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https://www.readbyqxmd.com/read/28215397/clinical-mimics-an-emergency-medicine-focused-review-of%C3%A2-influenza-mimics
#1
Erica Simon, Brit Long, Alex Koyfman
BACKGROUND: Influenza viruses are a significant cause of morbidity and mortality in the United States. Given the wide range of symptoms, emergency physicians must maintain a broad differential diagnosis in the evaluation and treatment of patients presenting with influenza-like illnesses. OBJECTIVE: This review addresses objective and subjective symptoms commonly associated with influenza and discusses important mimics of influenza viruses, while offering a practical approach to their clinical evaluation and treatment...
February 15, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28210364/caudal-edge-of-the-liver-in-the-right-upper-quadrant-ruq-view-is-the-most-sensitive-area-for-free-fluid-on-the-fast-exam
#2
Viveta Lobo, Michelle Hunter-Behrend, Erin Cullnan, Rebecca Higbee, Caleb Phillips, Sarah Williams, Philips Perera, Laleh Gharahbaghian
INTRODUCTION: The focused assessment with sonography in trauma (FAST) exam is a critical diagnostic test for intraperitoneal free fluid (FF). Current teaching is that fluid accumulates first in Morison's pouch. The goal of this study was to evaluate the "sub-quadrants" of traditional FAST views to determine the most sensitive areas for FF accumulation. METHODS: We analyzed a retrospective cohort of all adult trauma patients who had a recorded FAST exam by emergency physicians at a Level I trauma center from January 2012 - June 2013...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28210353/prevalence-of-horizontal-violence-among-emergency-attending-physicians-residents-and-physician-assistants
#3
Nico B Volz, Ryan Fringer, Bradford Walters, Terry Kowalenko
INTRODUCTION: Horizontal violence (HV) is malicious behavior perpetrated by healthcare workers against each other. These include bullying, verbal or physical threats, purposeful disruptive behavior, and other malicious behaviors. This pilot study investigates the prevalence of HV among emergency department (ED) attending physicians, residents, and mid-level providers (MLPs). METHODS: We sent an electronic survey to emergency medicine attending physicians (n=67), residents (n=25), and MLPs (n=24) in three unique EDs within a single multi-hospital medical system...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28198722/triad-viii-nationwide-multicenter-evaluation-to-determine-whether-patient-video-testimonials-can-safely-help-ensure-appropriate-critical-versus-end-of-life-care
#4
Ferdinando L Mirarchi, Timothy E Cooney, Arvind Venkat, David Wang, Thaddeus M Pope, Abra L Fant, Stanley A Terman, Kevin M Klauer, Monica Williams-Murphy, Michael A Gisondi, Brian Clemency, Ankur A Doshi, Mari Siegel, Mary S Kraemer, Kate Aberger, Stephanie Harman, Neera Ahuja, Jestin N Carlson, Melody L Milliron, Kristopher K Hart, Chelsey D Gilbertson, Jason W Wilson, Larissa Mueller, Lori Brown, Bradley D Gordon
OBJECTIVE: End-of-life interventions should be predicated on consensus understanding of patient wishes. Written documents are not always understood; adding a video testimonial/message (VM) might improve clarity. Goals of this study were to (1) determine baseline rates of consensus in assigning code status and resuscitation decisions in critically ill scenarios and (2) determine whether adding a VM increases consensus. METHODS: We randomly assigned 2 web-based survey links to 1366 faculty and resident physicians at institutions with graduate medical education programs in emergency medicine, family practice, and internal medicine...
February 14, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28164320/perception-of-point-of-care-ultrasound-performed-by-emergency-medicine-physicians
#5
Whitney Hansen, Carl E Mitchell, Bikash Bhattarai, Napatkamon Ayutyanont, Jeffrey R Stowell
PURPOSE: Point-of-care ultrasound (POCUS) is integral to the practice of emergency medicine (EM). Furthermore, EM-performed POCUS (EM-POCUS) offers consultants the opportunity to avoid delays in care due to wait times for confirmatory imaging studies. This study is the first to describe the perception of POCUS to consulting services at a single institution where EM-POCUS is routinely performed. METHODS: This study was conducted as a survey distributed to residents from consultant specialties (internal medicine [IM], general surgery [GS], and obstetrics and gynecology [OB-GYN])...
