Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Although more men are diagnosed as having chronic obstructive pulmonary disease (COPD), its prevalence is increasing among women. Little is known about gender differences in exacerbations of COPD. The objective of this study was to determine if acute presentation, management, and outcomes differ among men and women seeking care in the emergency department (ED) for exacerbation of COPD. ⋯ Men and women who present to the ED for treatment of an exacerbation of COPD have substantial differences in long-term medication use, self-treatment during exacerbation, delay in emergency care, and post-ED outcomes. Further studies are warranted to confirm and explain these gender-related differences.
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To determine the sensitivity and specificity of limited emergency ultrasonography of the kidney in diagnosing renal colic. ⋯ Emergency ultrasonography of the kidneys shows very good sensitivity and specificity for diagnosing renal colic in patients with flank pain and hematuria.
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To determine the availability and completeness of selected data elements from administrative and clinical sources for emergency department (ED) visits in a national pediatric research network. ⋯ Data elements important in emergency medical care for children are frequently missing in existing administrative and medical record sources; completeness varies widely across EDs. Researchers must be aware of these limitations in the use of existing data when planning studies.
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Comparative Study
Assessment of a new method to distinguish esophageal from tracheal intubation by measuring the endotracheal cuff pressure in a porcine model.
With the knowledge of differences in anatomic structures between the trachea and the esophagus, the authors conducted an animal study to evaluate the usefulness of endotracheal cuff pressure in distinguishing endotracheal and esophageal intubations. ⋯ The cuff pressure in the esophageal intubation was significantly higher than that in the endotracheal intubation under the same inflated volume from 1 to 10 mL. This may provide the basis for an adjunctive, simple, rapid, and reliable method to verify endotracheal intubation.
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Systems-based practice is one of the six core competencies implemented by the Accreditation Council for Graduate Medical Education to direct residency educational outcome assessment and accreditation. Emergency medicine-specific systems-based practice criteria have been described to define the expected knowledge and skill sets pertinent to emergency medicine practitioners. High-fidelity patient simulation is increasingly used in graduate medical education to augment case-based learning. The authors describe a simulation-based curriculum to address the emergency medicine-specific systems-based practice core competency.