Seasonal and Geographic Variation in Biodiversity of Forensically Important Blow Flies (Diptera: Calliphoridae) in New Jersey, USA

Determining the time of colonization of human or other animal remains by blow flies (Diptera: Calliphoridae) can play an important role in criminal investigations. However, blow fly presence in a given area is strongly influenced by abiotic and biotic variables such as temperature and habitat. We wanted to assess the biodiversity of adult blow flies in New Jersey, USA, where very little is known about these taxa. Toward that end we collected adult blow flies biweekly from traps baited with bovine liver and placed across three regions in New Jersey over a 2-yr period (2011-2013). We collected and identified 9,257 adult calliphorids, comprising six genera and 12 species. Blow fly assemblages composed of these species varied by season, but community composition did not vary among regions within a given season. Three species, Lucilia coeruleiviridis (Macquart), Lucilia sericata (Meigen), and Phormia regina (Meigen) comprised 88.5% of all adult blow flies collected (42.6, 25.9, 20.0%, respectively). Combining all regions, the dominant species for both spring and summer was L. coeruleiviridis comprising 35.1% of all adults caught in spring and 64.1% in summer. P. regina was the dominant species in fall, totaling 40.1% of all adults caught and Calliphora vicina (Robineau-Desvoidy) was the dominant species for winter, totaling 44.8% of all adults caught. Our findings provide the first assessment of blow fly communities in New Jersey, and these results can be applied to surrounding states where data are severely lacking for forensic application.

Effects of intercropping with flowering plants on predation of Ostrinia nubilalis (Lepidoptera: Crambidae) eggs by generalist predators in bell peppers

Bell pepper plots intercropped with flowering plants were measured for improving biological control provided by natural enemies of the European corn borer [Ostrinia nubilalis (Hübner)]. The intercropped plants Dill, Anethum graveolens L.; coriander, Coriandrum sativum L.; and buckwheat, Fagopyrum escuelentum Moench; were established on the edge of two pepper plots and compared with nonintercropped control plots. Predation by the three species Orius insidiosus Say; Coleomegilla maculata DeGeer; and Chrysoperla, sp. Stephens, was monitored by installing O. nubilalis egg masses on sentinel plants in 2008, 2009, and 2010. To assess negative impacts of alternative prey on O. nubilalis egg predation, green peach aphid, Myzus persicae (Sulzer) populations were monitored via whole-plant counts in 2009 and 2010. Myzus persicae densities on pepper plants peaked in June or July and then declined rapidly. Predation on O. nubilalis eggs increased rapidly after aphid populations declined. Aphid populations were reduced in two out of three field-seasons in intercropped plots. Seasonal predation by O. insidiosus was significantly higher in the intercropped system four out of five field-seasons and one field season by C. maculata. Results indicate that biocontrol of O. nubilalis can be improved by intercropping with flowering plants, although this capacity may depend on the abundance of alternative prey.

Case study on chronic organophosphate poisoning

Ernest and Leslie Rea, two farmers in their mid-fifties, contacted their local County Agricultural Extension Office in Cape May, New Jersey, regarding health problems associated with their use of pesticides. They were referred to Dr. Hamilton and the Environmental and Occupational Health Sciences Institute (EOHSI) clinic for consultation and evaluations. They were diagnosed with chronic intoxication of organophosphate pesticides. Recommendations were made to decrease health risks in the farming operations. These included the usage of personal protective equipment while handling or applying pesticides, transportation of pesticides in a separate trailer behind the farm truck, and construction of separate storage areas for herbicides, insecticides and fungicides. A separate wash site was also constructed for use at the end of the work day. Compliance with these strategies resulted in improvements in health for both farmers.

Definition of emergency medicine

This SAEM position paper clarifies the role of emergency medicine in health care delivery. It builds upon the working definition of emergency medicine developed by the American College of Emergency Physicians in 1994 by describing the health care role of emergency physicians (EPs). EPs are first-contact providers who care for all patients regardless of age, gender, time of presentation, or ability to pay. They remain the only continuously accessible specialty for patients seeking help and solace in the health care system. They are an essential link in the health care continuum between primary care physicians, specialists, the out-of-hospital system, the patient, inpatient services, and communication services. The EP's role is in organizing and monitoring the emergency care delivery system. Part of this role is to better align the health care provider training and ability with the specific medical needs of a patient. The emergency health care system remains the essential medical safety net for all individuals needing care in this country.

