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Beeson MS, Ankel F, Bhat R, Broder JS, Dimeo SP, Gorgas DL, Jones JS, Patel V, Schiller E, Ufberg JW, Keehbauch JN. The 2019 Model of the Clinical Practice of Emergency Medicine. J Emerg Med 2020; 59:96-120. [PMID: 32475725 DOI: 10.1016/j.jemermed.2020.03.018] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 03/18/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Michael S Beeson
- American Board of Emergency Medicine, East Lansing, Michigan; Summa Health, Akron, Ohio
| | - Felix Ankel
- American Board of Emergency Medicine, East Lansing, Michigan; Regions Hospital, St. Paul, Minnesota; Health Partners Institute, Bloomington, Minnesota; University of Minnesota Medical School, Minneapolis, Minnesota
| | - Rahul Bhat
- American College of Emergency Physicians, Irving, Texas; Georgetown University School of Medicine, Washington, District of Columbia; Medstar Washington Hospital Center, Washington, District of Columbia
| | - Joshua S Broder
- Society for Academic Emergency Medicine, Des Plaines, Illinois; Duke University School of Medicine, Durham, North Carolina
| | - Sara Paradise Dimeo
- Emergency Medicine Residents' Association, Irving, Texas; Prisma Health-Upstate, Greenville, South Carolina; University of South Carolina, Greenville, South Carolina
| | - Diane L Gorgas
- Residency Review Committee for Emergency Medicine, Chicago, Illinois; Department of Emergency Medicine, The Ohio State University College of Medicine, Columbus, Ohio; Health Sciences Center for Global Health, The Ohio State University, Columbus, Ohio
| | - Jonathan S Jones
- American Academy of Emergency Medicine, Milwaukee, Wisconsin; College of Osteopathic Medicine, William Carey University, Jackson, Mississippi
| | - Viral Patel
- Society for Academic Emergency Medicine, Des Plaines, Illinois; University of Massachusetts, Worcester, Massachusetts
| | - Elizabeth Schiller
- American College of Emergency Physicians, Irving, Texas; Saint Francis Hospital and Medical Center, Hartford, Connecticut; University of Connecticut Integrated Program in Emergency Medicine, Farmington, Connecticut
| | - Jacob W Ufberg
- Council of Emergency Medicine Residency Directors, Irving, Texas; Department of Emergency Medicine, The Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
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Abstract
OBJECTIVE The aim of the study was to detect sexual impairment in male hepatitis C virus patients and determine its associations. PATIENTS AND METHODS A total of 61 male hepatitis C virus patients were enrolled in this cross-sectional study. Sexual functioning was assessed using the International Index of Erectile Function. Health-related quality of life (HRQOL) was evaluated using the Greek version of the Short Form 36 Health Survey, and the presence and severity of anxiety and depression were assessed using the Greek version of the Hospital Anxiety and Depression Scale. RESULTS Noncirrhotic patients showed clinically significant dysfunction, mainly in intercourse (59.6%) and overall satisfaction (57.4%). Erectile functioning and desire were correlated with depression (r=-0.520, P=0.000 and r=-0.473, P=0.000), anxiety (r=-0.443, P=0.000 and r=-0.428, P=0.001), physical (r=0.427, P=0.001 and r=0.329, P=0.012), and mental (r=0.379, P=0.003 and r=0.432, P=0.001) HRQOL, platelet count (r=-0.357, P=0.012 and r=0.366, P=0.010), and international normalized ratio (INR) levels (r=-0.373, P=0.013 and r=-0.440, P=0.003). Erection was also correlated with albumin levels (r=0.310, P=0.032). Orgasmic functioning was associated significantly with platelet count (r=0.322, P=0.024) and INR levels (r=-0.425, P=0.004). Intercourse satisfaction was significantly related to depression (r=-0.435, P=0.001) and anxiety (r=-0.335, P=0.008) levels, physical (r=0.374, P=0.004) and mental (r=0.300, P=0.022) HRQOL, platelet count (r=0.333, P=0.020), and INR levels (r=-0.373, P=0.013), and overall satisfaction was significantly correlated with depressive (r=-0.435, P=0.001) and anxiety (r=-0.278, P=0.033) symptoms, mental HRQOL (r=0.340, P=0.010), platelet count (r=0.316, P=0.029), and INR levels (r=-0.332, P=0.030). CONCLUSION Hepatitis C is accompanied by poor sexual functioning even in the absence of cirrhosis and different correlations emerge for distinct subdomains of male sexuality.
