Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2008
ReviewReview article: leaving the emergency department without being seen.
Patients who leave the ED without being seen (LWBS) are unlikely to be satisfied with the quality of the service provided and might be at risk from conditions that have not been assessed or treated. We therefore examined the available research literature to inform the following questions: (i) In patients who attend for ED care, what factors are associated with the decision to LWBS? (ii) In patients who attend for ED care, are there adverse health outcomes associated with the decision to LWBS? (iii) Which interventions have been used to try to reduce the number of patients who attend for ED care and LWBS? From the available literature, there was insufficient evidence to draw firm conclusions; however, the literature does suggest that patients who LWBS have conditions of lower urgency and lower acuity, are more likely to be male and younger, and are likely to identify prolonged waiting times as a central concern. LWBS patients generally have very low rates of subsequent admission, and reports of serious adverse events are rare. ⋯ Further research is recommended to include comprehensive cohort or well-designed case-control studies. These studies should assess a wide range of related factors, including patient, hospital and other relevant factors. They should compare outcomes for groups of LWBS patients with those who wait and should include cross-sectoral data mapping to truly detect re-attendance and admission rates.
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Emerg Med Australas · Aug 2008
Australasian emergency physicians: A learning and educational needs analysis. Part six: differences in confidence, exposure to learning and expressed learning needs by subgroups of Australasian emergency physicians.
To determine differences in the confidence and learning needs between subgroups of Fellows of the Australasian College for Emergency Medicine (FACEM), according to sex, type of hospital of principal employment, region of practice in Australasia, year of obtaining the fellowship and percentage of hours worked clinically. ⋯ These findings might assist planning CPD for EP.
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Emerg Med Australas · Aug 2008
Australasian emergency physicians: a learning and educational needs analysis. Part five: barriers to CPD experienced by FACEM, and attitudes to the ACEM MOPS programme.
To determine the barriers to continuous professional development (CPD) perceived by Fellows of the Australasian College for Emergency Medicine (FACEM), their opinions on the maintenance of professional standards programme (MOPS), and other aspects of education. ⋯ These findings may assist in facilitating increased participation in CPD by FACEM.
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Emerg Med Australas · Aug 2008
Comparative StudyEffect of a review course on emergency medicine residents' self-confidence.
Several organizations offer review courses designed to guide final-year (postgraduate year five) residents' study for their certification examination. The effect of these courses on residents' confidence is unknown. Self-confidence has been positively linked with examination performance. The present study measures the impact of a review course on fifth-year emergency medicine residents' overall confidence and confidence in their: (i) knowledge and its application; (ii) planned study strategies to master the knowledge/application; and (iii) recognition that mastery of knowledge/application had been achieved. ⋯ A review course increased emergency medicine residents' self-assessed confidence in their knowledge/application, in their study strategies and in their recognition of mastery, beyond the course specifics.
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Emerg Med Australas · Aug 2008
Paediatric and adolescent horse-related injuries: does the mechanism of injury justify a trauma response?
To identify the frequency, variety and disposition of horse-related injury presentations to the ED and to use this information to evaluate the existing institutional trauma team activation criteria following horse-related injuries. ⋯ Although horse-related injury presentations are uncommon, severe injuries do occur. Patients presenting with severe horse-related injuries do not always activate a full trauma team response based on current trauma team activation criteria. These severe injury presentations are supported by a limited trauma team response, which activates on the mechanism of injury. The effectiveness of this as a contingency system needs to be evaluated.