Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
-
Pneumonia hospitalization rates are frequently reported as a measure of pneumonia disease burden in the United States. However, a detailed understanding of pneumonia burden in all health care settings, including the emergency department (ED), is essential for measuring the full effect of this disease on the population and planning and evaluating interventions to reduce pneumonia-related morbidity. The aim of this study was to quantify pneumonia-attributable ED visits in the United States among children and adults during the 3-year period July 2006 through June 2009. ⋯ Pneumonia accounts for 2.2% of ED visits in the United States and results in approximately seven to eight ED visits per 1000 persons per year. A substantial proportion of pneumonia cases diagnosed in the ED are managed in treat-and-release ED outpatient visits, highlighting that enumeration of ED visit rates provides important complementary information to hospitalization rates for the assessment of pneumonia burden.
-
Emergency physicians (EPs) frequently evaluate patients at risk for diseases that cause optic disc swelling, and they may encounter conditions that make traditional fundoscopy difficult or impossible. The objective was to assess whether EP-performed point-of-care (POC) ultrasound (US) could accurately assess swelling of the optic disc. ⋯ These data suggest that EP-performed POC US can detect clinically apparent optic disc swelling. Because sonography can be performed readily at the bedside, even in cases where fundoscopy is difficult or impossible, this technique may prove to be a valuable tool for the assessment of optic disc swelling in the emergency department (ED).
-
As residents, we constantly strive to independently manage our patients and develop care plans, while the role of the attending faculty varies between complete supervision and control, to allowing complete autonomy. This concept of attending physicians allowing appropriate autonomy so that residents can develop independence in their practice has been termed entrustment. Patients' and instructors' entrustment of responsibility reflects upon one's preparedness to assume professional responsibility after graduation. ⋯ Some experiences have been incredible as we develop our styles of practice, while others have been incredibly frustrating and soured the learning environment. As third-year residents, we studied the factors that allow faculty to foster an appropriate amount of entrustment and conducted discussions with multiple residents on this topic. We have found several themes of how this can be done well and share these ideas with a goal of improving autonomy for emergency medicine residents.