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Counselman FL, Babu K, Edens MA, Gorgas DL, Hobgood C, Marco CA, Katz E, Rodgers K, Stallings LA, Wadman MC, Beeson MS, Keehbauch JN. The 2016 Model of the Clinical Practice of Emergency Medicine. J Emerg Med 2017; 52:846-849. [PMID: 28351510 DOI: 10.1016/j.jemermed.2017.01.040] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 01/27/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Francis L Counselman
- American Board of Emergency Medicine, East Lansing, Michigan; Department of Emergency Medicine, Eastern Virginia Medical School, and Emergency Physicians of Tidewater, Norfolk, Virginia
| | - Kavita Babu
- Society for Academic Emergency Medicine, Des Plaines, Illinois; Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Mary Ann Edens
- American College of Emergency Physicians, Irving, Texas; Department of Emergency Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana
| | - Diane L Gorgas
- Residency Review Committee for Emergency Medicine, Chicago, Illinois; Department of Emergency Medicine, Ohio State University, Columbus, Ohio
| | - Cherri Hobgood
- Society for Academic Emergency Medicine, Des Plaines, Illinois; Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Catherine A Marco
- American Board of Emergency Medicine, East Lansing, Michigan; Department of Emergency Medicine, Wright State University Boonshoft School of Medicine, Dayton, Ohio
| | - Eric Katz
- Council of Emergency Medicine Residency Directors, Irving, Texas; Department of Emergency Medicine, Maricopa Integrated Health Systems, Phoenix, Arizona
| | - Kevin Rodgers
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana; American Academy of Emergency Medicine, Milwaukee, Wisconsin
| | - Leonard A Stallings
- Emergency Medicine Residents' Association, Irving, Texas; Department of Emergency Medicine, East Carolina University Brody School of Medicine, Greenville, North Carolina; Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, East Carolina University Brody School of Medicine, Greenville, North Carolina
| | - Michael C Wadman
- American College of Emergency Physicians, Irving, Texas; Department of Emergency Medicine, University of Nebraska Medical Center, Omaha, Nebraska
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Counselman FL, Beeson MS, Marco CA, Adsit SK, Harvey AL, Keehbauch JN, Counselman FL, Babu K, Edens MA, Gorgas DL, Hobgood C, Marco CA, Katz E, Rodgers K, Stallings L, Wadman MC. Evolution of the Model of the Clinical Practice of Emergency Medicine: 1979 to Present. Acad Emerg Med 2017; 24:257-264. [PMID: 27859987 DOI: 10.1111/acem.13137] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 11/07/2016] [Accepted: 11/15/2016] [Indexed: 11/28/2022]
Abstract
The Model of the Clinical Practice of Emergency Medicine (the EM Model) is a three-dimensional representation of the clinical practice of emergency medicine. It is a product of successful collaboration involving the American Board of Emergency Medicine (ABEM), the American College of Emergency Physicians (ACEP), the Society for Academic Emergency Medicine (SAEM), the Emergency Medicine Residents' Association (EMRA), the Council of Emergency Medicine Residency Directors (CORD), the Residency Review Committee for Emergency Medicine (RRC-EM), and the American Academy of Emergency Medicine (AAEM). In 2017, the most recent update and revision of the EM Model will be published. This document will represent the culmination of nearly 40 years of evolution, from a simple listing of presenting patient complaints, clinical symptoms, and disease states into a three-dimensional representation of the clinical practice of emergency medicine. These dimensions include conditions and components, physician tasks, and patient acuity. In addition, over the years, two other documents have been developed, the Knowledge, Skills, and Abilities (KSAs) and the Emergency Medicine Milestones. Both serve as related and complementary educational and assessment tools. This article will review the development of the EM Model from its inception in 1979 to today.
