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Purpose The use of social media by health professionals and medical journals is increasing. The aim of this study was to compare online views of articles in press (AIPs) released by Annals of Emergency Medicine before and after a nine-person social media team started actively posting links to AIPs using their personal Twitter accounts. Methods An observational before-and-after study was conducted. Web traffic data for Annals were obtained from the publisher (Elsevier), detailing the number of page views to annemergmed.com by referring websites during the study period. The preintervention time period was defined as January 1, 2013, to June 30, 2014, and the postintervention period as July 1, 2014, to July 31, 2015. The primary outcome was page views from Twitter per AIP released each month to account for the number of articles published each month. Secondary outcomes included page views from Facebook (on which there was no article-sharing intervention) and total article views per month. Results The median page views from Twitter per individual AIP released each month increased from 33 in the preintervention period to 130, for an effect size of 97 (95% confidence interval, 56-111; P < .001). There was a smaller increase in median page views from Facebook per individual AIP of 21 (95% confidence interval, 10-32). There was no significant increase in these median values for total page views per AIP. Conclusions Twitter sharing of AIPs increased the number of page views that came from Twitter but did not increase the overall number of page views. [ABSTRACT FROM AUTHOR]

Medical journals increasingly use social media to engage their audiences in a variety of ways, from simply broadcasting content via blogs, microblogs, and podcasts to more interactive methods such as Twitter chats and online journal clubs. Online discussion may increase readership and help improve peer review, for example, by providing postpublication peer review. Challenges remain, including the loss of nuance and context of shared work. Furthermore, uncertainty remains regarding how to assess the impact of journal social media outreach, abundant but unclear metrics, and the magnitude of benefit (if any), particularly given the substantial work required for substantive interactive engagement. Continued involvement and innovation from medical journals through social media offers potential in engaging journal audiences and improving knowledge translation. [ABSTRACT FROM AUTHOR]

Study Objective: Open educational resources such as blogs are increasingly used for medical education. Gestalt is generally the evaluation method used for these resources; however, little information has been published on it. We aim to evaluate the reliability of gestalt in the assessment of emergency medicine blogs.Methods: We identified 60 English-language emergency medicine Web sites that posted clinically oriented blogs between January 1, 2016, and February 24, 2016. Ten Web sites were selected with a random-number generator. Medical students, emergency medicine residents, and emergency medicine attending physicians evaluated the 2 most recent clinical blog posts from each site for quality, using a 7-point Likert scale. The mean gestalt scores of each blog post were compared between groups with Pearson's correlations. Single and average measure intraclass correlation coefficients were calculated within groups. A generalizability study evaluated variance within gestalt and a decision study calculated the number of raters required to reliably (>0.8) estimate quality.Results: One hundred twenty-one medical students, 88 residents, and 100 attending physicians (93.6% of enrolled participants) evaluated all 20 blog posts. Single-measure intraclass correlation coefficients within groups were fair to poor (0.36 to 0.40). Average-measure intraclass correlation coefficients were more reliable (0.811 to 0.840). Mean gestalt ratings by attending physicians correlated strongly with those by medical students (r=0.92) and residents (r=0.99). The generalizability coefficient was 0.91 for the complete data set. The decision study found that 42 gestalt ratings were required to reliably evaluate quality (>0.8).Conclusion: The mean gestalt quality ratings of blog posts between medical students, residents, and attending physicians correlate strongly, but individual ratings are unreliable. With sufficient raters, mean gestalt ratings provide a community standard for assessment. [ABSTRACT FROM AUTHOR]

Annals of Emergency Medicine collaborated with an educational Web site, Academic Life in Emergency Medicine (ALiEM) to host a public discussion featuring the 2014 Annals article on the outpatient management of patients with a spontaneous pneumothorax by using pigtail catheters. The objective was to curate a 14-day (November 10 to 23, 2014) worldwide academic dialogue among clinicians about the article. Four online facilitators hosted the multimodal discussion on the ALiEM Web site, Twitter, and Google Hangout. Comments across the social media platforms were curated for this report, as framed by 4 preselected questions. Engagement was tracked through Web analytic tools. Blog comments, tweets, and video expert commentary involving the featured article are summarized and reported. The dialogue resulted in 1,023 page views from 347 cities in 49 countries on the ALiEM Web site, 279,027 Twitter impressions, and 88 views of the video interview with experts. This Global Emergency Medicine Journal Club created a virtual community of practice from around the world and identified common themes around the management of spontaneous pneumothorax, which included substantial practice variation in regard to inpatient versus outpatient management, location of chest tube, the use of aspiration, and chest radiography after placement. [ABSTRACT FROM AUTHOR]