Optimal positioning for cervical immobilization

STUDY OBJECTIVE

We hypothesized that optimal positioning of the head and neck to protect the spinal cord during cervical spine immobilization can be determined with reference to external landmarks. In this study we sought to determine the optimal position for cervical spine immobilization using magnetic resonance imaging (MRI) and to define this optimal position in a clinically reproducible fashion.

METHODS

Our subjects were 19 healthy adult volunteers (11 women, 8 men). In each, we positioned the head to produce various degrees of neck flexion and extension. This positioning was followed by quantitative MRI of the cervical spine.

RESULTS

The mean ratio of spinal canal and spinal cord cross-sectional areas was smallest at C6 but exceeded 2.0 at all levels from C2 to T1 (P < .05). At the C5 and C6 levels, the maximal area ratio was most consistently obtained with slight flexion (cervical-thoracic angle of 14 degrees) (P < .05). For a patient lying flat on a backboard, this corresponds to raising the occiput 2 cm. More extreme flexion or extension produced variable results.

CONCLUSION

In healthy adults, a slight degree of flexion equivalent to 2 cm of occiput elevation produces a favorable increase in spinal canal/spinal cord ration at levels C5 and C6, a region of frequent unstable spine injuries.

Objectives to direct the training of emergency medicine residents on off-service rotations: surgery, Part 3

This is the 36th and final article in a series of objectives to direct emergency medicine resident experiences on off-service rotations. An understanding of the principles of surgical diagnosis and treatment is an essential component of the practice of emergency medicine. Emergency medicine residents rotating on surgical services require specific objectives to maximize their learning potential, emphasize early patient assessment, identify the possible need for surgery, and gain a basic understanding of definitive management. This article approaches surgical problems from the presenting complaint. It concludes with procedures not covered in the goals and objectives for traumatology.

Objectives to direct the training of emergency medicine residents on off-service rotations: Surgery, part 2

This is the 35th article in a continuing series of objectives to direct emergency medicine resident experiences on off-service rotations. Vascular and urological complaints are common problems in the emergency department and often lead to consultation with a surgeon. Because an understanding of the principles of surgical diagnosis and treatment is an essential component of the practice of emergency medicine, emergency medicine residents rotating on surgical services require specific goals and objectives to emphasize early patient assessment, identification of the possible need for surgery, and a basic understanding of definitive management. Unique aspects of pediatric surgery are also addressed in this segment.

Objectives to direct the training of emergency medicine residents on off-service rotations: surgery, Part 1

This is the 34th article in a continuing series of objectives to direct emergency medicine resident experiences on off-service rotations. Abdominal and gastrointestinal complaints are common problems in the emergency department and often lead to consultation with a surgeon. Because an understanding of the principles of surgical diagnosis and treatment is an essential component of the practice of emergency medicine, residents rotating on surgical services require specific goals and objectives to emphasize early patient assessment, identification of the possible need for surgery, and a basic understanding of definitive management.

Objectives to direct the training of emergency medicine residents on off-service rotations: psychiatry

Objectives for Emergency Medicine residents on a Psychiatry rotation is the 33rd article in this continuing series of off-service objectives. Psychiatric presentations, including substance abuse and violent behavior, are ubiquitous in the emergency department. In addition, psychological issues influence every aspect of clinical care. A psychiatry rotation can be valuable in emergency medicine training. This experience can be enhanced by clearly defined learning objectives in clinical psychiatry.

Objectives to direct the training of emergency medicine residents on off-service rotations: traumatology, Part 3

This is the thirty-second article in a continuing series of objectives to direct emergency medicine resident experiences on off-service rotations. Instruction during rotations in traumatology may be conducted at the bedside in difficult and demanding clinical settings. Yet, residents must not only obtain an essential fund of knowledge, but also become comfortable with a variety of life-saving and diagnostic procedures. It is essential for residents to have specific goals and objectives to guide their acquisition of knowledge and skills required to manage major trauma effectively.

Objectives to direct the training of emergency medicine residents on off-service rotations: traumatology, Part 2

This is the 31st article in a continuing series of objectives to direct emergency medicine resident experiences on off-service rotations. Neck and torso trauma accounts for a large portion of injuries, and its management is an essential part of training in emergency medicine. Due to the often life-threatening presentations of trauma victims, resident instruction may be conducted at the bedside in difficult and demanding situations. Therefore, it is essential for residents to have specific goals and objectives to guide their acquisition of knowledge required to make critical decisions for patients with major trauma.