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Affiliation(s)
- Francis L. Counselman
- Department of Emergency Medicine Eastern Virginia Medical School and Emergency Physicians of Tidewater Norfolk VA
| | - Michael S. Beeson
- Department of Emergency Medicine Cleveland Clinic–Akron General Medical Center Akron Ohio
| | - Catherine A. Marco
- Department of Emergency Medicine Wright State University Boonshoft School of Medicine Dayton Ohio
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Garg M, Peck GL, Arquilla B, Miller AC, Soghoian SE, Anderson Iii HL, Bloem C, Firstenberg MS, Galwankar SC, Guo WA, Izurieta R, Krebs E, Hansoti B, Nanda S, Nwachuku CO, Nwomeh B, Paladino L, Papadimos TJ, Sharpe RP, Swaroop M, Stawicki SP. A Comprehensive Framework for International Medical Programs: A 2017 consensus statement from the American College of Academic International Medicine. Int J Crit Illn Inj Sci 2017; 7:188-200. [PMID: 29291171 PMCID: PMC5737060 DOI: 10.4103/ijciis.ijciis_65_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The American College of Academic International Medicine (ACAIM) represents a group of clinicians who seek to promote clinical, educational, and scientific collaboration in the area of Academic International Medicine (AIM) to address health care disparities and improve patient care and outcomes globally. Significant health care delivery and quality gaps persist between high-income countries (HICs) and low-and-middle-income countries (LMICs). International Medical Programs (IMPs) are an important mechanism for addressing these inequalities. IMPs are international partnerships that primarily use education and training-based interventions to build sustainable clinical capacity. Within this overall context, a comprehensive framework for IMPs (CFIMPs) is needed to assist HICs and LMICs navigate the development of IMPs. The aim of this consensus statement is to highlight best practices and engage the global community in ACAIM's mission. Through this work, we highlight key aspects of IMPs including: (1) the structure; (2) core principles for successful and ethical development; (3) information technology; (4) medical education and training; (5) research and scientific investigation; and (6) program durability. The ultimate goal of current initiatives is to create a foundation upon which ACAIM and other organizations can begin to formalize a truly global network of clinical education/training and care delivery sites, with long-term sustainability as the primary pillar of international inter-institutional collaborations.
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Affiliation(s)
- Manish Garg
- Temple University School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Gregory L Peck
- Rutgers: Robert Wood Johnson Medical School, New Brunswick, United States of America
| | - Bonnie Arquilla
- Suny Downstate Medical Center, Brooklyn, United States of America
| | - Andrew C Miller
- East Carolina University, Greenville, NC, United States of America
| | | | | | - Christina Bloem
- Suny Downstate Medical Center, Brooklyn, United States of America
| | | | - Sagar C Galwankar
- University of Florida College of Medicine, Jacksonville, United States of America
| | - Weidun Alan Guo
- Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, United States of America
| | - Ricardo Izurieta
- University of South Florida, Tampa, FL, United States of America
| | - Elizabeth Krebs
- Thomas Jefferson University Hospital, Philadelphia, United States of America
| | - Bhakti Hansoti
- Johns Hopkins Medicine, Baltimore, MD, United States of America
| | - Sudip Nanda
- St. Luke's University Health Network, Bethlehem, PA, United States of America
| | - Chinenye O Nwachuku
- St. Luke's University Health Network, Bethlehem, PA, United States of America
| | - Benedict Nwomeh
- Nationwide Children's Hospital, Columbus, United States of America
| | - Lorenzo Paladino
- Suny Downstate Medical Center, Brooklyn, United States of America
| | - Thomas J Papadimos
- University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States of America
| | - Richard P Sharpe
- Warren Hospital, St. Luke's University Health Network, Phillipsburg, NJ, United States of America
| | - Mamta Swaroop
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
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Components of the Model of the Clinical Practice of Emergency Medicine: A Survey of American Board of Emergency Medicine Diplomates. J Emerg Med 2013; 44:1153-66. [DOI: 10.1016/j.jemermed.2012.11.089] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 10/24/2012] [Accepted: 11/22/2012] [Indexed: 11/23/2022]
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Abstract
INTRODUCTION Emergency medical care in Pakistan has not been a priority of medical education and training because of the country's need to address its lack of primary care. Resources and trained personnel are scarce. Despite these challenges, the value of emergency medical care is gaining attention. The objective of this study was to explore the breadth of Emergency Medicine training in Pakistan through an analysis of an Emergency Medicine residency in a teaching hospital. The Aga Khan University Hospital in Karachi is a teaching institution with the only Emergency Medicine residency program in the region. It was started in 2000, led by US-trained physicians, and it laid the foundation for Emergency Medicine in the country. METHODS The study was conducted over a four-week period in January of 2009. Data collection consisted of three components: (1) a survey of the Emergency Department and hospital services; (2) a survey of the Emergency Medicine training curriculum; and (3) a retrospective chart review of every tenth patient seen in the Aga Khan Emergency Department from December 1-14, 2008. RESULTS The training program is similar to that of the US models. Of the 153 patients selected for the chart review, the majority presented with GI complaints. Of these, 51 (33%) were admitted to the hospital; 20% (n = 15) left against medical advice; the remaining 57% (n = 87) were discharged. DISCUSSION/CONCLUSION The hospital admitted patients with complaints that were expected in the region. Although Aga Khan University Hospital is a pioneer in establishing Emergency Medicine as an official medical discipline in the region, the hospital's obstetrics and gynecology, trauma, toxicology and prehospital services training do not meet current curriculum standards set forth by the Society of Academic Emergency Medicine and the Council of Emergency Medicine Residency Directors. Nevertheless, the review provides a snapshot of the development of Emergency Medical Services in a developing nation. This information may assist other nations that are interested in developing such programs.