In July to August 2014, Annals of Emergency Medicine continued a collaboration with an academic Web site, Academic Life in Emergency Medicine (ALiEM), to host an online discussion session featuring the 2014 Annals Residents' Perspective article 'Integration of Social Media in Emergency Medicine Residency Curriculum' by Scott et al. The objective was to describe a 14-day worldwide clinician dialogue about evidence, opinions, and early relevant innovations revolving around the featured article and made possible by the immediacy of social media technologies. Six online facilitators hosted the multimodal discussion on the ALiEM Web site, Twitter, and YouTube, which featured 3 preselected questions. Engagement was tracked through various Web analytic tools, and themes were identified by content curation. The dialogue resulted in 1,222 unique page views from 325 cities in 32 countries on the ALiEM Web site, 569,403 Twitter impressions, and 120 views of the video interview with the authors. Five major themes we identified in the discussion included curriculum design, pedagogy, and learning theory; digital curation skills of the 21st-century emergency medicine practitioner; engagement challenges; proposed solutions; and best practice examples. The immediacy of social media technologies provides clinicians the unique opportunity to engage a worldwide audience within a relatively short time frame. [ABSTRACT FROM AUTHOR]

In July to August 2014, Annals of Emergency Medicine continued a collaboration with an academic Web site, Academic Life in Emergency Medicine (ALiEM), to host an online discussion session featuring the 2014 Annals Residents’ Perspective article “Integration of Social Media in Emergency Medicine Residency Curriculum” by Scott et al. The objective was to describe a 14-day worldwide clinician dialogue about evidence, opinions, and early relevant innovations revolving around the featured article and made possible by the immediacy of social media technologies. Six online facilitators hosted the multimodal discussion on the ALiEM Web site, Twitter, and YouTube, which featured 3 preselected questions. Engagement was tracked through various Web analytic tools, and themes were identified by content curation. The dialogue resulted in 1,222 unique page views from 325 cities in 32 countries on the ALiEM Web site, 569,403 Twitter impressions, and 120 views of the video interview with the authors. Five major themes we identified in the discussion included curriculum design, pedagogy, and learning theory; digital curation skills of the 21st-century emergency medicine practitioner; engagement challenges; proposed solutions; and best practice examples. The immediacy of social media technologies provides clinicians the unique opportunity to engage a worldwide audience within a relatively short time frame. [ABSTRACT FROM AUTHOR]

Study objective We investigate a new technique for the emergency airway management of patients with altered mental status preventing adequate preoxygenation. Methods This was a prospective, observational, multicenter study of patients whose medical condition led them to impede optimal preintubation preparation because of delirium. A convenience sample of emergency department and ICU patients was enrolled. Patients received a dissociative dose of ketamine, allowing preoxygenation with high-flow nonrebreather mask or noninvasive positive pressure ventilation (NIPPV). After preoxygenation, patients were paralyzed and intubated. The primary outcome of this study was the difference in oxygen saturations after maximal attempts at preoxygenation before delayed sequence intubation compared with saturations just before intubation. Predetermined secondary outcomes and complications were also assessed. Results A total of 62 patients were enrolled: 19 patients required delayed sequence intubation to allow nonrebreather mask, 39 patients required it to allow NIPPV, and 4 patients required it for nasogastric tube placement. Saturations increased from a mean of 89.9% before delayed sequence intubation to 98.8% afterward, with an increase of 8.9% (95% confidence interval 6.4% to 10.9%). Thirty-two patients were in a predetermined group with high potential for critical desaturation (pre–delayed sequence intubation saturations ≤93%). All of these patients increased their saturations post–delayed sequence intubation; 29 (91%) of these patients increased their post–delayed sequence intubation saturations to greater than 93%. No complications were observed in the patients receiving delayed sequence intubation. Conclusion Delayed sequence intubation could offer an alternative to rapid sequence intubation in patients requiring emergency airway management who will not tolerate preoxygenation or peri-intubation procedures. It is essentially procedural sedation, with the procedure being preoxygenation. Delayed sequence intubation seems safe and effective for use in emergency airway management. [ABSTRACT FROM AUTHOR]

Management of the difficult airway is a relatively common problem in emergency medicine. A popular adjunct technique is the use of a tracheal introducer (sometimes called a "bougie"). Blind digital intubation is also described. There is no discussion in the literature about the use of digital assistance for endotracheal tube delivery after successful laryngoscopy. [ABSTRACT FROM AUTHOR]

Purpose: The use of social media by health professionals and medical journals is increasing. The aim of this study was to compare online views of articles in press (AIPs) released by Annals of Emergency Medicine before and after a nine-person social media team started actively posting links to AIPs using their personal Twitter accounts.Methods: An observational before-and-after study was conducted. Web traffic data for Annals were obtained from the publisher (Elsevier), detailing the number of page views to annemergmed.com by referring websites during the study period. The preintervention time period was defined as January 1, 2013, to June 30, 2014, and the postintervention period as July 1, 2014, to July 31, 2015. The primary outcome was page views from Twitter per AIP released each month to account for the number of articles published each month. Secondary outcomes included page views from Facebook (on which there was no article-sharing intervention) and total article views per month.Results: The median page views from Twitter per individual AIP released each month increased from 33 in the preintervention period to 130, for an effect size of 97 (95% confidence interval, 56-111; P < .001). There was a smaller increase in median page views from Facebook per individual AIP of 21 (95% confidence interval, 10-32). There was no significant increase in these median values for total page views per AIP.Conclusions: Twitter sharing of AIPs increased the number of page views that came from Twitter but did not increase the overall number of page views. [ABSTRACT FROM AUTHOR]