Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Multicenter Study Comparative Study
Multivariate predictors of failed prehospital endotracheal intubation.
Conventionally trained out-of-hospital rescuers (such as paramedics) often fail to accomplish endotracheal intubation (ETI) in patients requiring invasive airway management. Previous studies have identified univariate variables associated with failed out-of-hospital ETI but have not examined the interaction between the numerous factors impacting ETI success. This study sought to use multivariate logistic regression to identify a set of factors associated with failed adult out-of-hospital ETI. ⋯ The authors used multivariate logistic regression to identify a set of factors associated with failure to accomplish ETI in adult out-of-hospital patients. Findings from this analysis could provide the basis for clinical protocols or decision rules aimed at minimizing the incidence of out-of-hospital ETI failure.
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Comparative Study
Emergency medicine resident scheduling and patient exposure.
As a result of increasing emergency department census and patient waiting times at the authors' institution, attending physician staffing was increased, followed by a change in resident shift schedule. A study was undertaken to ascertain any change in residents' exposure to patients during the times before and immediately following the staffing and scheduling changes. ⋯ After an increase in attending coverage, there was no change in the number or triage acuity of patients seen by residents. Staggered scheduling may decrease residents' exposure to patients compared with simultaneous scheduling.
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Practice Guideline Guideline
The Society for Academic Emergency Medicine position on optimizing care of the stroke patient.
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To examine the influence of emergency medicine (EM) certification of clinical teaching faculty on evaluations provided by residents. ⋯ Significant differences exist among instructors in the EM setting that affect their teaching rating scores. National certification in EM, academic track, rotation year, and site are all correlated with better teaching performance.
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To determine the effect of simultaneous ambulance diversion at multiple emergency departments (EDs) (gridlock) on transport delays for patients with chest pain. ⋯ Ambulance diversion was associated with delays in out-of-hospital ambulance transport for chest pain patients, but only when it resulted in gridlock. The magnitude of the out-of-hospital delay was the same regardless of the patient's severity of illness.