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https://www.readbyqxmd.com/read/29146418/diagnostic-accuracy-of-the-extended-focused-abdominal-sonography-for-trauma-e-fast-performed-by-emergency-physicians-compared-to-computed-tomography
#1
Haldun Akoglu, Omer Faruk Celik, Ali Celik, Rabia Ergelen, Ozge Onur, Arzu Denizbasi
INTRODUCTION: The diagnostic accuracy of the FAST exam performed by EM residents were shown to be similar to radiology residents. However, in the last 2 decades, an extended-FAST (E-FAST) protocol including thoracic examination to exclude pneumo- and hemothorax was introduced. The accuracy of emergency physicians (EPs) while performing E-FAST is a less studied area, especially in Europe. The aim of this study was to compare the diagnostic accuracy of the E-FAST exam performed by EM residents with the results of CT scan as a gold standard...
November 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29137674/the-development-of-the-parents-a-tool-for-parents-to-assess-residents-non-technical-skills-in-pediatric-emergency-departments
#2
Katherine A Moreau, Kaylee Eady, Kenneth Tang, Mona Jabbour, Jason R Frank, Meaghan Campbell, Stanley J Hamstra
BACKGROUND: Parents can assess residents' non-technical skills (NTS) in pediatric emergency departments (EDs). There are no assessment tools, with validity evidence, for parental use in pediatric EDs. The purpose of this study was to develop the Parents' Assessment of Residents Enacting Non-Technical Skills (PARENTS) educational assessment tool and collect three sources of validity evidence (i.e., content, response process, internal structure) for it. METHODS: We established content evidence for the PARENTS through interviews with physician-educators and residents, focus groups with parents, a literature review, and a modified nominal group technique with experts...
November 14, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29128041/intraperitoneal-urinary-bladder-perforation-with-pneumoperitoneum-in-association-with-indwelling-foley-catheter-diagnosed-in-emergency-department
#3
Chenyang Zhan, Pedro P Maria, R Joshua Dym
BACKGROUND: Indwelling Foley catheter is a rare cause of urinary bladder perforation, a serious injury with high mortality that demands accurate and prompt diagnosis. While the gold standard for diagnosis of bladder injury is computed tomography (CT) cystography, few bladder ruptures associated with Foley catheter have been reported to be diagnosed in the emergency department (ED). CASE REPORT: An 83-year-old man with indwelling Foley catheter presented to the ED for hematuria and altered mental status...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29128038/emergency-physicians-who-produce-higher-relative-value-units-per-hour-spend-similar-amounts-of-time-at-patient-bedsides-as-their-colleagues
#4
Michael Breyer, Heather Farley, Greg Neyman, Wendy Nichols, John Kendall
BACKGROUND: Emergency physicians (EPs) are expected to deliver quality care while maintaining high levels of efficiency and productivity as measured by the relative value unit (RVU). OBJECTIVES: We sought to determine whether academic EPs with higher RVUs spend less time at the bedside than their colleagues. METHODS: This was a prospective, observational, cohort study. A 13-item task list was generated, pilot-tested, and placed onto a computerized tablet...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29119470/failure-to-flow-an-exploration-of-learning-and-teaching-in-busy-multi-patient-environments-using-an-interpretive-description-method
#5
Teresa M Chan, Kenneth Van Dewark, Jonathan Sherbino, Alan Schwartz, Geoff Norman, Matthew Lineberry
INTRODUCTION: As patient volumes continue to increase, more attention must be paid to skills that foster efficiency without sacrificing patient safety. The emergency department is a fertile ground for examining leadership and management skills, especially those that concern prioritization in multi-patient environments. We sought to understand the needs of emergency physicians (EPs) and emergency medicine junior trainees with regards to teaching and learning about how best to handle busy, multi-patient environments...
November 8, 2017: Perspectives on Medical Education
https://www.readbyqxmd.com/read/29116692/a-pilot-study-evaluating-knowledge-of-indications-for-hyperbaric-oxygen-therapy
#6
Mark W Jones
A pilot study was conducted in mid-Michigan to evaluate knowledge of appropriate hyperbaric oxygen therapy referrals in "first contact" physicians who did not have additional hyperbaric training. The hypothesis for this study is that many first-contact physicians have little or no exposure to hyperbaric oxygen (HBO₂) therapy and its indications. A survey was distributed regarding accepted indications combined with conditions not currently approved or contraindicated for HBO₂. Answers were tallied for correct identification of approved indications, missed approved indications, and inappropriate identification of unapproved indications...
2017: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/29110738/what-can-we-learn-from-simulation-based-training-to-improve-skills-for-end-of-life-care-insights-from-a-national-project-in-israel
#7
Mayer Brezis, Yael Lahat, Meir Frankel, Alan Rubinov, Davina Bohm, Matan J Cohen, Meni Koslowsky, Orit Shalomson, Charles L Sprung, Henia Perry-Mezare, Rina Yahalom, Amitai Ziv
BACKGROUND: Simulation-based training improves residents' skills for end-of-life (EOL) care. In the field, staff providers play a significant role in handling those situations and in shaping practice by role modeling. We initiated an educational intervention to train healthcare providers for improved communication skills at EOL using simulation of sensitive encounters with patients and families. METHODS: Hospital physicians and nurses (n = 1324) attended simulation-based workshops (n = 100) in a national project to improve EOL care...
