Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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In the last several years, there has been increasing interest in international emergency medicine (IEM) programs. A number of residency programs offer or encourage international opportunities during residency. The purpose of this study was twofold: 1) to determine whether the availability of international opportunities during residency affected the ranking of emergency medicine (EM) residency programs by graduating medical students and 2) to determine whether prior international health experience among medical students influences interviewing and ranking of residency programs with international opportunities. ⋯ This study suggests that the availability of international opportunities during residency positively affected residency ranking. This relationship was stronger in medical students with prior international health experience.
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Smoking remains the leading preventable cause of morbidity and mortality in the United States. The efficacy of emergency department (ED)-based patient screening and counseling for smoking cessation is not currently known. ⋯ Strong evidence exists, in the primary care setting, that smoking cessation screening and counseling are effective. Limited data exist for ED-based practice, but, based on the burden of disease, relative ease of intervention, and likely efficacy, routine screening of all patients for tobacco use and referral of smokers to primary care and cessation programs are recommended.
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To test the hypothesis that heart rate variability (HRV) can provide an early indication of illness severity among patients presenting to the emergency department (ED) with sepsis. ⋯ A single variable, LFnu, which reflects sympathetic modulation of heart rate, accounted for 40-60% of the variance in illness severity scores among patients presenting to the ED with sepsis. HRV, as reflected in LFnu and the LF/HF ratio and measured with a single brief (5-minute) period of monitoring while in the ED, may provide the emergency physician with a readily available, noninvasive, early marker of illness severity. The threshold effect of LFnu and LF/HF in the prediction of early clinical deterioration was an unexpected finding and should be regarded as hypothesis-generating, pending further study.
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To assess the knowledge and attitudes of law enforcement officers regarding treating out-of-hospital cardiac arrest (OHCA) and using automated external defibrillators (AEDs). ⋯ Limited knowledge and negative attitudes of law enforcement officers regarding their involvement in treating OHCA and using AEDs are commonly present. These factors could result in barriers that negatively impact law enforcement AED programs.