Annals of emergency medicine
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The Essonne region of France is situated to the south of Paris. A population of more than 1 million, heavy commercial traffic, and industrial centers mandate first-rate prehospital and hospital emergency medicine. Medical education in France comprises 3 years of basic medical science, followed by 3 years of hospital rotations and a residency of variable length. ⋯ A two-tiered system of BLS ambulances run by the fire department and ALS ambulances run by hospitals provide 24-hour emergency coverage. Because of aggressive triage, only 65% of requests for service result in dispatch of an ambulance. Tasks for physicians involved in emergency medicine in France today include further development of firemen's medical skills, development and use of telemedicine, and accreditation of emergency medicine as a recognized specialty.
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To determine how emergency physicians and nurses spend their time on emergency department activities. ⋯ Emergency physicians and nurses spent almost half of their time on indirect patient care. Physicians spent significantly more time on indirect patient care activities and significantly less time on personal activities than did nurses.
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To compare the efficacy of the Valsalva maneuver with that of carotid sinus massage (CSM) in terminating paroxysmal supraventricular tachycardia (SVT) in the ED. ⋯ Vagal maneuvers are efficacious in terminating about one quarter of spontaneous SVT cases. There is no detectable difference in efficacy between the Valsalva maneuver and CSM. [Lim SH, Anantharaman V, Teo WS, Goh PP, Tan ATH: Comparison of treatment of supraventricular tachycardia by Valsalva maneuver and carotid sinus massage. Ann Emerg Med January 1998;31:30-35.].
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See editorial Objective: Patients with lacerations are most concerned about the ultimate cosmetic appearance of their wound. We evaluated methods to assess the long-term cosmetic appearance by telephone survey.
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We sought to describe the spectrum of illness and number of patients seen by pediatric residents rotating through a pediatric ED. ⋯ The number and type of patients seen by individual residents in this study showed significant variation. Many illnesses were not seen frequently enough for every resident to develop competence solely on the basis of clinical experience during ED rotations. A computerized, easily accessible ED database can be used to track the experience of individual residents or groups of residents. Such tracking would allow residents and program directors to identify areas that may require alternate educational strategies and would also document the residents' experience for future credentialing.