Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Medical students are taught some procedural skills during medical school, but there is no uniform set of procedures that all students learn before residency. ⋯ In the cohort studied, new PGY1 EM residents had not attained competence in performing LPs from training in medical school. Most new PGY1 residents probably require training, practice, and close, direct supervision of this procedure by attending physicians until the residents demonstrate competent performance.
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Clinical Trial
Assessment of the onset and persistence of amnesia during procedural sedation with propofol.
To assess patients' ability to repeat and recall words presented to them while undergoing procedural sedation with propofol, and correlate their recall with their level of awareness as measured by bispectral index (BIS) monitoring. ⋯ There is a range of BIS scores during which sedated patients are able to repeat words read to them but are not able to subsequently recall these words. Furthermore, patients had no recall of words repeated prior to procedural sedation in BIS ranges associated with recall after procedural sedation, suggestive of retrograde amnesia.
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Published information is limited regarding factors considered by emergency medicine resident candidates when selecting a residency program. ⋯ Residency applicants indicated that the most important factors when selecting residency program(s) were friendliness, environment, interview day, academics, and location.
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Multicenter Study Clinical Trial
Refining Emergency Severity Index triage criteria.
The Emergency Severity Index (ESI) version 3 is a five-level triage acuity scale with demonstrated reliability and validity. Patients are rated from ESI level 1 (highest acuity) to ESI level 5 (lowest acuity). Clinical experience has demonstrated two levels of ESI level 2 patients: those who require immediate intervention and those who are stable to wait for at least ten minutes. Studies have found that few patients are rated ESI level 1, and it has been suggested that revisions to the ESI might result in appropriate reclassification of some sickest level 2 patients as level 1. The purpose of this study was to identify level 2 patients who might be reclassified as level 1 patients. ⋯ Specific clinical findings at triage for a subset of ESI level 2 patients were associated with immediate delivery of lifesaving interventions. Revisions to the ESI level 1 criteria may be beneficial.