Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To report on the sixth survey of the Society for Academic Emergency Medicine (SAEM) of emergency medicine faculty salaries, benefits, work hours, and department demographics for all programs accredited by the Residency Review Committee for Emergency Medicine (RRC-EM). ⋯ Reported salaries for full-time emergency medicine residency faculty continue to rise overall but fell for the first time in one region (the Midwest). Academic rank continues to correlate directly with salary. Fellowship training continues to show a negative correlation with salary. Significant regional differences in salaries have been present in all six SAEM surveys.
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To assess waiting times in emergency departments (EDs) for on-call specialist response and how these might vary by facility or neighborhood characteristics. Limited availability of on-call specialists is thought to contribute to ED overcrowding. ⋯ Although the majority of on-call specialists met the federal recommendation of a 30-minute response, those in poor neighborhoods were less likely to do so. One in ten on-call specialists did not respond at all. State and federal policies should focus on making more funding available for on-call specialist panels in poor areas.
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To compare the demographic and injury characteristics of children visiting the emergency department (ED) for nonfatal injuries occurring at school with those of same-aged children who were injured outside of school. ⋯ A significant proportion of injuries to school-aged children occur at school. Notable differences exist between the epidemiology of in- and out-of-school injuries. The nature of these injuries differs by age group. Efforts to reduce school injuries will require that these differences be examined further and incorporated into prevention initiatives.
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Comparative Study
A highly sensitive ELISA D-dimer increases testing but not diagnosis of pulmonary embolism.
To determine the effect of introducing a rapid enzyme-linked immunosorbent assay (ELISA) D-dimer on the percentage of emergency department (ED) patients evaluated for pulmonary embolism (PE), the use of associated laboratory testing, pulmonary vascular imaging, and the diagnoses of PE. ⋯ In the study's academic ED, introduction of ELISA D-dimer testing was accompanied by an increase in PE evaluations, D-dimer testing, and pulmonary vascular imaging; there was no observed change in the rate of PE diagnosis.
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Patients in emergency departments who use methadone frequently use tricyclic antidepressants (TCAs) and/or benzodiazepines (BZDs). This is a potentially dangerous drug combination. The authors hypothesized that the presence of methadone and a TCA, a BZD, or both is associated with an "accidental" overdose (AOD) death more often than a death from any other cause. ⋯ Among the methadone-positive cases, testing positive for a TCA, a BZD, or both was associated with an AOD death.