{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T17:50:56Z","timestamp":1780595456141,"version":"3.54.1"},"reference-count":47,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["1 R01 HS027811\u201001"],"award-info":[{"award-number":["1 R01 HS027811\u201001"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Opioid\u2010related adverse events (AEs) resulting in or following an ED visit are well described. Less is known about AEs due to opioid administration in the ED, whose detection is limited by the high frequency of administration and poorly specific surveillance methods. We studied the use of the ED Trigger Tool (EDTT) for detection of AEs from high\u2010risk opioid administration in the ED.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a secondary analysis of a multicenter retrospective study of the EDTT for two selected triggers: M2\u2010 \u2265\u20093 doses of hydromorphone administered and M18\u2013 opioid + benzodiazepine administration. We applied the EDTT to an 18\u2010month extract of data from three sites and reviewed a balanced sample of ~3000 records\/site using a two\u2010tiered approach, characterizing opioid\u2010related AEs by occurrence, type, and severity. Analysis is descriptive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 13,601\/450,852 visits (3.0%) across three sites included one of these triggers: M2 (6447; 1.4%); M18 (6201; 1.4%); or both (853; 0.2%). In our sample of 8719 records, 458 (5.3%) included at least one of these triggers (78 with M2, 347 with M18, and 33 with both). Reviewer agreement was high (Kappa\u2009=\u20090.94). We identified 124 opioid\u2010related ED AEs among 120 triggered visits (26.2%): M2 (37\/78 visits; 47.4%); M18 (76\/347 visits; 21.9%), and both (7\/33 visits; 21.2%). There were no site differences in opioid\u2010related ED AE detection. Common AEs included hypotension, hypoxia, allergic reactions, and delirium, mostly resulting in temporary harm but 30% requiring urgent intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In our sample, 5% of visits included high\u2010risk opioid administration, of which 26% included an opioid\u2010related AE. AE rates were similar across sites, with expected variability in type and severity across triggers and sites. The EDTT is a useful approach for AE detection. Triggers focusing on high\u2010risk opioid administration may have a more favorable yield as a surveillance strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acem.70216","type":"journal-article","created":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T06:00:57Z","timestamp":1771048857000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Identifying Adverse Events Associated With High\u2010Risk Opioid Administration Using the Emergency Department Trigger Tool"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6279-7380","authenticated-orcid":false,"given":"Richard T.","family":"Griffey","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Washington University School of Medicine  St. Louis Missouri USA"},{"name":"Washington University School of Public Health  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neha","family":"Bollam","sequence":"additional","affiliation":[{"name":"University of Missouri School of Medicine  Columbia Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan M.","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmund S. H.","family":"Kwok","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine The Ottawa Hospital  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Ancona","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith E.","family":"Kocher","sequence":"additional","affiliation":[{"name":"Departments of Emergency Medicine and Learning Health Sciences University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2015.03.026"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-018-0728-y"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2020.06.049"},{"key":"e_1_2_12_5_1","first-page":"90109","article-title":"Risks Associated with Opioid Prescriptions for Headache in the Emergency Department","author":"Jake H.","year":"2025","journal-title":"American Journal of Emergency Medicine"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2020.01762"},{"key":"e_1_2_12_7_1","unstructured":"The Joint Commission \u201cSentinel Event Alert #49. Safe Use of Opioids in Hospitals \u201d(2012) 1\/14\/2026: at https:\/\/www.masimo.com\/siteassets\/us\/documents\/pdf\/sea_49_opioids_8_2_12.pdf."},{"key":"e_1_2_12_8_1","unstructured":"Society for Hospital Medicine \u201cReducing Adverse Drug Events Related to Opioids (RADEO) Guide: SHM Center for Hospital Innovation & Improvement \u201d(2015) 1\/14\/26: at https:\/\/www.hospitalmedicine.org\/wp\u2010content\/uploads\/2024\/11\/shm_reducingopiodevents_guide.pdf."},{"key":"e_1_2_12_9_1","volume-title":"IHI Global Trigger Tool for Measuring Adverse Events","author":"Griffin F. 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