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Western Journal of Emergency Medicine

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https://www.readbyqxmd.com/read/28435510/erratum-this-article-corrects-trends-in-nrmp-data-from-2007-2014-for-u-s-seniors-matching-into-emergency-medicine
#1
David E Manthey, Nicholas D Hartman, Aileen Newmyer, Jonah C Gunalda, Brian C Hiestand, Kim L Askew
[This corrects the article on p. 105 in vol. 18, PMID: 28116018.].
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435509/usmle-scores-predict-success-in-abem-initial-certification-a-multicenter-study
#2
Elie Harmouche, Nikhil Goyal, Ashley Pinawin, Jumana Nagarwala, Rahul Bhat
INTRODUCTION: There are no existing data on whether performance on the United States Medical Licensing Examination (USMLE) predicts success in American Board of Emergency Medicine (ABEM) certification. The aim of this study was to determine the presence of any association between USMLE scores and first-time success on the ABEM qualifying and oral certification examinations. METHODS: We retrospectively collected USMLE Step 1, Step 2 Clinical Knowledge (CK) scores and pass/fail results from the first attempt at ABEM qualifying and oral examinations from residents graduating between 2009 and 2011 from nine EM programs...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435508/a-novel-collaboration-to-reduce-the-travel-related-cost-of-residency-interviewing
#3
Eric Shappell, Abra Fant, Benjamin Schnapp, Jill P Craig, James Ahn, Christine Babcock, Michael A Gisondi
INTRODUCTION: Interviewing for residency is a complicated and often expensive endeavor. Literature has estimated interview costs of $4,000 to $15,000 per applicant, mostly attributable to travel and lodging. The authors sought to reduce these costs and improve the applicant interview experience by coordinating interview dates between two residency programs in Chicago, Illinois. METHODS: Two emergency medicine residency programs scheduled contiguous interview dates for the 2015-2016 interview season...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435507/blog-and-podcast-watch-orthopedic-emergencies
#4
Andrew Grock, Salim Rezaie, Anand Swaminathan, Alice Min, Kaushal H Shah, Michelle Lin
INTRODUCTION: The WestJEM Blog and Podcast Watch presents high quality open-access educational blogs and podcasts in emergency medicine (EM) based on the ongoing ALiEM Approved Instructional Resources (AIR) and AIR-Professional series. Both series critically appraise resources using an objective scoring rubric. This installment of the Blog and Podcast Watch highlights the topic of orthopedic emergencies from the AIR series. METHODS: The AIR series is a continuously building curriculum that follows the Council of Emergency Medicine Residency Directors (CORD) annual testing schedule...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435506/audience-response-system-facilitates-prediction-of-scores-on-in-training-examination
#5
Kaushal H Shah, Jaime Jordan, Katherine Jahnes, David P Lisbon, Lucienne Lutfy-Clayton, Grant Wei, Gary Winkel, Sally A Santen
INTRODUCTION: Audience response systems (ARS) are increasingly popular; however, their contribution to education is not completely clear. Our study found that scores from review quizzes delivered by an ARS correlate with in-training exam (ITE) scores and are viewed positively by residents. This information may be useful in identifying poor performers early so that targeted educational interventions can be made. The objective was to determine if scores on review quizzes delivered by an ARS correlate with ITE scores and to obtain participant feedback on use of the ARS for ITE preparation...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435505/inter-rater-agreement-of-end-of-shift-evaluations-based-on-a-single-encounter
#6
Steven Warrington, Michael Beeson, Amber Bradford
INTRODUCTION: End-of-shift evaluation (ESE) forms, also known as daily encounter cards, represent a subset of encounter-based assessment forms. Encounter cards have become prevalent for formative evaluation, with some suggesting a potential for summative evaluation. Our objective was to evaluate the inter-rater agreement of ESE forms using a single scripted encounter at a conference of emergency medicine (EM) educators. METHODS: Following institutional review board exemption, we created a scripted video simulating an encounter between an intern and a patient with an ankle injury...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435504/differentiating-urgent-and-emergent-causes-of-acute-red-eye-for-the-emergency-physician
#7
REVIEW
Christopher J Gilani, Allen Yang, Marc Yonkers, Megan Boysen-Osborn
Patients commonly present with an acute red eye to the emergency department (ED). It is important to distinguish between benign and sight-threatening diagnoses. Here we provide a comprehensive overview on the acute red eye in the ED.
