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physician assistant emergency medicine

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https://www.readbyqxmd.com/read/28342441/building-a-community-of-practice-in-rural-medical-education-growing-our-own-together
#1
Randall L Longenecker, David Schmitz
CONTEXT: This article chronicles the rise, decline, and recent resurgence of rural training track residency programs (RTTs) in the USA over the past 30 years and the emergence of a healthy community of practice in rural medical education. This has occurred during a time in the USA when federal and state funding of graduate medical education has been relatively stagnant and the rules around finance and accreditation of rural programs have been challenging. ISSUE: Many of the early family residency programs developed in the 1970s included a curricular focus on rural practice...
January 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/28315025/practices-and-attitudes-towards-radiation-risk-disclosure-for-computed-tomography-survey-of-emergency-medicine-residency-program-directors
#2
Jennifer R Marin, Karen E Thomas, Angela M Mills, Joshua S Broder, Kathy Boutis
PURPOSE: The purposes of this study were to evaluate the frequency with which emergency physicians involved in residency leadership disclose potential malignancy risks from computed tomography (CT), assess comfort with these discussions, and evaluate factors influencing risk disclosure. METHODS: We surveyed emergency medicine residency program directors and associate/assistant directors. Primary outcome was the proportion who "almost always" or "most of the time" discussed potential risks...
March 17, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28255637/involuntary-processes-knowledge-base-of-health-care-professionals-in-a-tertiary-medical-center-in-upstate-south-carolina
#3
Sharon M Holder, Calvert Warren, Kenneth Rogers, Benjamin Griffeth, Eunice Peterson, Dawn Blackhurst, Christian Ochonma
The involuntary hospitalization law provides a means by which love ones, caregivers and healthcare professionals can intervene when a mentally ill patient is a danger to self or others. Our study assessed the knowledge of professionals in one of the Greenville Health System (GHS) emergency department (ED) about the involuntary hospitalization process of mental health patients in South Carolina (SC). An eight item survey on the South Carolina involuntary hospitalization and commitment process was developed and distributed to GHS ED staff including: physicians, physician assistants, nurse practitioners, nurses, social workers and technicians...
March 2, 2017: Community Mental Health Journal
https://www.readbyqxmd.com/read/28238497/structured-clinical-decision-aids-are-seldom-compared-with-subjective-physician-judgment-and-are-seldom-superior
#4
David L Schriger, Joshua W Elder, Richelle J Cooper
STUDY OBJECTIVE: We determine how often studies that evaluate the performance of an aid for decisionmaking, be it a simple laboratory or imaging test or a complex multielement decision instrument, compare the aid's performance to independent, unaided physician judgment. METHODS: This was a cross-sectional survey of all Original Research and Brief Research Report articles in Annals of Emergency Medicine from 1998 to 2015. We included all articles that evaluated the performance of an aid for decisionmaking in assisting a physician with a decision about testing, treatment, diagnosis, or disposition...
February 23, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28225376/a-qualitative-analysis-of-general-emergency-medicine-providers-perceptions-on-pediatric-emergency-telemedicine
#5
Ji Won Kim, Gunjan Tiyyagura, Melissa Langhan
OBJECTIVE: Most children in the United States are evaluated in general emergency departments (ED), which are staffed by practitioners who care for both adults and children and may have limited pediatric resources. The application of telemedicine in pediatrics is growing and has been shown to be effective in outpatient as well as critical care settings. Telemedicine has the potential to address disparities in access to pediatric emergency care. The objective of this study was to explore experiences of general ED providers with telemedicine and their perception about a potential video telemedicine program with pediatric ED providers...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28210353/prevalence-of-horizontal-violence-among-emergency-attending-physicians-residents-and-physician-assistants
#6
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/28188055/the-emergency-medicine-management-of-severe-alcohol-withdrawal
#7
Drew Long, Brit Long, Alex Koyfman
INTRODUCTION: Alcohol use is widespread, and withdrawal symptoms are common after decreased alcohol intake. Severe alcohol withdrawal may manifest with delirium tremens, and new therapies may assist in management of this life-threatening condition. OBJECTIVE: To provide an evidence-based review of the emergency medicine management of alcohol withdrawal and delirium tremens. DISCUSSION: The underlying pathophysiology of alcohol withdrawal syndrome (AWS) is central nervous system hyperexcitation...
