Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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The senior year provides an excellent opportunity for medical students to experience the specialty of emergency medicine for career exploration and skill development. This educational experience can provide the medical school with the means to meet the Liaison Committee on Medical Education recommendation that all graduating students should be capable of handling emergencies. The senior rotation may be a mandatory or elective experience. ⋯ A guide to the development and implementation of a new course is described, in which the course objectives and prerequisites must be set, the core didactic curriculum formulated, the clinical experience defined, and a system of evaluation and feedback developed. Students generally enjoy their emergency medicine experience as it is often their first opportunity to assume primary responsibility for patient care. Clerkship directors can develop their leadership skills in managing a major educational component of the senior year that may prove beneficial in developing a career in the field of medical education.
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Older adults in emergency departments (EDs) can have complicated health problems that defy straightforward diagnosis and management. Implementation of the 11 core principles in the geriatric emergency care model requires changes in care processes. The Domain Management Model (DMM) is one solution to organize care efficiently using a standard language. ⋯ Financial). Specific geriatric cases illustrate improved communication using these standard domains. This model can educate health care staff, facilitate team care, improve flow of relevant information, improve decision making, and facilitate more meaningful interactions with patients.
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The authors sought to validate a clinical decision rule that young adult (younger than 40 years) chest pain patients without known cardiac disease who had either no cardiac risk factors and/or a normal electrocardiogram (ECG) are at low risk (<1%) for acute coronary syndromes (ACS) and 30-day adverse cardiovascular (CV) events. ⋯ A modified clinical decision rule described a group of patients with a 0.14% risk of ACS that was free from 30-day adverse CV events.
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Comparative Study
A novel method of evaluating the impact of secondary brain insults on functional outcomes in traumatic brain-injured patients.
Prior studies suggest that the emergency department (ED) occurrence of secondary brain insults (SBIs), such as systemic hypotension and hypoxia, worsens outcome in patients with traumatic brain injury. However, previous methods of assessing SBIs have been relatively crude, generally only determining the incidence and duration of events. The authors hypothesized that a new method that accounts for the cumulative depth and duration of SBIs would provide a more informative measure that better correlates with outcome. ⋯ New methods of measuring SBIs that take into account depth and duration of episodes may more accurately reflect the influence of these events on outcome after head trauma.