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435503/ultrasound-guided-radial-artery-compression-to-assess-blood-pressure
#8
Leonard Bunting, Andrew Butki, Ashley Sullivan
INTRODUCTION: We proposed using compression sonography to observe the coaptation and collapse of the radial artery as a surrogate for automated cuff blood pressures (BP). We hypothesize that the pressure required to achieve coaptation and complete collapse of the artery would correlate to the diastolic and systolic BP, respectively. This pilot study was to assess the feasibility of ultrasound-guided radial artery compression (URAC) for BP measurement and compare patient comfort levels during automated cuff with URAC measurements...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435502/inferior-vena-cava-measurement-with-ultrasound-what-is-the-best-view-and-best-mode
#9
Nathan M Finnerty, Ashish R Panchal, Creagh Boulger, Amar Vira, Jason J Bischof, Christopher Amick, David P Way, David P Bahner
INTRODUCTION: Intravascular volume status is an important clinical consideration in the management of the critically ill. Point-of-care ultrasonography (POCUS) has gained popularity as a non-invasive means of intravascular volume assessment via examination of the inferior vena cava (IVC). However, there are limited data comparing different acquisition techniques for IVC measurement by POCUS. The goal of this evaluation was to determine the reliability of three IVC acquisition techniques for volume assessment: sub-xiphoid transabdominal long axis (LA), transabdominal short axis (SA), and right lateral transabdominal coronal long axis (CLA) (aka "rescue view")...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435501/impact-of-clinical-decision-support-on-radiography-for-acute-ankle-injuries-a-randomized-trial
#10
Shahein Tajmir, Ali S Raja, Ivan K Ip, James Andruchow, Patricia Silveira, Stacy Smith, Ramin Khorasani
INTRODUCTION: While only 15-20% of patients with foot and ankle injuries presenting to urgent care centers have clinically significant fractures, most undergo radiography. We examined the impact of electronic point-of-care clinical decision support (CDS) on adherence to the Ottawa Ankle Rules (OAR), as well as use and yield of foot and ankle radiographs in patients with acute ankle injury. METHODS: We obtained institutional review board approval for this randomized controlled study performed April 18, 2012-December 15, 2013...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435500/skin-to-intramuscular-compartment-thigh-measurement-by-ultrasound-in-pediatric-population
#11
Myto Duong, Albert Botchway, Jonathan Dela Cruz, Richard Austin, Kevin McDaniel, Cassie Jaeger
INTRODUCTION: Pediatric obesity threatens the efficacy of medications given intramuscularly. In anaphylactic patients, epinephrine auto-injector needle lengths are potentially too short to reach the muscle compartment in patients with elevated body habitus. The objective of the study was to determine needle-length requirements for intramuscular injections in pediatric patients. METHODS: We used ultrasound to measure the distance from skin to muscle compartment of the thigh in 200 pediatric patients of various weight and body mass index who presented to the emergency department...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435499/the-fast-and-the-furious-low-risk-chest-pain-and-the-rapid-rule-out-protocol
#12
REVIEW
Maite Anna Huis In 't Veld, Louise Cullen, Simon A Mahler, Barbra E Backus, Zachary D W Dezman, Amal Mattu
Accelerated diagnostic pathways (ADP) have been designed to identify low-risk chest pain patients in the emergency department. This review article discusses the Asia-Pacific Evaluation of Chest Pain Trial (ASPECT) score, the Accelerated Diagnostic Protocol for Chest Pain Trial (ADAPT) score, the Emergency Department Assessment of Chest Pain Score (EDACS), the HEARTScore and the HEART pathway. These ADPs have been validated in various studies and aid the emergency provider with identifying the low-risk chest pain patient who is appropriate for discharge home, while at the same time highlighting those patients who would benefit from further in-patient work up...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435498/security-violent-events-and-anticipated-surge-capabilities-of-emergency-departments-in-washington-state
#13
Jonathan S Weyand, Emily Junck, Christopher S Kang, Jason D Heiner
INTRODUCTION: Over the past 15 years, violent threats and acts against hospital patients, staff, and providers have increased and escalated. The leading area for violence is the emergency department (ED) given its 24/7 operations, role in patient care, admissions gateway, and center for influxes during acute surge events. This investigation had three objectives: to assess the current security of Washington State EDs; to estimate the prevalence of and response to threats and violence in Washington State EDs; and to appraise the Washington State ED security capability to respond to acute influxes of patients, bystanders, and media during acute surge events...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435497/improved-accuracy-and-quality-of-information-during-emergency-department-care-transitions
#14
Nnaemeka Okafor, Justin Mazzillo, Sara Miller, Kimberly A Chambers, Samar Yusuf, Vanessa Garza-Miranda, Yashwant Chathampally