February 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28116024/demographics-and-fellowship-training-of-residency-leadership-in-em-a-descriptive-analysis
#8
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/28116015/transition-of-care-practices-from-emergency-department-to-inpatient-survey-data-and-development-of-algorithm
#9
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
#10
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/27964737/evidence-based-decision-support-for-pediatric-rheumatology-reduces-diagnostic-errors
#11
COMPARATIVE STUDY
Michael M Segal, Balu Athreya, Mary Beth F Son, Irit Tirosh, Jonathan S Hausmann, Elizabeth Y N Ang, David Zurakowski, Lynn K Feldman, Robert P Sundel
BACKGROUND: The number of trained specialists world-wide is insufficient to serve all children with pediatric rheumatologic disorders, even in the countries with robust medical resources. We evaluated the potential of diagnostic decision support software (DDSS) to alleviate this shortage by assessing the ability of such software to improve the diagnostic accuracy of non-specialists. METHODS: Using vignettes of actual clinical cases, clinician testers generated a differential diagnosis before and after using diagnostic decision support software...
December 13, 2016: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/27955985/quarterly-reporting-of-computed-tomography-ordering-history-reduces-the-use-of-imaging-in-an-emergency-department
#12
Richard Ehrlichman, Zachary Dezman, Joel Klein, Jean Jeudy, Daniel Lemkin
BACKGROUND: Computed tomography (CT) is a useful and necessary part of many emergency department (ED) assessments. However, the costs of imaging and the health risks associated with radiation exposure have sparked national efforts to reduce CT ordering in EDs. STUDY OBJECTIVE: We analyzed CT ordering habits prior to and following implementation of a feedback tool at a community hospital. METHODS: In this intervention study, we identified the CT-ordering habits of physicians and mid-level care providers (physician assistants and nurse practitioners) at baseline and after implementation of a system that sent quarterly feedback reports comparing their ordering habits with those of their peers...
December 9, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27942002/the-impact-of-adding-a-physician-assistant-to-a-critical-care-outreach-team
#13
Hayley B Gershengorn, Yunchao Xu, Carri W Chan, Mor Armony, Michelle N Gong
RATIONALE: Hospitals are increasingly using critical care outreach teams (CCOTs) to respond to patients deteriorating outside intensive care units (ICUs). CCOT staffing is variable across hospitals and optimal team composition is unknown. OBJECTIVES: To assess whether adding a critical care medicine trained physician assistant (CCM-PA) to a critical care outreach team (CCOT) impacts clinical and process outcomes. METHODS: We performed a retrospective study of two cohorts-one with a CCM-PA added to the CCOT (intervention hospital) and one with no staffing change (control hospital)-at two facilities in the same system...
2016: PloS One
https://www.readbyqxmd.com/read/27932271/deactivation-of-left-ventricular-assist-devices-differing-perspectives-of-cardiology-and-hospice-palliative-medicine-clinicians
#14
Colleen K McIlvennan, Sara E Wordingham, Larry A Allen, Daniel D Matlock, Jacqueline Jones, Shannon M Dunlay, Keith M Swetz
BACKGROUND: Beliefs around deactivation of a left ventricular assist device (LVAD) vary substantially between clinicians, institutions, and patients. Therefore, we sought to understand perspectives regarding LVAD deactivation among cardiology and hospice/palliative medicine (HPM) clinicians. METHODS AND RESULTS: We administered a 41-item survey via electronic mail to members of 3 cardiology and 1 HPM professional societies. A convergent parallel mixed methods design was used...
