Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Thoracic aortic aneurysm and thoracic aortic dissection are related and potentially deadly diseases that present with nonspecific symptoms. Transthoracic echocardiography (TTE) may detect thoracic aortic pathology and is being increasingly performed by the emergency physician at the bedside; however, the accuracy of point-of-care (POC) focused cardiac ultrasound (FOCUS) for thoracic aortic aneurysm and thoracic aortic dissection has not been studied. The objective of this pilot study was to explore the agreement, sensitivity, and specificity of FOCUS for thoracic aortic dimensions, dilation, and aneurysm compared with CT angiography (CTA) as the reference standard. ⋯ In this retrospective pilot study, FOCUS demonstrated good agreement with CTA measurements of maximal thoracic aortic diameter. FOCUS appears to be specific for aortic dilation and aneurysm when compared to CTA, but requires further prospective study.
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Recent efforts to increase emergency medical services (EMS) prehospital research productivity by focusing on reducing systems-related barriers to research participation have had limited effect. The objective of this study was to explore the barriers and motivators to participating in research at the agency and provider levels and to solicit suggestions for improving the success of prehospital research projects. ⋯ This study identified factors that influence the participation of EMS personnel in research and gathered suggestions for improvement. These findings were organized into the PRECEDE/PROCEED planning model that may help researchers successfully plan, implement, and complete prehospital research projects. The authors provide guidance to improve the research process including directly involving EMS providers throughout, a strong theme that emerged from the data. Future work is needed to determine the validity of this model and to assess if these findings are generalizable across prehospital settings other than those affiliated with PECARN.
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The main objective was to explore the relationship between socioeconomic status and the spatial distribution of ambulance calls, as modeled in the island nation of Singapore, at the Development Guide Plan (DGP) level (equivalent to census tracts in the United States). ⋯ This study demonstrates the utility of geospatial analysis to relate population socioeconomic factors with ambulance call volumes. This can serve as a model for analysis of other public health systems.
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Program evaluation remains a critical but underutilized step in medical education. This study compared traditional and retrospective pre-post self-assessment methods to objective learning measures to assess which correlated better to actual learning. ⋯ Students were able to accurately identify, but not quantify, learning using either traditional or retrospective pre-post "self-assessment" measures. Retrospective pre-post self-assessment was more accurate in excluding perceived change in understanding of subject matter that was not taught.