Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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The 2008 election brought sweeping political change to Washington, DC. For a variety of reasons, there is also substantial political momentum for reform of our health care system. At the 2008 Association of American Medical Colleges meeting in San Antonio, Texas, the Association of Academic Chairs of Emergency Medicine, meeting in conjunction with the Society for Academic Emergency Medicine, chose to examine the topic of "advocacy and political influence." This article summarizes comments made at the meeting and develops the argument that expertise in health policy and political advocacy are valuable skills that should be considered legitimate components of scholarly activity in academic emergency medicine. Strategies for effective advocacy of issues relevant to emergency medicine and emergency patient care are also discussed.
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Randomized Controlled Trial Multicenter Study
Antibiotic prescriptions are associated with increased patient satisfaction with emergency department visits for acute respiratory tract infections.
Health care providers cite patient satisfaction as a common reason for prescribing antibiotics for viral acute upper respiratory infections (URIs), even though quality performance measures emphasize nonantibiotic treatment for these conditions. In a secondary analysis of a cluster-randomized trial to test a combined patient and physician educational intervention to reduce antibiotic prescribing for URIs, the authors examined whether satisfaction is greater among patients diagnosed with URIs who are prescribed antibiotics in emergency department (ED) settings. ⋯ Antibiotic prescriptions are associated with increased overall patient satisfaction in non-VA, but not VA, ED visits for URIs. Continued efforts to reduce unnecessary prescriptions in these settings must address ways to maintain patient satisfaction and still reduce antibiotic prescriptions.
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This prospective observational study was performed to investigate if the hand position used for external chest compressions is in an optimal position for compressing the ventricles during standard cardiopulmonary resuscitation (CPR). ⋯ The outflow of the left ventricle is affected during standard CPR, resulting in varying degrees of narrowing in the LVOT and/or the aortic root.
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The ability of emergency care research (ECR) to produce meaningful improvements in the outcomes of acutely ill or injured patients depends on the optimal configuration, infrastructure, organization, and support of emergency care research networks (ECRNs). Through the experiences of existing ECRNs, we can learn how to best accomplish this. A meeting was organized in Washington, DC, on May 28, 2008, to discuss the present state and future directions of clinical research networks as they relate to emergency care. ⋯ The most commonly cited weaknesses were studies with too narrow a focus and restrictive inclusion criteria, a vast organizational structure with a risk of either too much or too little central organization or control, and heterogeneity of institutional policies and procedures among sites. Through the survey and structured discussion process involving multiple stakeholders, the authors have identified strengths and weaknesses that are consistent across a number of existing ECRNs. By leveraging the strengths and addressing the weaknesses, strategies can be adopted to enhance the scientific value and productivity of these networks and give direction to future ECRNs.