validation. Methods Our study enrolled a random sample of children with acute diarrhea in Bangladesh. Local nurses prospectively applied both the DHAKA score and the WHO algorithm to children on arrival and obtained serial weights as they were rehydrated. The percent weight change with rehydration was used to classify subjects with severe (>9%) dehydration, some (3%–9%) dehydration, or no (

The field of international emergency medicine has grown rapidly over the past several decades, with an increase in the number of interested individuals and in the range of topics included under its rubric. One of the greatest obstacles, however, faced by international emergency medicine researchers and practitioners alike remains the lack of a high-quality, consolidated, and easily accessible evidence base of literature. In response to this perceived need, members of the Emergency Medicine Residents' Association International Emergency Medicine Committee, in conjunction with members of the Society for Academic Emergency Medicine International Interest Group, embarked on the task of creating a recurring review of international emergency medicine literature. Articles for this first annual review, covering research published in 2005, were selected according to explicit, predetermined criteria that included both methodological quality and perceived impact of the research. It is our hope that this annual review will act as a forum for disseminating best practices, while also stimulating further research in the field of international emergency medicine.