New in JACEP Open: Trends in Laboratory Evaluation and Risk Factors for Transfusion Therapy in Pediatric Epistaxis Laboratory testing and transfusions were uncommon in children presenting to the ED with epistaxis. Prolonged or recurrent bleeding and underlying bleeding disorders, cancer, or anticoagulant use were associated with greater need for testing and transfusion. Article link in the comments ⬇️

New Image on JACEP Open: A Teenager With Testicular Pain A teenager with intermittent testicular pain was found to have absent testicular blood flow consistent with torsion. Article link in comments ⬇️

New in JACEP Open: Suzetrigine for Acute Pain in the Emergency Department: A First-in-Class NaV1.8 Blocker Suzetrigine is a new nonopioid analgesic targeting peripheral NaV1.8 channels, providing acute pain relief comparable to hydrocodone/acetaminophen without observed respiratory depression or abuse potential. Its safety profile and opioid-sparing potential are promising for ED pain management, though ED-specific studies are still needed. Article link in the comments ⬇️

New in JACEP Open: Opioid Prescribing Patterns of Board-Certified Emergency Physicians Compared With Other Physicians Practicing Emergency Medicine Among Medicare Part-D Beneficiaries Between 2018 and 2020 in the United States Board-certified emergency physicians prescribed substantially fewer opioid days than non-EM board-certified physicians working in EDs. Across four common opioids, non-EM physicians prescribed roughly 3–4.5 times greater total day supplies. Article link in the comments ⬇️

New Image on JACEP Open: A Woman with Vaginal Bleeding After Starting a New Oral Contraceptive A 19-year-old woman with vaginal bleeding and passage of tissue was found to have a decidual cast rather than a miscarriage. Decidual casts are a rare complication of hormonal contraception that can mimic pregnancy loss. Article link in comments ⬇️

New in JACEP Open: Leveraging Observation Units for Disaster Response: Cases of Efficient Care Delivery in Disaster Incidents Emergency department observation units can help maintain patient flow, expand surge capacity, and preserve inpatient resources during disasters. Their flexibility makes EDOUs valuable assets for hospital disaster preparedness and response. Article link in the comments ⬇️

New in JACEP Open: Acute Urinary Retention and Guillain-Barré Syndrome: A Zebra or a Horse Guillain-Barré syndrome can present with back pain and urinary retention, closely mimicking cauda equina syndrome. The case emphasizes avoiding diagnostic anchoring when imaging excludes the initial suspected diagnosis. Article link in the comments ⬇️

New in JACEP Open: Health Insurance Portability and Accountability Act Liability in the Age of Generative Artificial Intelligence Public AI tools can create HIPAA and legal risks when clinicians enter protected patient information without appropriate safeguards. Clinicians should verify institutional agreements and privacy policies before using AI with patient data and know how to respond to potential breaches. Article link in the comments ⬇️

New Image on JACEP Open: Neck Swelling After Total Parenteral Nutrition A malpositioned PICC infiltrated TPN into the mediastinum, causing pneumomediastinum, mediastinitis, and bacteremia. The case highlights the importance of recognizing delayed PICC complications and promptly stopping line use. Article link in comments ⬇️

New in JACEP Open: Development and Validation of a Prognostic Risk Score for Patients With Cancer and Neutropenic Fever Presenting to the Emergency Department A new objective risk score effectively identified ED patients with neutropenic fever at low risk for adverse outcomes. Using readily available clinical data, the tool could support safer disposition decisions and reduce unnecessary hospitalizations. Article link in the comments ⬇️