Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Practice Guideline Guideline
The Society for Academic Emergency Medicine position on optimizing care of the stroke patient.
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To examine the influence of emergency medicine (EM) certification of clinical teaching faculty on evaluations provided by residents. ⋯ Significant differences exist among instructors in the EM setting that affect their teaching rating scores. National certification in EM, academic track, rotation year, and site are all correlated with better teaching performance.
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To determine the effect of simultaneous ambulance diversion at multiple emergency departments (EDs) (gridlock) on transport delays for patients with chest pain. ⋯ Ambulance diversion was associated with delays in out-of-hospital ambulance transport for chest pain patients, but only when it resulted in gridlock. The magnitude of the out-of-hospital delay was the same regardless of the patient's severity of illness.
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To use a geographic information system (GIS) and spatial statistics to describe the geographic variation of burn injuries in children 0-14 years of age in a major metropolitan area. ⋯ This study shows the utility of geographic mapping in providing information about injury patterns within a defined area. The combination of mapping injury rates and spatial statistical analysis provides a detailed level of injury surveillance, allowing for identification of small geographic areas with elevated rates of specific injuries.
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The performance of out-of-hospital systems is frequently evaluated based on the times taken to respond to emergency requests and to transport patients to hospital. The 90th percentile is a common statistic used to measure these indicators, since they reflect performance for most patients. Traditional regression models, which assess how the mean of a distribution varies with changes in patient or system characteristics, are thus of limited use to researchers in out-of-hospital care. ⋯ In other words, ambulance diversion disproportionately affects those patients who already have longer transport intervals. Second, the distribution of transport intervals, conditional on a given set of variables, is positively skewed, and not uniformly or symmetrically distributed. The flexibility of quantile regression models makes them particularly well suited to out-of-hospital research, and they may allow for more relevant evaluation of out-of-hospital system performance.