Objectives to direct the training of emergency medicine residents on off-service rotations: traumatology, Part 1

This is the 30th article in a continuing series of objectives to direct emergency medicine resident experiences on off-service rotations. Because injuries account for tremendous morbidity and mortality, management of trauma is an essential part of training in emergency medicine. Instruction in traumatology during off-service rotations may be conducted at the bedside in difficult and demanding clinical settings. Therefore, it is essential for residents to have specific goals and objectives to guide their acquisition of knowledge required to make rapid, accurate decisions for patients with major trauma.

Objectives to direct the training of emergency medicine residents on off-service rotation in cardiology, Part 2

This article is the second of two parts outlining the objectives for a resident rotation in cardiology. Cardiology is offered as an off service rotation or an elective at some emergency medicine residency training programs. An organized core curriculum may provide a structured learning environment to help ensure that certain principles and objectives important to the practice of emergency medicine are learned. We have developed a written core curriculum containing a subject content list, learning objectives, and references for emergency medicine residents on cardiology services. This is a continuation of a series of objectives for off-service rotations for emergency medicine residents.

Objectives to direct the training of emergency medicine residents of off-service rotations: toxicology

Toxicology is an integral component in the training of the emergency physician. This is the 27th article in a continuing series of goals and objectives. The article provides basic guidelines for the organization of the toxicology elective with specific goals and objectives and a list of the contents of the toxicology briefcase. This information should aid in providing a comprehensive experience in toxicology for emergency medicine residents.

Objectives to direct the training of emergency medicine residents on off-service rotations: internal medicine III

Internal medicine is an essential but diverse field. This is the third in a three-part set of objectives for an off-service rotation in general internal medicine for emergency medicine residents. This series may be used to guide the resident during the rotation or to serve as part of a teaching program integrated with didactic training and emergency department experience.

A preliminary epidemiological study of the patient population visiting an urban ED in the Republic of China

The objective of this study was to evaluate the characteristics of the patient population of an urban emergency department (ED) in The People's Republic of China. A prospective observational study was conducted at a university-affiliated hospital adult ED medical unit and included all patients visiting the medical unit of the ED during a 2-week period. A data collection log was designed and placed in the ED. Data were recorded by the attending ED physician for all patients presenting during the study period. There were 569 patients recorded in the 2-week period. The major presenting complaints were fever (20.9%), abdominal pain (20.1%), and chest pain (11.4%). The most common diagnosis were upper respiratory tract infection (11.6%), angina pectoris (6.3%), and acute gastritis (4.9%). Eight percent of the patients were admitted, 29.0% were held in an observation unit, and 0.6% died. The average length of stay in the ED observation unit was 5.6 days. These data offer emergency physicians a preliminary understanding of the clinic presentations and diagnoses of patients seen in a university-affiliated urban hospital ED in China. The number and length of time patients were held in observation unit point out the shortage of in-hospital beds. This study is useful for describing and understanding characteristics of the patient encounter and for improving the delivery of emergency care in China.

Objectives to direct the training of emergency medicine residents on off-service rotations: internal medicine. II

Internal medicine is an essential but diverse field. This is the second in a three-part set of objectives for an off-service rotation in general internal medicine. This series may be used to guide the resident during the rotation or to serve as part of a teaching program integrated with didactic training and emergency department experience.

Objectives to direct the training of emergency medicine residents on off-service rotations: Internal Medicine. I

Internal Medicine is an essential but diverse field. This is the first in a three-part set of objectives for an off-service rotation in general internal medicine. This series may be used to guide the resident during the rotation or to serve as part of a teaching program integrated with didactic training and emergency department experience.

Objectives to direct the training of emergency medicine residents on off-service rotations: hyperbaric medicine

Objectives for Emergency Medicine residents on Hyperbaric Medicine rotations is the 22nd article in this continuing series of "off-service" goals and objectives. The role of the emergency medicine physician in hyperbaric treatment is evolving as part of a multidisciplinary approach to patients with widely divergent disease states who may benefit from serum hyperoxia and compression. Therefore, emergency residents with interests in this area will benefit from clear goals and objectives during a 2 to 4-week Hyperbaric Medicine Elective.

Objectives to direct the training of emergency medicine residents on off-service rotations: neurology

This is the twenty-first article in a continuing series of objectives to direct resident training in emergency medicine. Presented is a set of objectives with references for curriculum goals in neurology. Knowledge of neurology and clinical skills in diagnosing neurological illness is important in the practice of emergency medicine. Not all emergency residents have adequate exposure to the subspecialty of neurology. Many residents who have exposure to a neurology elective often spend only two weeks on the service. Therefore, a clear set of goals and objectives is essential for the resident to obtain a comprehensive knowledge of this complex specialty.