INTRODUCTION: Suboptimal communication during emergency department (ED) care transitions has been shown to contribute to medical errors, sometimes resulting in patient injury and litigation. The study objective was to determine whether a standardized checkout process would decrease the number of relevant missed clinical items (MCI). METHODS: In this prospective pre- and post-intervention study conducted in an urban academic ED, we collected data on omitted or inaccurately conveyed medical information before and after the initiation of a standardized checkout process...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435496/-choosing-wisely-imaging-recommendations-initial-implementation-in-new-england-emergency-departments
#15
Ali S Raja, Arjun Venkatesh, Nathan Mick, Cristopher P Zabbo, Kohei Hasegawa, Janice A Espinola, Jane C Bittner, Carlos A Camargo
INTRODUCTION: In June 2016, the American College of Emergency Physicians (ACEP) Emergency Quality Network began its Reduce Avoidable Imaging Initiative, designed to "reduce testing and imaging with low risk patients through the implementation of Choosing Wisely recommendations." However, it is unknown whether New England emergency departments (ED) have already implemented evidence-based interventions to improve adherence to ACEP Choosing Wisely recommendations related to imaging after their initial release in 2013...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435495/areas-of-potential-impact-of-the-patient-protection-and-affordable-care-act-on-ems-a-synthesis-of-the-literature
#16
REVIEW
Daniel G Ostermayer, Charles A Brown, William G Fernandez, Emily Couvillon
INTRODUCTION: This comprehensive review synthesizes the existing literature on the Patient Protection and Affordable Care Act (ACA) as it relates to emergency medical services (EMS) in order to provide guidance for navigating current and future healthcare changes. METHODS: We conducted a comprehensive review to identify all existing literature related to the ACA and EMS and all sections within the federal law pertaining to EMS. RESULTS: Many changes enacted by the ACA directly affect emergency care with potential indirect effects on EMS systems...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435494/the-efficacy-of-lucas-in-prehospital-cardiac-arrest-scenarios-a-crossover-mannequin-study
#17
Robert A Gyory, Scott E Buchle, David Rodgers, Jeffrey S Lubin
INTRODUCTION: High-quality cardiopulmonary resuscitation (CPR) is critical for successful cardiac arrest outcomes. Mechanical devices may improve CPR quality. We simulated a prehospital cardiac arrest, including patient transport, and compared the performance of the LUCAS™ device, a mechanical chest compression-decompression system, to manual CPR. We hypothesized that because of the movement involved in transporting the patient, LUCAS would provide chest compressions more consistent with high-quality CPR guidelines...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435493/prehospital-care-for-the-adult-and-pediatric-seizure-patient-current-evidence-based-recommendations
#18
Eric C Silverman, Karl A Sporer, Justin M Lemieux, John F Brown, Kristi L Koenig, Marianne Gausche-Hill, Eric M Rudnick, Angelo A Salvucci, Greg H Gilbert
INTRODUCTION: We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of adult and pediatric patients with a seizure and to compare these recommendations against the current protocol used by the 33 emergency medical services (EMS) agencies in California. METHODS: We performed a review of the evidence in the prehospital treatment of patients with a seizure, and then compared the seizure protocols of each of the 33 EMS agencies for consistency with these recommendations...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435492/applying-systems-engineering-reduces-radiology-transport-cycle-times-in-the-emergency-department
#19
Benjamin A White, Brian J Yun, Michael H Lev, Ali S Raja
INTRODUCTION: Emergency department (ED) crowding is widespread, and can result in care delays, medical errors, increased costs, and decreased patient satisfaction. Simultaneously, while capacity constraints on EDs are worsening, contributing factors such as patient volume and inpatient bed capacity are often outside the influence of ED administrators. Therefore, systems engineering approaches that improve throughput and reduce waste may hold the most readily available gains. Decreasing radiology turnaround times improves ED patient throughput and decreases patient waiting time...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435491/agreement-between-serum-assays-performed-in-ed-point-of-care-and-hospital-central-laboratories
#20
Meir Dashevsky, Steven L Bernstein, Carol L Barsky, Richard A Taylor
INTRODUCTION: Point-of-care (POC) testing allows for more time-sensitive diagnosis and treatment in the emergency department (ED) than sending blood samples to the hospital central laboratory (CL). However, many ED patients have blood sent to both, either out of clinical custom, or because clinicians do not trust the POC values. The objective of this study was to examine the level of agreement between POC and CL values in a large cohort of ED patients. METHODS: In an urban, Level I ED that sees approximately 120,000 patients/year, all patients seen between March 1, 2013, and October 1, 2014, who had blood sent to POC and CL labs had levels of agreement measured between serum sodium, potassium, blood urea nitrogen (BUN), creatinine, and hematocrit...
April 2017: Western Journal of Emergency Medicine
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