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Search Results: 1 - 10 of 8888 matches for " Emergency medicine "
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A Blended Module for the Emergency Medicine Resident: An Introduction to Vital Signs and Emergency Stabilization  [PDF]
Bobby Desai
Creative Education (CE) , 2015, DOI: 10.4236/ce.2015.63035
Abstract: Beginning a residency in Emergency Medicine is a daunting task, and the new physician must be aware of what abnormal vital signs are and understand when to initiate emergency therapy. This module was created to teach the new physician about the vital sign of temperature. The module is blended to incorporate online learning via both direct and asynchronous methods, as well as face-to-face interactions using high fidelity simulation.
Emergency Department: Basic Prerequisites for the Upgrade of the NHS
Georgios Charalambous
International Journal of Caring Sciences , 2012,
Abstract: The Emergency Department is an autonomous hospital unit comprised of doctors, nurses and paramedics, who deliver emergency care on a 24-hour basis. It provides an interface between patients and their specialized treatment, as well as a point of contact between primary and tertiary care. The need for medical services has increased disproportionately to the available resources for medical care; a fact that has given rise to difficulties in maintaining the effective function of the Emergency Department. As a result, the provision of high standard services is not ensured. In order to help establish and maintain the effective operation of the Emergency Department, new methods should be established which efficiently utilize existing and up-and-coming information and communication technologies. This will allow for the acceleration of the Department’s operational procedures, more effective treatment of emergency cases, and ultimately assists in maintaining a high level of patient satisfaction. The expansion and development of specific services offered by the ED will also assist in the Department becoming a system of qualitative assessment for primary care. This would lead to a better outcome for emergency cases as a result of fast, spherical and effective treatment.
Qualitative Research on Emergency Medicine Physicians: A Literature Review  [PDF]
Charlotte Paltved, Peter Musaeus
International Journal of Clinical Medicine (IJCM) , 2012, DOI: 10.4236/ijcm.2012.37A136
Abstract:

Aim: This study aims to review the qualitative research studying Emergency Medicine (EM) physicians in Emergency Departments (ED). Background: Qualitative research aims to study complex social phenomena by other means than quantification often through verbal or observational investigation. EM is a highly complex medical and social environment that has been investigated through qualitative methodologies. A literature review is needed to show what qualitative studies illuminate about EM and why this work is important to develop EM as a complex organizational and communicative practice. Methods: Electronic databases of English peer-reviewed articles were searched from 1971 to 2012 using Medline through PubMed and PsychINFO. This search was supplemented with hand-searches of Academic Emergency Medicine and Emergency Medicine Journal from 1999 to 2012 and cross references were reviewed. The key words used were emergency medicine, qualitative, ethnography, observation, interview, video, anthropology, simulation, and simulation-based. Results: 820 papers were identified and 46 studies were included in this review. This literature review found that the reviewed qualitative studies on EM physicians were designed using the following strategies of inquiry: Ethnography, mixed methods, action research, grounded theory, phenomenology, content analysis, discourse analysis, and critical incident analysis. The reviewed studies were categorized into four main themes: Education and training, communication, professional roles, and organizational factors, and into 12 sub-themes. Conclusion: The strength of qualitative research is its ability to grasp and operationalize complex relations within EM. Although qualitative research methodologies have gained in rigor in recent years and few researchers would question their value in studying complex medical and social phenomena, rigorous design in qualitative studies is needed. Qualitative research studies that stick with one strategy of inquiry that they follow closely are likely to yield more valid studies.

Evaluation of a Pediatric Mock Code Educational Training Program at a Large, Tertiary Care Pediatric Hospital  [PDF]
Ayelet Rimon, Amit Hess, Dennis Scolnik, Oren Tavor, Shirley Friedman, Miguel Glatstein
Open Journal of Pediatrics (OJPed) , 2015, DOI: 10.4236/ojped.2015.54047
Abstract: Background: Management of the acutely ill children represents one of the more complex clinical skills required of pediatric physicians. Our goal was to develop and evaluate a multidisciplinary pediatric mock code training program for the pediatric residents in our institution. Methods: We performed a before and after evaluation of pediatric residents. The residents were educated by attending five mock code scenarios, followed by debriefing. Before and after the five sessions, the residents completed a self-assessment questionnaire. Results: Residents reported a significant improvement in their comfort in all aspects of managing pediatric resuscitations, with notable improvement seen in running a resuscitation requiring airway management, managing fluid resuscitation and performing endotracheal intubation. The most prominent change was demonstrated in the comfort level of the overall management of a pediatric resuscitation. Conclusion: The pediatric mock code educational training program improved residents’ self-reported knowledge and comfort level in managing pediatric emergency situations.
