Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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This article is designed to serve as a guide for emergency medicine (EM) educators seeking to comply with the measurement and reporting requirements for Phase 3 of the Accreditation Council for Graduate Medical Education (ACGME) Outcome Project. A consensus workshop held during the 2006 Council of Emergency Medicine Residency Directors (CORD) "Best Practices" conference identified specific measures for five of the six EM competencies--interpersonal communication skills, patient care, practice-based learning, professionalism, and systems-based practice (medical knowledge was excluded). The suggested measures described herein should allow for ease in data collection and applicability to multiple core competencies as program directors incorporate core competency outcome measurement into their EM residency training programs.
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Randomized Controlled Trial
Impact of point-of-care testing in the emergency department evaluation and treatment of patients with suspected acute coronary syndromes.
To assess the impact of point-of-care testing (POCT) for troponin I (cTnI) measurement on the time to anti-ischemic therapy (TAIT) for patients with suspected non-ST-segment elevation acute coronary syndrome (NSTE-ACS) presenting to the emergency department (ED). ⋯ Point-of-care testing for cTnI measurement might be clinically relevant for ED patients with a suspicion of NSTE-ACS, particularly for high-risk patients with a low suspicion of ACS.
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To assess the time to treatment for emergency department (ED) patients with critical hyperkalemia and to determine whether the timing of treatment was associated with clinical characteristics or electrocardiographic abnormalities. ⋯ Recognition of patients with severe hyperkalemia is challenging, and the initiation of appropriate therapy for this disorder is frequently delayed.
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As emergency physicians (EPs) and other noncardiologists incorporate bedside ultrasound (US) and bedside echocardiography (echo) into their practice, confusion has resulted from the differing imaging conventions used by cardiac and general imaging. The author discusses the origin of these differences, current cardiac imaging conventions, and controversies in emergency medicine (EM) regarding adoption of imaging conventions. Also discussed in detail are specific echo windows and experience with different approaches. While there is no perfect solution to merging the differing conventions, it is important that those performing and teaching bedside US and echo have a thorough understanding of the issues involved, and adopt a consistent approach.