Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To determine how often emergency physicians (EPs) scanning the abdominal aorta (AA) of nonfasted emergency department (ED) patients are able to visualize the entire AA. ⋯ Significant portions of AA (at least one third of its length) were not visualized on bedside US in 8% of nonfasted patients; this rate is higher than radiology studies of fasted patients receiving US for evaluation of their aortas.
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Comparative Study
Customer satisfaction in a large urban fire department emergency medical services system.
The purpose of this study was to determine if emergency medical services (EMS) customer satisfaction could be assessed using telephone-survey methods. The process by which customer satisfaction with the EMS service in a large, fire department-based EMS system is reported, and five month results are presented. ⋯ It is possible to conduct a survey of EMS customer satisfaction using telephone-survey methods. Although difficulties exist in contacting patients, useful information is made available with this method. Such surveys should be an integral part of any EMS system's quality-improvement efforts. In this survey, the overwhelming majority of patients, both transported and not transported, were satisfied with their encounter with EMS.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effectiveness of an adult-learning, self-directed model compared with traditional lecture-based teaching methods in out-of-hospital training.
Until recently, the U.S. Army Combat Medic School used a traditional teaching model with heavy emphasis on large group lectures. Skills were taught separately with minimal links to didactics. ⋯ In this study setting, an adult-learning model offers only a modest improvement in cognitive evaluation scores over traditional teaching when measured at the end of the course. Additionally, students in the traditional teaching model assess themselves as proficient more frequently than instructors, whereas instructor and student perception of proficiency more closely matched in the adult-learning model.
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Many people die in emergency departments (EDs) across the United States from sudden illnesses or injuries, an exacerbation of a chronic disease, or a terminal illness. Frequently, patients and families come to the ED seeking lifesaving or life-prolonging treatment. In addition, the ED is a place of transition-patients usually are transferred to an inpatient unit, transferred to another hospital, or discharged home. ⋯ However, these end-of-life care models are based on chronic disease trajectories and have difficulty accommodating sudden-death trajectories common in the ED. There is very little information about end-of-life care in the ED. This article explores ED culture and characteristics, and examines the applicability of current end-of-life care models.