The American journal of emergency medicine
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A study was undertaken to determine if use of a structured review instrument (SRI) increased the perceived overall satisfaction with a journal club in a group of emergency medicine residents. Before and 6 months after the introduction of a structured checklist format for article review, a 5-point Likert scale (1 = worst, 5 = best) was used to assess residents' satisfaction with the journal club, as well as the following subsidiary outcome parameters resident and leader workload, educational value in interpreting the medical literature, and application of the information to clinical practice. Additional measured outcome variables included resident attendance and number of articles read per attendee. ⋯ Following introduction of the SRI, residents were more satisfied with the journal club (3.8 v 3.2, P < .05). There was no change in resident attendance (92% v 71%, P = .65), total articles read (75% v 70%, P = .33), or perceived workload (3.3 v 3.1; P = .3). The use of a SRI was found to increase resident satisfaction and improve the perceived educational value of a journal club without increasing residents' workload or decreasing attendance.
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A case is presented of simultaneous uvulitis and epiglottitis in an afebrile patient without elevation in the white blood cell count. This case is reported to illustrate the need for a high index of suspicion for the rare association of uvulitis and epiglottitis.
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A novel strategy using videotape recordings of initial trauma resuscitations was incorporated into the quality assurance program at a level 1 trauma center. Described are the process of taping the resuscitations, the multidisciplinary nature of the resuscitation team, the security measures taken to assure patient confidentiality, and the review process involved. The videotape review process was incorporated into a multidisciplinary educational trauma conference. ⋯ The videotape process allowed an unblased, indisputable accurate documentation of the sequential application of the protocols of evaluation and resuscitation espoused in the ATLS course. We found 23% overall deviation from ATLS resuscitation principles, with at least one aspect of the resuscitation deviating from expected ATLS performance in 64% of the patients. In addition to documenting adherence to ATLS principles, this study illustrated the impact of the videotape review process on the education of eight senior residents in surgery.