J Emerg Med
-
Comparative Study
Prehospital cardiac arrest survival and neurologic recovery.
Many studies of prehospital defibrillation have been conducted but the effects of airway intervention are unknown and neurologic follow-up has been incomplete. A non-randomized cohort prospective study was conducted to determine the effectiveness of defibrillation in prehospital cardiac arrest. Two ambulance companies in the study area developed a defibrillation protocol and they formed the experimental group. ⋯ No effect of defibrillation was found on survival to hospital discharge. However, endotracheal intubation improved survival in defibrillated patients. Survivors had a good functional outcome.
-
Reported is the case of a 24-year-old female who presented to the Emergency Department complaining of lower abdominal pain and vaginal bleeding, whose initial transvaginal ultrasound was interpreted as showing a viable intrauterine pregnancy (IUP) of 8 weeks gestation. Repeat transvaginal ultrasound during a subsequent Emergency Department (ED) visit 3 days later revealed bilateral ectopic pregnancies of 6.5 weeks gestation. ED physicians should be familiar with the limitations of transvaginal sonography, and should be wary of early "intrauterine" pregnancies that are diagnosed ultrasonographically by inexperienced operators.
-
The hospital emergency department (ED) has become an important means of access to health care for the elderly. Inadequacies in the current health care system for the elderly are reflected in their high utilization rates of the ED, continuing questions about the appropriateness of elderly ED patients, differences in the ED care offered the elderly versus the young, and poor coordination of care to and from the ED. ⋯ Economic, legal, and ethical issues that have changed the way medicine is practiced in other settings are finally reaching the sector of emergency services. The current and future roles of emergency medicine services, and the impact these issues will have on the practice of emergency medicine, are discussed.
-
Emergency medicine is on the front line of many important health issues, such as access for the poor and uninsured, the AIDS epidemic, and domestic violence. Virtually all key policy issues relating to emergency medicine deal with the concept of quality. During the 1970s, quality issues dealt with issues of value. ⋯ Key definitions of efficacy, effectiveness, and efficiency are provided. A policy approach to quality definition and assessment is suggested based upon the concepts of continuous quality improvement. The role of emergency physicians in health policy and the future of emergency medicine are discussed.
-
Historical Article
The Canadian Association of Emergency Physicians (CAEP/ACMU).
The Canadian Association of Emergency Physicians is a diverse group of 500 practitioners providing emergency care to the ill and injured. The specialty section of the organization represents Royal College certificants and is 120 strong. The Association, with headquarters in Ottawa, has a major interest in the continuing education of its members, policy development and the improvement of emergency health care in the country.