Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Multicenter Study
Impact of interventions for patients refusing emergency medical services transport.
To evaluate the effect of a documentation checklist and on-line medical control contact on ambulance transport of out-of-hospital patients refusing medical assistance. ⋯ Contact with on-line medical control increased the likelihood of transport of high-risk patients who initially refused medical assistance. The appropriateness of the decreased transport rate of patients not meeting high-risk criteria needs further evaluation.
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To assess whether outcome and first-monitored rhythm for patients who sustain a witnessed, nonmonitored, out-of-hospital cardiac arrest are associated with on-scene CPR provider group. ⋯ Of 217 cardiac arrest victims, 153 (71%) had received BCPR and 64 (29%) had received FRCPR. The BCPR patients were slightly younger (62.4 vs 68.4 years, p = 0.01) and had slightly shorter ALS response intervals (6.4 vs 7.7 minutes, p = 0.02). There was no difference in BLS response time intervals or automatic external defibrillator (AED) use rates. The percentage of patients with a first-monitored rhythm of pulseless ventricular tachycardia/ventricular fibrillation (VT/VF) and the percentage of patients grouped by CPR provider who survived to hospital admission or to hospital discharge were: [see text]
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To define sources of job satisfaction and stress among emergency physicians and assess self-projected career longevity. ⋯ This study confirms the relatively high levels of projected attrition in EM and supports the perception that stress and burnout are associated with the specialty. Differences in job satisfaction and stress between those ABEM diplomates who were residency-trained in EM and those who became eligible for the board examination through practice or special-category eligibility appear minor.
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To determine the effects of a case-based, core content-oriented emergency medicine (EM) curriculum on the basic EM knowledge of senior medical students. ⋯ A case-based EM curriculum coupled with ED clinical experience improves basic EM diagnostic and management knowledge of senior medical students.
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To describe one urban trauma transport system to clarify the impact of transport by nonmedical personnel on patient outcome. ⋯ NP transport of assaulted patients is generally associated with equivalent outcomes in comparison with FM transport in this urban environment. However, these data also provide evidence of an on-scene implicit triage with more severely injured patients generally transported by FMs.