December 5, 2016: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/27889359/elevated-liver-enzymes-emergency-department-focused-management
#15
Eric Sulava, Samuel Bergin, Brit Long, Alex Koyfman
BACKGROUND: Liver function test (LFT) abnormalities are a common problem faced by emergency physicians. This has become more common with the introduction of laboratory panels and automated routine laboratory testing. Fortunately, not all patients with irregularities in liver enzymes possess underlying pathology. This emergency medicine focused review provides a discussion of the various biochemical tests, their underlying biological basis, and an algorithmic approach to the interpretation of abnormalities...
November 23, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27873322/non-medical-prescribing-versus-medical-prescribing-for-acute-and-chronic-disease-management-in-primary-and-secondary-care
#16
REVIEW
Greg Weeks, Johnson George, Katie Maclure, Derek Stewart
BACKGROUND: A range of health workforce strategies are needed to address health service demands in low-, middle- and high-income countries. Non-medical prescribing involves nurses, pharmacists, allied health professionals, and physician assistants substituting for doctors in a prescribing role, and this is one approach to improve access to medicines. OBJECTIVES: To assess clinical, patient-reported, and resource use outcomes of non-medical prescribing for managing acute and chronic health conditions in primary and secondary care settings compared with medical prescribing (usual care)...
November 22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27849499/trauma-resuscitation-evaluation-times-and-correlating-human-patient-simulation-training-differences-what-is-the-standard
#17
Timothy J Bonjour, Grigory Charny, Robert E Thaxton
BACKGROUND: Rapid effective trauma resuscitations (TRs) decrease patient morbidity and mortality. Few studies have evaluated TR care times. Effective time goals and superior human patient simulator (HPS) training can improve patient survivability. OBJECTIVES: The purpose of this study was to compare live TR to HPS resuscitation times to determine mean incremental resuscitation times and ascertain if simulation was educationally equivalent. The study was conducted at San Antonio Military Medical Center, Department of Defense Level I trauma center...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27812729/-under-scrutiny-by-the-state-prosecutor-legal-pitfalls-in-emergency-medicine
#18
REVIEW
P Schelling
Physicians who allow a suicide attempt to happen, which from an ex ante viewpoint was completely voluntary, cannot be held punishable for homicide or failing to provide medical assistance when the suicide corresponds to the putative will of the patient according to plausible information supplied by an authorized person with healthcare proxy. Guidelines for resuscitation also play a central role in the forensic practice for assessment of whether and when resuscitation can be terminated; therefore, it is urgently advised to follow and implement these guidelines: deviations are possible if they can be factually justified...
November 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27660369/amssm-position-statement-on-cardiovascular-preparticipation-screening-in-athletes-current-evidence-knowledge-gaps-recommendations-and-future-directions
#19
Jonathan A Drezner, Francis G O'Connor, Kimberly G Harmon, Karl B Fields, Chad A Asplund, Irfan M Asif, David E Price, Robert J Dimeff, David T Bernhardt, William O Roberts
Cardiovascular screening in young athletes is widely recommended and routinely performed prior to participation in competitive sports. While there is general agreement that early detection of cardiac conditions at risk for sudden cardiac arrest and death (SCA/D) is an important objective, the optimal strategy for cardiovascular screening in athletes remains an issue of considerable debate. At the centre of the controversy is the addition of a resting ECG to the standard preparticipation evaluation using history and physical examination...
September 22, 2016: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/27630003/nonsuicidal-self-injury-of-adolescents
#20
Shannon Lovell, Marvin Clifford
Nonsuicidal self-injury (NSSI) is more common in adolescent and young adult populations than in the past. NSSI is typically used to deal with distressing negative affective states, especially anger and depression, and mixed emotional states. Pediatricians; primary care, family medicine, and emergency room physicians; and mental health professionals are faced with the charge of responding to NSSI behaviors among patients. Physicians in family medicine, pediatrics, and primary care settings play an essential role in initiating the beginning step in the treatment process for those who self-injure...
October 2016: Clinical Pediatrics
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