February 6, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28152936/improving-transitions-of-care-through-implementation-of-a-standardized-handoff-at-a-comprehensive-cancer-center
#6
Mohamed Ait Aiss, Helene P Phu, Lakeisha R Day, Varkey Abraham, Karen Chen, Mejia Rodrigo, Shehla Razvi, Carmen E Gonzalez, Norman Brito-Dellan, Srinivas Banala, David Rubio, Nicole Vaughan-Adams, Debra S Ruiz, Tan Jens, Charles F Levenback, Michael M Frumovitz, Behrouz Zand, Carmelita P Escalante
: 242 Background: Communication failures cause two-thirds of sentinel events in hospitals. These adverse occurrences are often both fatal and preventable. Consequently, improving the quality of handoffs has been identified by multiple accreditation constituents as a top priority patient safety goal. This project was part of an institutional initiative to standardize handoffs among physicians, trainees, and midlevel providers. METHODS: Four subgroups were identified as pilot areas: Gynecologic Oncology (Gyn Onc) fellows to nocturnalists, Surgical Oncology fellows, Pediatric Oncology residents and fellows, and Emergency Center attending staff to inpatient hospitalists...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28146046/brazilian-specialists-perspectives-on-the-patient-referral-process
#7
Carmen Juliani, Maura MacPhee, Wilza Spiri
Since 1988, healthcare has been considered a citizen's right in Brazil. The Sistema Único de Saúde (SUS), has undergone development and expansion to ensure universal health coverage for the Brazilian public, the world's fifth largest population. The coordination of effective communications between primary care physicians, specialists and patients is a significant challenge, particularly the referral process. Our study objective was to understand the facilitators and barriers associated with referral process communications between primary care physicians and regional university hospital specialists in the State of Sao Paulo...
January 29, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/28132998/end-of-life-care-bonus-promoting-end-of-life-care-in-nursing-homes-an-11-year-retrospective-longitudinal-prefecture-wide-study-in-japan
#8
Sho Nishiguchi, Nagisa Sugaya, Kentaro Sakamaki, Shunsaku Mizushima
The end-of-life (EOL) care bonus introduced by the Japanese government works as a financial incentive and framework of quality preservation, including advance care planning, for EOL care among nursing home residents. This study aims to clarify the effects of the EOL care bonus in promoting EOL care in nursing homes. A longitudinal observational study using a questionnaire was conducted. We invited 378 nursing homes in Kanagawa prefecture in Japan, a region with a rapidly aging population, to participate in the study...
January 30, 2017: Bioscience Trends
https://www.readbyqxmd.com/read/28124018/effectiveness-of-resident-as-teacher-curriculum-in-preparing-emergency-medicine-residents-for-their-teaching-role
#9
Hooman Hosein Nejad, Mehdi Bagherabadi, Alireza Sistani, Helen Dargahi
INTRODUCTION: Over the past 30 years, recognizing the need and importance of training residents in teaching skills has resulted in several resident-as-teacher programs. The purpose of this study was to explore the impact of this teaching initiative and investigate the improvement in residents' teaching skills through evaluating their satisfaction and perceived effectiveness as well as assessing medical students' perception of the residents' teaching quality. METHODS: This research is a quasi-experimental study with pre- and post-tests, continuing from Dec 2010 to May 2011 in Imam Hospital, Tehran University of Medical Sciences...
January 2017: Journal of Advances in Medical Education & Professionalism
https://www.readbyqxmd.com/read/28121953/the-influence-of-resident-seniority-on-supervised-practice-in-the-emergency-department
#10
I-Min Chiu, Yuan-Jhen Syue, Chia-Te Kung, Fu-Jen Cheng, Chien-Hung Lee, Yan-Ren Lin, Chao-Jui Li
To investigate the influence of resident seniority on supervised clinical practice in the emergency department (ED).This was a retrospective, 1-year cohort study conducted in 5 EDs within Taiwan largest healthcare system. All adult nontrauma visits presenting to the EDs during the day shift between July 1, 2011 and June 30, 2012 were included in the analysis. Visits were divided into supervised (ie, treated by resident under attending physician's supervision) and attending-alone. Supervised visits were further categorized by resident seniority (junior, intermediate, and senior)...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28116028/characteristics-of-real-time-non-critical-incident-debriefing-practices-in-the-emergency-department
#11
Nur-Ain Nadir, Suzanne Bentley, Dimitrios Papanagnou, Komal Bajaj, Stephan Rinnert, Richard Sinert
INTRODUCTION: Benefits of post-simulation debriefings as an educational and feedback tool have been widely accepted for nearly a decade. Real-time, non-critical incident debriefing is similar to post-simulation debriefing; however, data on its practice in academic emergency departments (ED), is limited. Although tools such as TeamSTEPPS® (Team Strategies and Tools to Enhance Performance and Patient Safety) suggest debriefing after complicated medical situations, they do not teach debriefing skills suited to this purpose...
January 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28116026/efficient-and-effective-use-of-peer-teaching-for-medical-student-simulation
#12
Joseph B House, Carol H Choe, Heather L Wourman, Kristin M Berg, Jonathan P Fischer, Sally A Santen
INTRODUCTION: Simulation is increasingly used in medical education, promoting active learning and retention; however, increasing use also requires considerable instructor resources. Simulation may provide a safe environment for students to teach each other, which many will need to do when they enter residency. Along with reinforcing learning and increasing retention, peer teaching could decrease instructor demands. Our objective was to determine the effectiveness of peer-taught simulation compared to physician-led simulation...
