International journal of emergency medicine
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The incidence of delayed emergency calls and the outcome of out-of-hospital cardiac arrest (OHCA) may differ among public facilities when emergency calls are placed by institutional staff. The purpose of this study was to identify the actions prescribed in the rules and/or manuals of public facilities and to clarify whether the incidence of delayed emergency call placement and the outcome of OHCA differ among these facilities. ⋯ Manuals or rules for making emergency calls in our public facilities may contain incorrect information, and emergency calls may be delayed owing to correctable human factors. Such manuals should be checked and revised.
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The RightSpotpH™ indicator is a new device designed to facilitate pH-based confirmation of nasogastric tube placement while minimizing exposure of the operator to nasogastric contents. ⋯ The RightSpotpH™ indicator is sensitive and specific for determination of intragastric pH determination as less than or greater than 4.5 as commonly used for nasogastric tube placement.
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The Emergency Severity Index (ESI) has earned reliability and validity in adult populations but has not been adequately evaluated in pediatric patients. The aim of this study was to assess the reliability of the ESI version 4 and inter-rater reliability measures to evaluate the performance of nurses in the emergency ward. ⋯ ESI scores assigned to the pediatric patients are reliable in the hands of experienced PT nurses and PEM physicians. The very good agreement between PT nurses and PEM physicians, demonstrated in this study, is essential in cooperative work in crowded referral emergency departments and helpful in challenging triage cases.
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The number of international emergency medicine (IEM) fellowships available in the US has grown dramatically since the inception of subspecialty training in 1994 Bayram et al. (Acad Emerg Med 17:748-757, 2010). These fellowships vary according to their curricular structure, intensity of fellow exposure and requirements for program completion. The variety of fellowship structures may have negative connotations for graduates from its fellowships and reflect upon the translatability of their skill sets.The recent article "Core Curricular Elements for International Emergency Medicine Fellowships" Alagappan and Holliman (Emerg Med Clin 23(1):1-10, 2005) was designed as a curricular development tool and enumerates seven foci within the broad field of IEM. ⋯ The result is a plausible curriculum where fellows would gain exposure to more areas of IEM than they may have otherwise while still earning their MPH, working clinical shifts and carrying out academic fellowship requirements. The authors conclude that this structure allows fellowships to continue drawing on their strengths, provides a more well-rounded fellowship experience and increases structure without requiring standardization.