November 6, 2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/29108080/-utilization-of-outpatient-emergency-care-in-westphalia-lippe-a-health-geographic-analysis
#8
Sebastian Völker
Identification of geographical variations in the utilization of outpatient emergency care facilities is the most effective tool to locate regions with the greatest potential for increasing quality and efficiency in emergency care. The aim of the study was to estimate utilization of emergency care facilities in a regression model, taking into account local dependencies and agglomeration effects. The basis of this ecological study was formed by all outpatient emergency patient contacts in 2013 (n=1,927,471), which were aggregated according to the place of residence to the 231 municipalities of the supply area of the Association of Statutory Health Insurance Physicians Westphalia-Lippe...
November 6, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/29108079/prevalence-and-correlates-of-emergency-contraceptive-use-in-transitional-albania
#9
Dajana Roshi, Salvatore Italia, Genc Burazeri, Helmut Brand
Objectives The two emergency contraceptive drugs ("morning-after pill") ulipristal acetate and levonorgestrel are available without prescription in many European countries. In Albania, ulipristal acetate is not marketed yet and levonorgestrel has still prescription-only status. The objective of this study was to assess the prevalence and socioeconomic correlates of emergency contraceptive (EMC) use, collect sales figures, and gain information on the women's way of purchasing EMCs in post-communist Albania. Methods For this cross-sectional study, self-administered questionnaires were made accessible to women in Albania in March 2015 by hard copy or online via social networks...
November 6, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/29098043/relationship-between-canadian-medical-school-student-career-interest-in-emergency-medicine-and-postgraduate-training-disposition
#10
Riyad B Abu-Laban, Ian M Scott, Margot C Gowans
Background: Canada has two independent routes of emergency medicine (EM) training and certification. This unique situation may encourage medical students with EM career aspirations to apply to family medicine (FM) residencies to subsequently acquire College of Family Physicians of Canada (CFPC) training and certification in EM. We sought answers to the following: 1) Are medical students who indicate EM as their top career choice on medical school entry, and then complete a FM residency, more likely to undertake subsequent CFPC-EM training than other FM residents who did not indicate EM as their top career choice; and 2) What are the characteristics of medical students in four predefined groups, based upon their early interest in EM as a career and ultimate postgraduate training disposition...
June 2017: Canadian Medical Education Journal
https://www.readbyqxmd.com/read/29088995/a-multicenter-survey-of-house-staff-knowledge-about-sepsis-and-the-surviving-sepsis-campaign-guidelines-for-management-of-severe-sepsis-and-septic-shock
#11
Richard R Watkins, Nairmeen Haller, Melinda Wayde, Keith B Armitage
BACKGROUND: We aimed to assess the knowledge, attitudes, and perceptions of resident physicians regarding sepsis in general and the Surviving Sepsis Campaign Guidelines in particular. METHODS: After institutional review board approval, we surveyed internal medicine (IM) and emergency medicine (EM) house staff from 3 separate institutions. House staff were notified of the survey via e-mail from their residency director or chief resident. The survey was Internet-based (using http://www...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29080550/frequency-of-use-and-acceptability-of-clinical-prediction-rules-for-pulmonary-embolism-among-swiss-general-internal-medicine-residents
#12
N Faller, O Stalder, A Limacher, S Bassetti, J H Beer, D Genné, E Battegay, D Hayoz, J Leuppi, B Mueller, A Perrier, G Waeber, N Rodondi, D Aujesky
INTRODUCTION: Whether clinical prediction rules for pulmonary embolism are accepted and used among general internal medicine residents remains uncertain. We therefore evaluated the frequency of use and acceptability of the Revised Geneva Score (RGS) and the Pulmonary Embolism Severity Index (PESI), and explored which factors were associated with rule use. MATERIALS/METHODS: In an online survey among general internal medicine residents from 10 Swiss hospitals, we assessed rule acceptability using the Ottawa Acceptability of Decision Rules Instrument (OADRI) and explored the association between physician and training-related factors and rule use using mixed logistic regression models...
October 18, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29075375/gender-differences-in-attending-physicians-feedback-to-residents-a-qualitative-analysis
#13
Anna S Mueller, Tania M Jenkins, Melissa Osborne, Arjun Dayal, Daniel M O'Connor, Vineet M Arora
BACKGROUND : Prior research has shown a gender gap in the evaluations of emergency medicine (EM) residents' competency on the Accreditation Council for Graduate Medical Education (ACGME) milestones, yet the practical implications of this are not fully understood. OBJECTIVE : To better understand the gender gap in evaluations, we examined qualitative differences in the feedback that male and female residents received from attending physicians. METHODS : This study used a longitudinal qualitative content analysis of narrative comments by attending physicians during real-time direct observation milestone evaluations of residents...