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Perina DG, Brunett CP, Caro DA, Char DM, Chisholm CD, Counselman FL, Heidt J, Keim SM, Ma OJ. The 2011 model of the clinical practice of emergency medicine. Acad Emerg Med 2012; 19:e19-40. [PMID: 22651693 DOI: 10.1111/j.1553-2712.2012.01385.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The 2011 Model of the Clinical Practice of Emergency Medicine.
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Quest TE, Asplin BR, Cairns CB, Hwang U, Pines JM. Research priorities for palliative and end-of-life care in the emergency setting. Acad Emerg Med 2011; 18:e70-6. [PMID: 21676052 PMCID: PMC3368013 DOI: 10.1111/j.1553-2712.2011.01088.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Palliative care focuses on the physical, spiritual, psychological, and social care from diagnosis to cure or death of a potentially life-threatening illness. When cure is not attainable and end of life approaches, the intensity of palliative care is enhanced to deliver the highest quality care experience. The emergency department (ED) frequently cares for patients and families during the end-of-life phase of the palliative care continuum. The intersection between palliative care and emergency care continues to be more clearly defined. Currently, there is a mounting body of evidence to guide the most effective strategies for improving palliative and end-of-life care in the ED. In a workgroup session at the 2009 Agency for Healthcare Research and Quality (AHRQ)/American College of Emergency Physicians (ACEP) conference "Improving the Quality and Efficiency of Emergency Care Across the Continuum: A Systems Approach," four key research questions arose: 1) which patients are in greatest need of palliative care services in the ED, 2) what is the optimal role of emergency clinicians in caring for patients along a chronic trajectory of illness, 3) how does the integration and initiation of palliative care training and services in the ED setting affect health care utilization, and 4) what are the educational priorities for emergency clinical providers in the domain of palliative care? Workgroup leaders suggest that these four key questions may be answered by strengthening the evidence using six categories of inquiry: descriptive, attitudinal, screening, outcomes, resource allocation, and education of clinicians.
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Perina DG, Beeson MS, Char DM, Counselman FL, Keim SM, McGee DL, Rosen CL, Sokolove PE, Tantama SS. The 2007 Model of the Clinical Practice of Emergency Medicine: the 2009 update. Acad Emerg Med 2011; 18:e8-e26. [PMID: 21255180 DOI: 10.1111/j.1553-2712.2010.00962.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Debra G Perina
- American Board of Emergency Medicine, East Lansing, MI, USA.
