Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Pediatric cardiopulmonary arrest (CPA) outside of the hospital has a very high mortality rate. ⋯ This is one of the largest population-based, prospective cohorts of pediatric CPA reported to date, and it reveals that most pediatric arrests are unwitnessed and receive no bystander CPR. Those that are witnessed most often are caused by respiratory arrests or trauma. Trauma, SIDS, and respiratory disease are the most common etiologies overall. These data are vital to planning large resuscitation trials looking at specific interventions (i.e., increasing bystander CPR) and highlight the need for better strategies for prevention and early recognition.
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Resident teaching is a competency that must be recognized, developed, and assessed. The ACGME core competencies include the role of physician as educator to "educate patients and families" and to "facilitate the learning of students and other health care professionals." Residents spend a significant proportion of their time in teaching activities, and students report achieving much of their clinical learning from their interactions with residents. Although many residents enjoy their critical role as teacher, many do not feel well prepared to teach. ⋯ The goal of these modules is to provide learning objectives and an initial structure through which residents could improve basic teaching skills. Many of these skills are adaptable to residents' interactions with each other and with students, other healthcare professionals, and patients. Each module and corresponding teaching exercises can be found at http://www.saem.org.
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Periodic surveys of research directors (RDs) in emergency medicine (EM) are useful to assess the specialty's development and evolution of the RD role. ⋯ Research productivity of EM residency programs is associated with the presence of dedicated research faculty and staff and with reduced clinical demands for research faculty. Despite perceiving deficiencies in important resources, most RDs are professionally satisfied.
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Pediatric patients often require sedation for diagnostic procedures such as magnetic resonance imaging and computed tomography scanning. In October 2002, a dedicated sedation service was started at a tertiary care pediatric facility as a joint venture between pediatric emergency medicine and pediatric critical care medicine. Before this service, sedation was provided by the department of radiology by using a standard protocol, with high-risk patients and failed sedations referred for general anesthesia. ⋯ The implementation of a dedicated pediatric-sedation service resulted in fewer incomplete studies related to inadequate sedation, in fewer canceled studies secondary to patient illness, in fewer referrals for general anesthesia, and in fewer recorded instances of sedation-associated hypoxia. These findings have important implications in terms of patient safety and resource utilization.
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To obtain a detailed description of the injury scene in an attempt to identify methods for prevention and to describe the morbidity and mortality of children who present to an urban pediatric emergency department (ED) with an injury caused by a falling television. ⋯ Children may present to the ED with injuries caused by falling televisions. These injuries are usually not severe; however, the potential for severe injury exists, and some children may require ICU monitoring. Our data indicate a lack of parental awareness and an absence of primary prevention as a root cause for this problem. Thus, more aggressive education to warn parents about the risk of injury must be implemented so that more families will take the time to place their televisions safely.