J Emerg Med
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Multicenter Study Observational Study
Disparities in Adherence to Pediatric Sepsis Guidelines across a Spectrum of Emergency Departments: A Multicenter, Cross-sectional Observational In Situ Simulation Study.
Each year in the United States, 72,000 pediatric patients develop septic shock, at a cost of $4.8 billion. Adherence to practice guidelines can significantly reduce mortality; however, few methods to compare performance across a spectrum of emergency departments (EDs) have been described. ⋯ Using standardized in situ scenarios, we revealed high variability in adherence to the pediatric sepsis guideline across a spectrum of EDs. PEDs demonstrated greater adherence to the guideline than GEDs; however, in adjusted analysis, only composite team experience level of the providers was associated with improved guideline adherence.
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Randomized Controlled Trial
Comparison of the C-MAC Videolaryngoscope and Rigid Fiberscope with Direct Laryngoscopy in Easy and Difficult Airway Scenarios: A Manikin Study.
Intubation is a fundamental skill in maintaining adequate oxygenation and ventilation of seriously ill patients. ⋯ The Bonfils and C-MAC enabled better visualization of the glottic opening when compared with the Macintosh laryngoscope.
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The emergency department (ED) is an ideal environment to teach learners about the "undifferentiated patient." Student learning may be inconsistent because of inherent variability in the ED. Previous research has suggested that standardizing the emergency medicine (EM) clerkship by implementing didactics and requiring students to see patients with particular chief complaints improves educational outcomes. ⋯ A DL model combining clinical and enhanced didactic requirements for an EM clerkship led to greater knowledge gain than the standard curriculum. This model may suggest ways to improve the educational experience in the EM clerkship.
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Although patients with anemia are frequently seen in emergency departments (EDs), studies on patients presenting there with symptomatic chronic anemia--usually iron-deficiency anemia (IDA) caused by occult gastrointestinal bleeding--are lacking. Awareness of predictors of hospitalization could direct the ED triage to the appropriate diagnostic setting. ⋯ While these predictors do not necessarily reflect the need for hospitalization, they are easily evaluated during the initial ED visit and can guide the triage of similar IDA patients to the suitable setting for timely investigation.