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Martin-Gill C, Roth RN, Mosesso VN. Resident Field Response in an Emergency Medicine Prehospital Care Rotation. PREHOSP EMERG CARE 2010; 14:370-6. [DOI: 10.3109/10903121003770647] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Christian Martin-Gill
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA
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Hack JB, Bakhtiari P, O'Brien K. Emergency Medicine Residents and Statistics: What is the Confidence? J Emerg Med 2009; 37:313-8. [DOI: 10.1016/j.jemermed.2007.07.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2007] [Revised: 05/26/2007] [Accepted: 07/02/2007] [Indexed: 10/22/2022]
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Falvo T, McKniff S, Smolin G, Vega D, Amsterdam JT. The business of emergency medicine: a nonclinical curriculum proposal for emergency medicine residency programs. Acad Emerg Med 2009; 16:900-7. [PMID: 19689483 DOI: 10.1111/j.1553-2712.2009.00506.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Over the course of their postgraduate medical education, physicians are expected not only to acquire an extensive knowledge of clinical medicine and sound procedural skills, but also to develop competence in their other professional roles as communicator, collaborator, mediator, manager, teacher, and patient advocate. Although the need for physicians to develop stronger service delivery skills is well recognized, residency programs may underemphasize formal training in nonclinical proficiencies. As a result, graduates can begin their professional careers with an incomplete understanding of the operation of health care systems and how to utilize system resources in the manner best suited to their patients' needs. This article proposes the content, educational strategy, and needs assessment for an academic program entitled The Business of Emergency Medicine (BOEM). Developed as an adjunct to the (predominantly) clinical content of traditional emergency medicine (EM) training programs, BOEM is designed to enhance the existing academic curricula with additional learning opportunities by which EM residents can acquire a fundamental understanding of the nonclinical skills of their specialty.
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Affiliation(s)
- Thomas Falvo
- Health Services Design Section, Department of Emergency Medicine, York Hospital, WellSpan Health System, York, PA, USA.
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Smith SW, Clark M, Nelson J, Heegaard W, Lufkin KC, Ruiz E. Emergency department skull trephination for epidural hematoma in patients who are awake but deteriorate rapidly. J Emerg Med 2009; 39:377-83. [PMID: 19535215 DOI: 10.1016/j.jemermed.2009.04.062] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2008] [Revised: 12/30/2008] [Accepted: 04/11/2009] [Indexed: 11/20/2022]
Abstract
BACKGROUND Blunt head trauma patients who have been alert but are deteriorating (talk and deteriorate [T&D]) due to a rapidly expanding epidural hematoma (EDH) usually have poor outcome if they must wait for hospital transfer for evacuation. We therefore have continued to teach skull trephination to emergency physicians (EPs). We are unaware of any literature on EP trephination for EDH in the age of computed tomography (CT) scanning. METHODS Patients with EDH from blunt trauma, either in our institution or known to our graduate network, who were T&D with anisocoria despite intubation plus medical therapy, and who had pre-transfer EP trephination, were compared to those who were transferred without trephination. RESULTS There were 5 patients with blunt trauma and CT-proven EDH who were T&D with anisocoria who underwent Emergency Department (ED) trephination at outlying hospitals before transfer. All 5 had improvement in condition and good outcomes. Three had complete recovery without disability and 2 others had mild disability with good cognitive function. None had complications. Two patients with T&D and anisocoria were transferred without trephination. Both had good neurologic outcomes. The mean time to pressure relief in the trephination group vs. transfer group was 55 vs. 207 min, respectively. CONCLUSION In T&D patients with CT-proven EDH and anisocoria, ED skull trephination before transfer resulted in uniformly good outcomes without complications. Time to relief of intracranial pressure was significantly shorter with trephination. Neurologic outcomes were not different.
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Affiliation(s)
- Stephen W Smith
- Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota, USA
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Abstract
Airway management in the emergency department is a critical skill that must be mastered by emergency physicians. When rapid-sequence induction with oral-tracheal intubation performed by way of direct laryngoscopy is difficult or impossible due to a variety of circumstances, an alternative method or device must be used for a rescue airway. Retrograde intubation requires little equipment and has few contraindications. This technique is easy to learn and has a high level of skill retention. Familiarity with this technique is a valuable addition to the airway-management armamentarium of emergency physicians caring for ill or injured patients. Variations of the technique have been described, and their use depends on the individual circumstances.
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Affiliation(s)
- David Burbulys
- David Geffen School of Medicine at UCLA, Department of Emergency Medicine, Harbor-UCLA Medical Center, 1000 West Carson Street, Box 21, Torrance, CA 90504, USA.