October 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/29074070/comparison-of-intubation-devices-in-level-c-personal-protective-equipment-a-cadaveric-study
#14
R Scott Taylor, Matthew Pitzer, Grayson Goldman, Augusta Czysz, Thomas Simunich, John Ashurst
BACKGROUND: With the advancement of chemical, biological and nuclear warfare and the reemergence of infectious diseases, the possibility of intubating in personal protective equipment has become increasingly more real to the emergency physician. Human cadaveric models have been found to simulate real world conditions better than mannequins. The aim of the study was to determine the first pass success rate and average time to successful intubation while wearing Personal Protective Equipment (PPE)...
October 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29072885/cardiopulmonary-ultrasound-for-critically-ill-adults-improves-diagnostic-accuracy-in-a-resource-limited-setting-the-africa-trial
#15
Torben K Becker, Chelsea A Tafoya, Maxwell Osei-Ampofo, Matthew J Tafoya, Ross A Kessler, Nikhil Theyyunni, Hussein A Yakubu, Daniel Opuni, Daniel J Clauw, James A Cranford, Chris K Oppong, Rockefeller A Oteng
OBJECTIVE: To assess the effects of a cardiopulmonary ultrasound (CPUS) examination on diagnostic accuracy for critically ill patients in a resource-limited setting. METHODS: Approximately half of the emergency medicine resident physicians at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, were trained in a CPUS protocol. Adult patients triaged to the resuscitation area of the emergency department (ED) were enrolled if they exhibited signs or symptoms of shock or respiratory distress...
October 26, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/29064035/-patient-sharing-networks-new-approaches-in-the-analysis-and-transformation-of-geographic-variation-in-healthcare
#16
REVIEW
Dominik von Stillfried, Tatiana Ermakova, Frank Ng, Thomas Czihal
The analysis of geographic variations has spurred arguments that area of residence determines access to and quality of healthcare. In this paper we argue that unwarranted geographic variations can be traced back to actions of individual patients and their healthcare providers (doctors, hospitals). These actors interact in a complicated web of shared responsibilities. Designing effective interventions to reduce unwarranted geographic variations may therefore depend on methods to identify these interactions and communities of providers with a shared accountability...
October 24, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/29040811/mobile-emergency-simulation-training-for-rural-health-providers
#17
Douglas Martin, Brent Bekiaris, Gregory Hansen
INTRODUCTION: Mobile emergency simulation offers innovative continuing medical educational support to regions that may lack access to such opportunities. Furthermore, satisfaction is a critical element for active learning. Together, the authors evaluated Canadian rural healthcare providers' satisfaction from high fidelity emergency simulation training using a modified motorhome as a mobile education unit (MEU). METHODS: Over a 5-month period, data was collected during 14 educational sessions in nine different southern Manitoban communities...
July 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/29038132/provider-perspectives-of-high-quality-pediatric-hospital-to-home-transitions-for-children-and-youth-with-chronic-disease
#18
Carolyn C Foster, Elizabeth Jacob-Files, Kimberly C Arthur, Stephanie A Hillman, Todd C Edwards, Rita Mangione-Smith
OBJECTIVE: The objective of this study was to describe health care providers' and hospital administrators' perspectives on how to improve pediatric hospital-to-home transitions for children and youth with chronic disease (CYCD). METHODS: Focus groups and key informant interviews of inpatient attending physicians, primary care physicians, pediatric residents, nurses, care coordinators, and social workers were conducted at a tertiary care children's hospital. Key informant interviews were performed with hospital administrators...
November 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29016368/perioperative-point-of-care-ultrasound-in-ambulatory-anesthesia-thinking-beyond-nerve-blocks
#19
Ranjit Deshpande, Davinder Ramsingh
PURPOSE OF REVIEW: Ultrasound has become readily available in the perioperative area. In this review, we aim to bring forth some uses of ultrasound beyond that in regional anesthesia. RECENT FINDINGS: Critical care and emergency physicians have embraced ultrasound in their respective fields. We as anesthesiologists and practitioners of acute care medicine are not immune to this penetration. There is been a lot of recent literature on the various uses of perioperative point of care ultrasound...
October 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28984431/what-do-we-know-about-alara-is-our-knowledge-sufficient-about-radiation-safety
#20
Ibrahim B Atci, Hakan Yilmaz, Veysel Antar, Nuriye G Ozdemir, Oguz Baran, Sila Sadillioglu, Mehmet Ozel, Okan Turk, Mehmet Yaman, Hakan Topacoglu
BACKGROUND: The aim of this study was to determine the knowledge of neurosurgeons and emergency physicians about ALARA (as low as reasonably achievable) and to gain awareness to them about this topic. METHODS: A multiple-choice survey comprising 17 questions was performed to 30 neurosurgeons and 70 emergency room doctors. RESULTS: Emergency medicine doctors, neurosurgeons, emergency medicine residents, neurosurgery residents and general practitioners participated in the survey...
December 2017: Journal of Neurosurgical Sciences
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