The Effect on Physician Interpretation after Ultrasound Video Transmission  [PDF]
Eric Zevallos, Joseph Coppiano, Ann Marie Kuchinski, Taylor Mueller, Bradley White, Patrick Loeffler, Zachary Farmer, Patricia Hall, Matt Lyon
Open Journal of Emergency Medicine (OJEM) , 2017, DOI: 10.4236/ojem.2017.52004
Abstract: Title: The Effect on Physician Interpretation After Ultrasound Video Transmis-sion. Objective: There is a limited amount of qualified sonographers, which is problematic to rural, and prehospital settings that require clinical ultrasound. One solution is the use of telemedicine to transmit ultrasound videos to a distant expert. Our objective was to determine the effect of video image transfer using Skype on physician image interpretation. Methods: Three emergency medicine physicians of varied ultrasound proficiency were given 72 pairs of transmitted and non-transmitted ultrasound video clips in random order. Raters were instructed to determine whether ultrasound clips were positive or negative for pathology. Same interpretations between video pairs were categorized as homodiagnostic while different interpretations were categorized as heterodiagnostic. Raters were also asked to rate the image resolution, image detail, and total image quality using a 10-point Likert scale. For the diagnostic results, rater agreement, accuracy, sensitivity, and specificity were calculated. Results: The raters collectively demonstrated high agreement (92.1%), sensitivity (96.3%), specificity (92.8%), and accuracy (94.1%). Raters 1 (95.8%, κ = 0.912) and 3 (97.2%, κ = 0.942) had near perfect agreement, while rater 2 (83.3%, κ = 0.666) had substantial agreement. Only raters 1 and 3 detected a decrease in image resolution, image detail, and total image quality (p < 0.05). Rater agreement on transmitted videos was not significantly different statistically from non-transmitted videos and the presence of heterodiagnostic video pairs did not correlate with video transmission. Conclusions: This study demonstrates that transmission via Skype has minimal effect on a physician’s interpretation of an ultrasound video. The implications of these results are that ultrasound video transmission can be used to improve access to specialists without compromising accuracy which will ultimately increase patients’ quality of care.
Value of Mandatory Screening Studies in Emergency Department Patients Cleared for Psychiatric Admission
Parveen Parmar,Craig A. Goolsby,Kavid Udompanyanan,Leslie D. Matesick
Western Journal of Emergency Medicine : Integrating Emergency Care with Population Health , 2012,
Abstract: Introduction: Laboratory and radiographic studies are often required by psychiatric services priorto admitting emergency patients who are otherwise deemed medically stable. Such testing mayrepresent an unnecessary expense that prolongs emergency department stays without significantlyimproving care. This study determines the prevalence of such testing and how often it leads tochanges in care.Methods: We prospectively tracked laboratory testing among psychiatric patients presenting tothe emergency departments of two academic tertiary care facilities. For each visit we determinedwhether laboratory or radiographic studies were ordered, and whether the examination wasconducted at the request of the emergency physician as part of a medical screening examinationor requested by the psychiatry service. We then determined if this testing changed patientdisposition.Results: Our study enrolled 598 patients. Of these, emergency physicians ordered testing as a partof medical screening on 155 patients (25.9%). We found the psychiatry service ordered laboratoryor radiographic studies for 191 of 434 patients (44.0%) who emergency physicians determineddid not require ancillary testing for medical clearance. Of these 191 patients, only one (0.5%; 95%Confidence Interval: 0.01% - 2.9%) had an abnormal result that led to a change in disposition. TotalMedicare reimbursement rates for the additional ancillary testing in this study was $37,682.Conclusion: Ancillary testing beyond what is required for medical clearance of psychiatricemergency patients rarely alters care. Policies that require panels of testing prior to psychiatricadmission are costly and appear to be unnecessary.