Objectives to direct the training of emergency medicine residents in pediatric emergency medicine

This article outlines the objectives for a resident rotation on a pediatric emergency medicine service that is geographically separate from adult-oriented facilities. In this setting, pediatric emergency department care is considered an off service. However, these objectives incorporate key pediatric knowledge and techniques in a practical format for emergency medicine trainees who have no separate pediatric emergency department experience. The content of the pediatric emergency department educational exposure can be attained in a concentrated 2-month exposure at a pediatric facility or extracted throughout the course of multiple pediatric encounters at a general emergency department. These objectives are a part of a continuing series on the goals and objectives to direct emergency medicine resident training on off-service rotations.

Objectives to direct the training of emergency medicine residents in in-patient pediatrics

This article outlines the objectives for a resident rotation in an in-patient pediatric service. The objectives can be successfully implemented in a 2-month sequential exposure to an in-patient ward service followed by an intensive care unit rotation in the first year of postgraduate training. These objectives are a part of a continuing series in the goals and objectives to direct emergency medicine resident training on off-service rotations.

Objectives to direct the training of emergency medicine residents on off-service rotations; radiologic imaging 2: contrast and imaging techniques

Interpretation of radiologic images is an essential skill for the emergency physician. This is the second of two sets of objectives for an off-service rotation in radiology. The first covered the interpretation of plain films. This series addresses commonly used imaging modalities such as contrast media, ultrasound, computed tomography, nuclear medicine, and magnetic resonance imaging. This set of objectives may be used to guide a one-month radiology rotation or to serve as part of a teaching program integrated with didactic training and emergency department experience.

Objectives to direct the training of emergency medicine residents on off-service rotations: research

This is the 16th in a series of objectives to direct resident training in Emergency Medicine. Research is recognized as an important component of physician training, yet it is often neglected in medical school and residency curricula. We offer here an objective-based program for resident physicians' exposure to research design and methodology.

Objectives to direct the training of emergency medicine residents on off-service rotations; radiologic imaging 1: Plain films

Interpretation of radiologic images is an essential skill for the emergency physician. This is the first of two sets of objectives for an off-service rotation in radiology. It covers the interpretation of plain films. The second series will address commonly used, but more sophisticated, imaging modalities including the use of contrast materials, ultrasound, nuclear medicine, computed tomography, and magnetic resonance imaging. This set of objectives may be used to guide a one-month radiology rotation or serve as part of a teaching program integrated with didactic training and emergency department experience.

Objectives to direct the training of emergency medicine off-service rotations: anesthesiology

This is the 15th article in a continuing series of "off-service" goals and objectives for resident education in emergency medicine. Knowledge and skills in providing anesthesia and analgesia are essential in managing patients in the emergency department, critical care unit, and surgery. However, Anesthesiology off-service rotations are often limited to a 2-week rotation. Therefore, clear goals and objectives in Anesthesiology are essential for the resident in training.

Objectives to direct the training of emergency medicine residents on off-service rotations: administration

Administrative knowledge and skills are essential for the emergency physician. This is the 12th article in a continuing series of "off-service" goals and objectives. It outlines a mechanism for conveying important points of Emergency Medicine Administration to the EM III resident. The article includes materials describing the Administrative Content, Goals and Objectives, Key Contact System, and Contents of the EM Administrative briefcase. This information should assist faculty charged with the development or revision of the Administrative literature review and experiential block rotation in an emergency medicine residency.

Objectives to direct the training of emergency medicine residents on off-service rotations: pulmonary

This article outlines the objectives for a resident rotation in pulmonary diseases. It is part of a continuing series on the goals and objectives to direct Emergency Medicine resident training on off-service rotations. Pulmonary disease accounts for a high percentage of presenting complaints and potentially life-threatening disease in the emergency department. Because of the frequency of respiratory disease in Emergency Medicine, many Emergency Medicine residencies offer individual off-service rotations in Pulmonary Medicine. The objectives of this article are viewed as a one-month component of an Internal Medicine Rotation in the first year of training. These objectives are designed to help focus the resident's reading and study during a pulmonary off-service rotation.