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Lammers RL, Davenport M, Korley F, Griswold-Theodorson S, Fitch MT, Narang AT, Evans LV, Gross A, Rodriguez E, Dodge KL, Hamann CJ, Robey III WC. Teaching and Assessing Procedural Skills Using Simulation: Metrics and Methodology. Acad Emerg Med 2008. [DOI: https:/onlinelibrary.wiley.com/doi/full/10.1111/j.1553-2712.2008.00233.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Lammers RL, Davenport M, Korley F, Griswold-Theodorson S, Fitch MT, Narang AT, Evans LV, Gross A, Rodriguez E, Dodge KL, Hamann CJ, Robey WC. Teaching and assessing procedural skills using simulation: metrics and methodology. Acad Emerg Med 2008; 15:1079-87. [PMID: 18828833 DOI: 10.1111/j.1553-2712.2008.00233.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Simulation allows educators to develop learner-focused training and outcomes-based assessments. However, the effectiveness and validity of simulation-based training in emergency medicine (EM) requires further investigation. Teaching and testing technical skills require methods and assessment instruments that are somewhat different than those used for cognitive or team skills. Drawing from work published by other medical disciplines as well as educational, behavioral, and human factors research, the authors developed six research themes: measurement of procedural skills; development of performance standards; assessment and validation of training methods, simulator models, and assessment tools; optimization of training methods; transfer of skills learned on simulator models to patients; and prevention of skill decay over time. The article reviews relevant and established educational research methodologies and identifies gaps in our knowledge of how physicians learn procedures. The authors present questions requiring further research that, once answered, will advance understanding of simulation-based procedural training and assessment in EM.
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Affiliation(s)
- Richard L Lammers
- Department of Emergency Medicine, Michigan State University/Kalamazoo Center for Medical Studies, Kalamazoo, MI, USA.
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Cheng D. Board review course effect on resident in-training examination. Int J Emerg Med 2008; 1:327-9. [PMID: 19384650 PMCID: PMC2657258 DOI: 10.1007/s12245-008-0068-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2008] [Accepted: 09/10/2008] [Indexed: 11/29/2022] Open
Abstract
Background The in-training examination is a national and yearly exam administered by the American Board of Emergency Medicine to all emergency medicine residents in the USA. The purpose of the examination is to evaluate a resident’s progress toward obtaining the fundamental knowledge to practice independent emergency medicine. Aims The purpose of this study was to determine the effects of a 40 hour board review lecture course on the resident in-training examination in emergency medicine. Methods A 40 hour board review lecture course was designed and implemented during the weekly 5 hour long resident conferences during the 8 weeks preceding the in-training examination date in 2006. Attendance was mandatory at the Accreditation Council for Graduate Medical Education (ACGME) standard of 70% or greater. A positive result was considered to be a 10% increase or greater in the resident’s individual national class percentile ranking among their national peers for their class year for the emergency medicine in-training examination. A resident was excluded from the study if there was no 2005 in-training examination score for self-comparison. The 95% confidence intervals (CI) were used to analyze the results. Results Of 16 residents, 1 (6.25%; 95% CI: 0–18%) showed a positive result of increasing their national class percentile ranking by 10% or greater. For the PGY2, one of the eight had a positive result (12.5%; 95% CI: 0–35.4%). For PGY3, no resident (0%; 95% CI: 0–35.4%) had a positive result. Conclusions A 40 hour board review lecture course has no positive effect on improving a resident’s in-training examination score.
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Affiliation(s)
- David Cheng
- UH Emergency Department, Hackettstown, NJ 07840, USA.
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Thomas HA, Beeson MS, Binder LS, Brunett PH, Carter MA, Chisholm CD, McGee DL, Perina DG, Tocci MJ. The 2005 Model of the Clinical Practice of Emergency Medicine: the 2007 update. Acad Emerg Med 2008; 15:776-9. [PMID: 18783490 DOI: 10.1111/j.1553-2712.2008.00194.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Thomas HA, Beeson MS, Binder LS, Brunett PH, Carter MA, Chisholm CD, McGee DL, Perina DG, Tocci MJ. The 2005 Model of the Clinical Practice of Emergency Medicine: The 2007 Update. Ann Emerg Med 2008; 52:e1-17. [DOI: 10.1016/j.annemergmed.2008.06.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Alagappan K, Schafermeyer R, Holliman CJ, Iserson K, Sheridan IA, Kapur GB, Thomas T, Smith J, Bayram J. International Emergency Medicine and the Role for Academic Emergency Medicine. Acad Emerg Med 2007. [DOI: 10.1111/j.1553-2712.2007.tb01807.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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