Pneumothorax in a Single Lung Patient
Bertrand Sauneuf,Benoit Champigneulle,Medical Intensive Care Unit, Cochin Hospital, AP-HP, Paris, France
Western Journal of Emergency Medicine : Integrating Emergency Care with Population Health , 2012,
Abstract:
Docencia en medicina de urgencias y emergencias
Ayuso,F.; Nogué,R.; Coll Vinent,B.; Fernández Esáin,B.; Miró,ò.;
Anales del Sistema Sanitario de Navarra , 2010, DOI: 10.4321/S1137-66272010000200020
Abstract: the appropriate care of patients in emergency services can reach a level of complexity as to make a sound training necessary, which should be based on a medical speciality, as happens in the majority of the countries in our context. in spain at present there is no regulated and homogeneous training in urgency and emergency medicine (uem), either during the period of undergraduate training (in the form of a universally compulsory subject in the faculties of medicine) or during the postgraduate period (in the form of a medical speciality). in this respect, the definitive approval of the speciality in uem is currently pending within the framework of a reform of the residence program that will evolve towards a core training program of specialities. until thus occurs, the reality in spain is that professionals who work in this care setting possess a heterogeneous training. as a result of this vacuum and the training needs of these professionals, a wide range of specific training proposals has been developed over the years in order to optimise the skills and abilities of the professionals who provide initial emergency care to the patient. a new generation of courses has been set underway using the new didactic methodologies of training, into which didactic tools of e-learning and robotic simulation have been incorporated.
La investigación en medicina de urgencias y emergencias
Miró,ò.; Sesma,J.; Burillo-Putze,G.;
Anales del Sistema Sanitario de Navarra , 2010, DOI: 10.4321/S1137-66272010000200021
Abstract: health research is consubstantial with clinical excellence, a fact that is also inherent in urgency and emergency medicine (uem). besides, the specific characteristics of the spanish health care system and the organisation of hospital emergency care offer a probably unique scenario, offering unique opportunities for their scientific analysis and study. although the indices of spanish scientific production in uem were traditionally below those registered for researchers of other medical specialities, as well for uem researchers of other countries, there has been a dynamic of continuous growth since 1995: it is the highest with respect to the former and second amongst our european colleagues. besides, there is a great deal of low level scientific activity (papers presented to conferences). to increase scientific production in uem there is a need to solve some aspects that hinder this task, such as: the lack of a scientific culture, doubtless united to the lack of a recognised speciality; the limited training in research methodology; the lack of explicit recognition of scientific work; the limited scientific infrastructure; the practically 100% dedication to the work of care tasks; the scarce participation in national grants for research projects; and the absence in spain of an indexed journal specialising in uem. besides, we believe that it is necessary to promote and interrelate the research groups of different hospitals and emergency medical systems, both locally and amongst the different autonomous communities, so that they work in a coordinated way and thus obtain the necessary critical mass that will enable the formation of a thematic network of cooperative research.
Desfecho clínico de pacientes tratados por epistaxe com tamponamento nasal após a alta hospitalar
Faistauer, Marina;Faistauer, ?ngela;Grossi, Rafaeli S;Roithmann, Renato;
Brazilian Journal of Otorhinolaryngology , 2009, DOI: 10.1590/S1808-86942009000600015
Abstract: epistaxis is a common clinical condition and in most public hospitals these patients received nasal packing and were admitted to the hospital as initial management strategies. however, little is known about the follow-up of these patients after they leave the hospital. aim: to identify the clinical outcome of patients treated for epistaxis following discharge. materials and methods: we analyzed the results of questionnaires from patients hospitalized for non-traumatic epistaxis between march 2006 and march 2007. study design: cohort longitudinal. results: fifty-four of eighty-seven patients answered (62%). epistaxis recurred in 37% of the patients. of the patients who had recurrent bleeding, 70% were hypertensive, 35% were chronic users of acetylsalicylic acid, and 55% used tobacco. forty per cent of the recurrences occurred in the first week after discharge, and fifty per cent needed to return to the emergency room. seventy per cent of those who returned to the emergency room required a second treatment. conclusions: recurrence after epistaxis treatment is common and may occur soon after the initial discharge. although our sample was small, this data suggests the need for a reevaluation of the current treatment mode of patients with epistaxis in the emergency rooms of public hospitals.
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