Emergency medicine Australasia : EMA
-
Emerg Med Australas · Apr 2015
Comparative Study Observational StudyComparison of the C-MAC video laryngoscope with direct Macintosh laryngoscopy in the emergency department.
To investigate the first pass success rate, airway grade and complications in two tertiary EDs with the C-MAC video laryngoscope (VL), when compared with standard direct laryngoscopy (DL). ⋯ This is the first observational study of airway management comparing the C-MAC VL with DL blades in an Australian ED population. Our findings revealed that although the C-MAC VL overall did not provide an enhanced view of the larynx over the Macintosh DL, it was superior to DL when the grade was at least grade III. Currently we are unable to reliably predict the grade by any algorithm prior to intubation. Findings from this study suggest that the C-MAC VL should be considered as the first line laryngoscope in all ED intubations not just the ones predicted to be difficult.
-
The Australasian College for Emergency Medicine (ACEM) will introduce high stakes simulation-based summative assessment in the form of Objective Structured Clinical Examinations (OSCEs) into the Fellowship Examination from 2015. Miller's model emphasises that, no matter how realistic the simulation, it is still a simulation and examinees do not necessarily behave as in real life. ⋯ However, the need to validate the OSCE is emphasised by conflicting evidence on correlation with long-term faculty assessments, between essential actions checklists and global assessment scores and variable interrater reliability within individual OSCE stations and for crisis resource management skills. Although OSCEs can be a valid, reliable and acceptable assessment tool, the onus is on the examining body to ensure construct validity and high interrater reliability.
-
Emerg Med Australas · Apr 2015
Low acuity and general practice-type presentations to emergency departments: A rural perspective.
To estimate the number of general practice (GP)-type patients attending a rural ED and provide a comparative rural estimate to a metropolitan study. ⋯ The proportion of GP-type presentations identified using the four methods ranged from 15% to 69%. The results suggest that triage status and self-referral are not reliable indicators of low acuity in this rural area. In rural areas with a shortage of GPs, it is likely that many people appropriately self-refer to ED because they cannot access a GP. The results indicate that the ACEM method might be most useful for identifying GP-type patients in rural ED. However, this requires validation in other regions of Australia.