January 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28116024/demographics-and-fellowship-training-of-residency-leadership-in-em-a-descriptive-analysis
#13
Josh Greenstein, Ross Hardy, Jerel Chacko, Abbas Husain
INTRODUCTION: Emergency medicine (EM) fellowships are becoming increasingly numerous, and there is a growing trend among EM residents to pursue postgraduate fellowship training. Scant data have been published on the prevalence of postgraduate training among emergency physicians. We aimed to describe the prevalence and regional variation of fellowships among EM residency leadership. METHODS: We conducted an online anonymous survey that was sent to the Council of EM Residency Directors (CORD) membership in October 2014...
January 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28116017/emergency-medicine-resident-orientation-how-training-programs-get-their-residents-started
#14
Jillian McGrath, Michael Barrie, David P Way
INTRODUCTION: The first formal orientation program for incoming emergency medicine (EM) residents was started in 1976. The last attempt to describe the nature of orientation programs was by Brillman in 1995. Now almost all residencies offer orientation to incoming residents, but little is known about the curricular content or structure of these programs. The purpose of this project was to describe the current composition and purpose of EM resident orientation programs in the United States...
January 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28116015/transition-of-care-practices-from-emergency-department-to-inpatient-survey-data-and-development-of-algorithm
#15
Sangil Lee, Jaime Jordan, H Gene Hern, Chad Kessler, Susan Promes, Sarah Krzyzaniak, Fiona Gallahue, Ted Stettner, Jeffrey Druck
INTRODUCTION: We aimed to assess the current scope of handoff education and practice among resident physicians in academic centers and to propose a standardized handoff algorithm for the transition of care from the emergency department (ED) to an inpatient setting. METHODS: This was a cross-sectional survey targeted at the program directors, associate or assistant program directors, and faculty members of emergency medicine (EM) residency programs in the United States (U...
January 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28116009/teaching-the-emergency-department-patient-experience-needs-assessment-from-the-cord-em-task-force
#16
Kory S London, Jeffrey Druck, Matthew Silver, Douglas Finefrock
INTRODUCTION: Since the creation of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction (PS) scores, patient experience (PE) has become a metric that can profoundly affect the fiscal balance of hospital systems, reputation of entire departments and welfare of individual physicians. While government and hospital mandates demonstrate the prominence of PE as a quality measure, no such mandate exists for its education. The objective of this study was to determine the education and evaluation landscape for PE in categorical emergency medicine (EM) residencies...
January 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28114984/professionalism-professionalization-expertise-and-compassion-a-qualitative-study-of-medical-residents
#17
Susan P Phillips, Nancy Dalgarno
BACKGROUND: Formal and informal medical curricula convey expectations about professionalization, that is, the development of physician identity, and also about professionalism. This study examined whether, in general, junior residents experienced any dissonance between these roles and focused particularly on how they negotiated conflicts between compassion, self-care, duty and medical expertise. METHODS: In 2015, purposive sampling was used to select 21 first-year residents at a Canadian medical school...
January 23, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28114159/revolution-or-evolution-a-proposal-for-the-integration-of-point-of-care-ultrasound-into-physician-assistant-clinical-practice
#18
Jonathan Monti
Advances in technology and increased affordability of machines have allowed ultrasound to become ubiquitous across the spectrum of medical care. Increasing portability has brought ultrasound to the point of care in multiple medical specialties. Formal ultrasound training is rapidly being incorporated into multispecialty residency programs and undergraduate medical education curricula, yet little formal training exists for physician assistants (PAs) on this emerging clinical adjunct. This article outlines recommendations for and barriers to the incorporation of bedside ultrasound into PA clinical practice...
March 2017: Journal of Physician Assistant Education
https://www.readbyqxmd.com/read/28111067/standardized-direct-observation-assessment-tool-using-a-training-video
#19
Kathleen E Kane, Kevin R Weaver, Gavin C Barr, Gary Bonfante, Nicole L Bendock, Brian M Berry, Stephanie L Goren-Garcia, Marc B Lewbart, Allison L Raines, Gregory Smeriglio, Bryan G Kane
BACKGROUND: We developed a DVD training tool to educate physicians evaluating emergency residents on accurate Standardized Direct Observation Assessment Tool (SDOT) application. OBJECTIVE: Our goal was to assess whether this training video improved attendings' and senior residents' SDOT use. METHODS: Participants voluntarily completed SDOT evaluations based on a scripted "test" video. A DVD with "positive" and "negative" scenarios of proper SDOT use was viewed...
January 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28079728/surveying-resident-and-faculty-physician-knowledge-attitudes-and-experiences-in-response-to-public-lead-contamination
#20
D Kay Taylor, Brenda Lovegrove Lepisto, Nicolas Lecea, Ranine Ghamrawi, Ghassan Bachuwa, Jenny LaChance, Mona Hanna-Attisha
Environmental health crises can appear anywhere and without warning. After research revealed a significant incidence of elevated pediatric blood lead levels following a water source change, Genesee County declared a public health emergency in Flint, Michigan. Hospital patients and family members began approaching Hurley Medical Center's physicians with questions regarding the health implications of the lead contamination. Many of the physicians voiced concerns about responding appropriately to patient needs and increasing demands for information...
March 2017: Academic Medicine: Journal of the Association of American Medical Colleges
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