Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2004
Why don't trainees pass the emergency medicine fellowship examination?
The pass rate in the Australasian College for Emergency Medicine Fellowship exams between 1996 and 2003 inclusive averaged 61%, substantially lower than that of other specialties with comparable training structures. The explanation for this pass rate, which many would judge as unacceptably low, is likely to be multi-factorial. Possible factors that should be considered include trainee selection, training programme structure, the impact of the Director of Emergency Medicine Training, examination preparation, examination validity and examination reliability. Each of these potential factors needs to be addressed in a systematic fashion in the context of inevitable and increasing internal and external scrutiny of the outcomes of our training programme.
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Emerg Med Australas · Aug 2004
The first year of a formal emergency medicine training programme in Papua New Guinea.
To describe a programme catalyzing the development of emergency medicine in Papua New Guinea (PNG). ⋯ There is now considerable enthusiasm for the development of emergency medicine as the hospital generalists' specialty. Emergency nursing training has also made a start. Limitations on resources will require flexibility to sustain the project. Further support by emergency physicians will be needed.
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To identify the difficulties encountered with the emergency management of morbidly obese patients and formulate recommendations to streamline care. ⋯ Very obese patients present a variety of logistical and medical challenges for EDs. A series of recommendations are made based on available data. Further studies in this area would be desirable to more specifically address ED issues.
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Emerg Med Australas · Aug 2004
ReviewDrotrecogin alfa: a role in emergency department treatment of severe sepsis?
Human protein C is a serine protease that circulates in the blood as an inactive zymogen. It is converted to its active form by interaction with thrombomodulin on the endothelial wall. ⋯ This review describes the physiology of the protein C pathway and its importance in sepsis. It will also focus on the use of drotrecogin alfa in sepsis, and its use in the ED.
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Emerg Med Australas · Aug 2004
ReviewFamily member presence during resuscitation in the emergency department: An Australian perspective.
The practice of family member presence during resuscitation in the ED has attracted widespread attention over the last few decades. Despite the recommendations of international organizations, clinical staff remain reluctant to engage in this practice in many EDs. This paper separates the evidence from opinion to determine the current state of knowledge about this practice. ⋯ Although critics point to the lack of rigour in this body of literature, the current state of knowledge suggests merit in pursuing future research to examine and measure effects of family member presence during resuscitation on patients, family members and healthcare providers.