Objectives to direct the training of emergency medicine residents on off-service rotations: ophthalmology

This is the ninth article in a continuing series for emergency medicine education. Ophthalmology is the topic. Since ophthalmologic problems are common in the emergency department and have obvious importance in clinical care, the time spent on an ophthalmology rotation can be very valuable in emergency medicine training. This experience is often limited to a 2-week rotation. Therefore, clear goals and objectives take on a greater significance for the resident-in-training.

Objectives to direct the training of emergency medicine residents on off-service rotations: critical care medicine, Part 2

This article is the second of two parts outlining the objectives for resident rotations in intensive care units. It is part of a larger continuing series on the goals and objectives to direct the training of emergency medicine residents on off-service rotations. The critical care unit allows the resident an opportunity to provide continuing care for critically ill patients, many of whom enter the health care system through the emergency department. Critical care medicine is a natural continuum of emergency medicine, and provides the resident with the ability to follow the natural progression of seriously ill patients, as well as build confidence and experience in caring for the critically ill and injured. These objectives are designed to help focus the resident's reading and study during the rotation.

Autonomous departments of emergency medicine in contemporary academic medical centers

There are currently 20 autonomous departments of emergency medicine in United States medical schools. EDs seeking autonomous status should institute a faculty development program to channel faculty energy into worthwhile research projects; establish protected time for clinical faculty to increase research productivity; develop expertise to compete for extramural funding; initiate an intramural research program so that faculty can learn the basics of grantsmanship; teach health care issues in ambulatory medicine; become involved in interdisciplinary teaching programs and curriculum development; maintain the present faculty commitment to 24-hour attending coverage; and develop university-based programs that originate from the ED. Program directors should establish liaisons with the medical school dean to acquaint him with the advantages of an autonomous department of emergency medicine; attempt to assess other relationships within the medical school to determine support for emergency medicine and to uncover and address opposition to autonomous departmental status; attempt to serve on medical school committees to meet other faculty, solve problems with them and develop trusting relationships; and develop broad-based support for autonomous departmental status both within and outside of the university. By devising and following a deliberate approach to attaining departmental status, emergency medicine will be assured of continued growth in the important decade ahead.

Objectives to direct the training of emergency medicine residents on off-service rotations: critical care medicine, Part 1

This article is the first of two parts outlining the objectives for a resident rotating in the intensive care unit (ICU). It is part of a larger continuing series on the goals and objectives to direct the training of emergency medicine residents on off-service rotations. The critical care unit is a valuable rotation that allows the resident to see and care for critically ill patients, many of whom present initially to the emergency department. Critical care is a logical continuum for the sick and injured patient as he moves from the prehospital and emergency department (ED) settings to the ICU. These objectives are designed to focus the resident's reading and study during a critical care rotation.

Objectives to direct the training of emergency medicine residents on off-service rotations: electrocardiology

This is a continuing series of objectives to direct resident training in emergency medicine. Electrocardiography may not receive individual attention in many training programs. However, the importance, omnipresence, and medicolegal potential of electrocardiography in the practice of emergency medicine suggests its individual attention. Contents and specific learning objectives are presented to provide guidelines for resident mastery, following the format presented by preceding subjects.

Objectives to direct the training of emergency medicine residents on off-service rotation: otolaryngology

This is the sixth article in a continuing series on objectives for emergency medicine training; otolaryngological objectives will be presented. Otolaryngological skills and knowledge areas are frequently encountered in clinical practice. The Core Content in emergency medicine devotes an entire section to their listing. Off-service rotations provide some one-half of all rotational-based experience in emergency medicine training. Specific behaviorally based objectives for mastery of knowledge and skill areas provide guidance in a training rotation not directly under emergency medicine faculty supervision. References are suggested for additional and supportive information and reinforcement in skill and knowledge area mastery. These objectives are presented to aid in directing training of emergency medicine residents on an otolaryngological service.

Objectives to direct the training of emergency medicine residents on off-service rotations: emergency medical services

Emergency Medical Services are an area of special interest in emergency medicine. Many emergency physicians are called upon to direct, train, or manage emergency medical services. Residents training in emergency medicine have a need for a defined curriculum in emergency medical services. Residency training should provide a basic foundation in EMS including on- and off-line medical control, medicolegal aspects, communications, disaster management, and EMS history, structure, and function. The resident must gain experience through on-scene observation, EMT/Paramedic education, medical direction, and quality assurance activities. This paper is one in a continuing series of goals and objectives to direct resident training in off-service rotations. Specific resources, learning objectives, and experiences are suggested.

