The review of positive culture results by clinical pharmacists in pediatric patients discharged from the emergency department (ED) has not been described. This study aimed to compare review and family notification times of genital and urine cultures before and after initiation of review of positive cultures by clinical pharmacists in a pediatric ED. This was a retrospective review of charts for the study period of 1 year before and 1 year after initiation of review of positive cultures by clinical pharmacists. Positive culture timing results as well as types and rates of interventions were obtained from the electronic chart records. A total of 681 urine and 171 genital cultures were analyzed. The number of genital and urine cultures were similar in the nurse-driven and pharmacist-driven periods. For urine cultures, the cumulative percentage of notifications in the pharmacist-driven period exceeded that in the nurse-driven period until about 24 hours and again between 24 and 48 hours. By 12 hours, 5.4% of families had been notified in the pharmacist-driven period compared with 1.8% in the nurse-driven period ( = 0.011). More positive cultures were reviewed early in the pharmacist-driven period as well, but by 12 hours, the cumulative percentages were similar 30.4% in the pharmacist-driven period compared with 27.7% in the nurse-driven period ( = 0.431). For genital cultures, the distribution of notification and review times were similar in both periods. The review of positive cultures by clinical pharmacists in a pediatric ED can shorten review and notification times compared with nurses, especially in the first 12 hours.The review of positive cultures by clinical pharmacists in a pediatric ED can shorten review and notification times compared with nurses, especially in the first 12 hours. Pediatric emergency physicians complete either a pediatric or emergency residency before fellowship training. Fewer emergency graduates are pursuing a pediatric emergency fellowship during the past decade, and the reasons for this decrease are unclear. The purpose of this study was to explore emergency residents' incentives and barriers to pursuing a fellowship in pediatric emergency medicine (PEM). This was a cross-sectional survey-based study. In 2016, we emailed the study survey to all Emergency Medicine Residents' Association (EMRA) members. Survey questions included respondents' interest in a PEM fellowship and perceived incentives and barriers to PEM. Of 6620 EMRA members in 2016, 322 (5.0%) responded to the survey. Respondents were 59.6% male, with a mean age of 30.6 years. A total of 105 respondents (32.6%) were in their first year of emergency medicine residency, 92 (28.6%) were in their second year, 77 (23.9%) were in their third year, and 48 (14.9%) were in their fourth or fifth year. A totents considered a PEM fellowship. PEM leaders who want to promote emergency medicine to pediatric emergency residents will need to leverage the incentives and mitigate the perceived barriers to a PEM fellowship to increase the number of emergency residency applicants. Intensive care unit (ICU) admissions near the end of life have been associated with worse quality of life and burdensome costs. Patients may not benefit from ICU admission if appropriate end-of-life care can be delivered elsewhere. The objective of this study was to descriptively analyze patients receiving end-of-life care in an emergency department (ED)-based ICU (ED-ICU). This is a retrospective analysis of patient outcomes and resource use in adult patients receiving end-of-life care in an ED-ICU. In 2015, an "End of Life" order set was created to standardize delivery of palliative therapies and comfort measures. We identified adult patients (>18 years) receiving end-of-life care in the ED-ICU from December 2015 to March 2020 whose clinicians used the end-of-life order set. A total of 218 patients were included for analysis; 50.5% were female, and the median age was 73.6 years. The median ED-ICU length of stay was 13.3hours (interquartile range, 7.4-20.6). Two patients (0.9%) were admitted to an inpatient ICU, 117 (53.7%) died in the ED-ICU, 77 (35.3%) were admitted to a non-intensive care inpatient service, and 22 (10.1%) were discharged from the ED-ICU. An ED-ICU can be used for ED patients near the end of life. Only 0.9% were subsequently admitted to an ICU, and 10.1% were discharged from the ED-ICU. This practice may benefit patients and families by avoiding costly ICU admissions and benefit health systems by reducing ICU capacity strain.An ED-ICU can be used for ED patients near the end of life. Only 0.9% were subsequently admitted to an ICU, and 10.1% were discharged from the ED-ICU. This practice may benefit patients and families by avoiding costly ICU admissions and benefit health systems by reducing ICU capacity strain. The objective of this study was to determine whether instituting an alternative to opioids (ALTO) protocol significantly reduced opioid use in emergency departments (EDs). The secondary objective was to determine whether patient-reported pain and satisfaction were affected. Electronic health records for 10 EDs in Colorado were retrospectively examined for the 6 months before the intervention and for the same 6 months the following year after the intervention, which consisted of systemic and educational initiatives in line with the . Of the total preintervention and postintervention unique patient visits, 47.2% received 1 of the drugs of interest, an opioid or ALTO, while in the ED. In aggregate, the EDs decreased opioid usage, measured in morphine equivalent units per 1000 ED visits, by 37.4% (95% confidence interval, 33.6%-76.2%; < 0.0001) after the intervention. Selleckchem JTZ-951 Statistically significant decreases were seen in every type of opioid. Statistically significant increases in ALTO usage were also notting without an overall reduction in patient perception of pain or satisfaction with care. Given the increase in narcotic addiction and diversion, understanding how patients use their opioid prescriptions and store or dispose of any remainders is important. We set out to determine the frequency in which patients had leftover opioid quantities from prescriptions received in the emergency department (ED). In addition, we sought to describe patients' reasons for taking or not taking all of their prescribed medications and their strategies to manage and/or dispose of any excess or leftovers. This cross-sectional study took place at an academic center in an urban environment in mid-Missouri with an annual emergency department volume of 55,000patients. Potential participants were identified using a patient discharge prescription log and consisted of adult patients who received opioid prescriptions. A single researcher recruited participants via phone and invited them to participate in the study by completing a short phone survey. The discharge log included 301 patient encounters; of those, 170 potential participants were successfully contacted by phone and 89 agreed to participate in the survey.