Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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The objective was to determine the level of agreement between emergency physicians (EPs) and consulting psychiatrists in their diagnosis and disposition of emergency department (ED) patients with behavioral emergencies. ⋯ The 67% agreement between EPs and consulting psychiatrists regarding need for involuntary hold, and 76% agreement regarding final disposition, demonstrate a substantial disagreement between EPs and psychiatrists regarding management and disposition of ED patients with psychiatric complaints. Further studies with patient follow-up are needed to determine the accuracy of the ED assessments by both EPs and consulting psychiatrists.
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Consultation difficulty occurs in hospitals located in many countries, and it is understood that strategies to improve the emergency department (ED) consultation process are needed. The authors constructed a computerized consultation management system in the ED of a tertiary care teaching hospital to improve the consultation process and evaluate the influence of the consultation management system on ED length of stay (LOS) and the throughput process. ⋯ This study found decreased ED LOS by implementation of a computerized consultation management system in a tertiary care teaching hospital. The automated consultation and monitoring process formalized communication between physicians providing ED patient care in the academic ED with high consultation and admission rates.
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During disasters, the public expects that emergency care will be available at a moment's notice. As such, an emergency medical services (EMS) workforce that is trained and prepared for disasters is imperative. The primary objectives of this study were to quantify the amount of individual-level training EMS professionals receive in terrorism and disaster-preparedness, as well as to assess EMS professionals' participation in multiagency disaster drills across the United States. Characteristics of those most likely to have received individual-level training or participated in multiagency disaster drills were explored. The secondary objectives were to assess EMS professional's perception of preparedness and to determine whether the amount of training individuals received was correlated with their perceptions of preparedness. ⋯ While areas where EMS should focus attention for improvement were identified, a majority of nationally certified EMT-Basics and paramedics reported participating in both individual and multiagency disaster-preparedness training. A large majority of respondents reported feeling adequately prepared to respond to man-made and natural disasters and the perception of preparedness correlated with hours of training.
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The following is the keynote address to the First Emergency Medicine Conference in Vietnam, held in the historic city of Hue, March 22-26, 2010. This presentation reviewed the global history of emergency medicine (EM) and presented the need for the establishment of EM residency programs in Vietnam in a culturally sensitive manner. Immediately following this presentation, the Deputy Minister of Health for Vietnam announced recognition of EM as a specialty in Vietnam, and the establishment of EM residency programs, with the first starting October 1, 2010, in association with the Hue College of Medicine.
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Previous studies have demonstrated that ischemia-modified albumin (IMA) is a useful marker for the diagnosis of ischemic events. This study aimed to determine the value of ischemia-modified plasma albumin in the early diagnosis of acute mesenteric ischemia in an experimental model. ⋯ Serum IMA values were not useful in the early diagnosis of acute mesenteric ischemia. Further studies to investigate ischemic and nonischemic conditions that affect IMA levels are needed.