J Emerg Med
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Prior studies of admitted geriatric syncope patients suggest that diagnostic tests affect management < 5% of the time; whether this is true among all emergency department (ED) patients with syncope remains unclear. ⋯ Although routine testing is prevalent in ED patients with syncope, the diagnostic yield is relatively low. Nevertheless, some testing, particularly echocardiography, may yield critical findings. Current efforts to reduce the cost of medical care by eliminating nondiagnostic medical testing and increasing emphasis on practicing evidence-based medicine argue for more discriminate testing when evaluating syncope.
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Ultrasound-assisted lumbar puncture in the pediatric emergency medicine setting has not been well established, but ultrasound could serve as a valuable tool in this setting. ⋯ The use of ultrasound in the pediatric emergency setting can be a valuable adjunct with lumbar puncture.
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Disclosing potential future malignancy risks from diagnostic tests that expose children to ionizing radiation in the emergency department may be challenging. ⋯ Approximately one-third of pediatric emergency physicians were able to identify the best available estimate of the malignancy risk from a head CT. Although there are some barriers, many PEM physicians report regularly participating in risk-benefit disclosures.
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For graduating emergency medicine (EM) residents, little information exists as to what attributes department chairs are seeking in hiring new attendings. ⋯ How a physician relates to others was consistently rated as the most important part of the candidate's application. However, finding a job in academic EM is difficult, with graduates having limited job prospects.
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As the specialty of emergency medicine (EM) continues to spread around the world, a growing number of academic emergency physicians have become involved in global EM development, research, and teaching. While academic departments have always found this work laudable, they have only recently begun to accept global EM as a rigorous academic pursuit in its own right. ⋯ Reflecting a growing interest in global health, more of today's EM faculty members are ascending the academic ranks as global EM specialists. Whether attempting to climb the academic ladder as a clinician-educator or clinician-researcher, advanced planning and the firm support of one's academic chair is crucial to the success of the promotion process. Given the relative youth of the subspecialty of global EM, however, it will take time for the pathways to academic promotion to become well delineated.