Objectives to direct the training of emergency medicine residents on off-service rotations: dermatology

This is the fifth in a continuing series of objectives to direct resident training in emergency medicine. Approximately 50% of resident experience and training in emergency medicine takes place outside of the direct control and influence of full-time emergency medicine faculty. To gain some direction and control over these off-service rotations, objectives and references are offered here. Objectives for a dermatology rotation as well as contents and references are presented.

Objectives to direct the training of emergency medicine residents in off-service rotations: plastic surgery

This is the fourth article in a continuing series on objectives for emergency medicine training; plastic surgery objectives will be presented. Plastic surgery topics overlap many in emergency medicine. Specific behaviorally based objectives for mastery of skills in plastic surgery are outlined. Specific references are provided for additional information and reinforcement in skill mastery. The basic concepts of plastic surgery are probably best learned by observation and supervised performance. Specific objectives provide guidance and direction for the didactic as well as the supervised experiences in skill mastery. These objectives provide a structure for systematically learning and mastering the content presented on a plastic surgical rotation or experience in emergency medicine training.

Objectives to direct the training of emergency medicine residents on off-service rotations: orthopedics

In this third article in a continuing series on objectives for emergency medicine training, orthopedic objectives are presented. Orthopedic complaints are common in emergency medicine. Direction in mastering evaluative, cognitive, and procedural skills are provided utilizing behaviorally based objectives and references. These objectives provide a structure for systematically learning the content of orthopedics through enlightened patient care, questioning of attending physicians and supervisors, and directed reading.

Objectives to direct the training of emergency medicine residents in off-service rotations: dental emergencies

Patients presenting for emergency care with complaints of dental origin are common. Rarely are dental topics systematically addressed during training rotations. In this second article in a continuing series on objectives for emergency medicine resident training, dental emergency objectives will be presented. Instructions for use of the references and objectives are provided. Cognitive and evaluative objectives are organized for mastery. A list of resources including references and audio visual materials are outlined. The objectives and reference materials presented provide a structure for the systematic study of dental emergencies in emergency medicine resident training.

Objectives to direct the training of emergency medicine residents on off-service rotations

Up to 50% of the 36 months of resident training in emergency medicine may be on off-service rotations. The experience on these rotations can lack educational content and opportunity pertinent to emergency medicine. The resident rarely has readily available and structured guidance to optimize training in terms of the anticipated needs of the specialty. In response to this problem, the authors have written curricula containing subject content listings, objectives, and supplied references for 16 off-service rotations. A plan for implementing the materials and an example from the obstetrics-gynecology rotation is given. After 12 months' experience, the authors have subjective responses from residents and off-service program directors that support the value of this information. Positive reports include: Residents having a better understanding of faculty expectations, improved "consistency of experience," residents appreciating the added attention, improved performance, and expanded reading efforts. One expressed concern is "too much to read." The project continues to evolve.

Content listings for consistency of policies and procedures in an academic department

Communicating expectations is central to effective management. In a large academic department spread over several sites, written guidelines are often necessary to limit misinterpretation of these expectations. Three "operation manuals" for residents, faculty, and support staff were developed to supply these guidelines. They have evolved into an effective means of communicating departmental policy and standards for performance. The table of contents are provided as a guide for those developing new academic departments.

Influence of emergency medical services systems and prehospital defibrillation on survival of sudden cardiac death victims

This article reviews the influence of emergency medical systems and prehospital defibrillation on survival of sudden cardiac death. The historical perspective and epidemiologic considerations of prehospital sudden cardiac death are highlighted. Factors predictive of successful resuscitation and impact of community activity on sudden death are discussed. Influences of emergency medical services on outcome of prehospital cardiac arrest are reviewed, with emphasis on the role of dispatchers, emergency medical technicians, and paramedics. The recent emergence of prehospital automatic defibrillation by emergency medical technicians, first responders, and lay persons is discussed in depth, as it has great potential to positively influence outcome of prehospital sudden cardiac death.

A library to assist in the development of academic faculty in emergency medicine

Faculty development is a training process that strives continually to improve the creativity, productivity, and longevity of individuals committed to the practice of academic medicine. Information pertinent to faculty development is contained in textbooks scattered throughout the medical literature. From a more than 80-volume personal library, a list of 15 recommended texts in 11 major topics is given. The cost of this library is +333.50. This library was designed to assist emergency physicians in obtaining useful sources of information as part of their continuing education as academic faculty.