The western journal of emergency medicine
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Opioid exposure has been identified as a contributing factor to the opioid epidemic. Reducing patient exposure, by altering heavy opioid prescribing patterns but appropriately addressing patient pain, may represent one approach to combat this public health issue. Our goal was to create and implement an opioid education program for emergency medicine (EM) interns as a means of establishing foundational best practices for safer and more thoughtful prescribing. ⋯ An opioid reduction education program targeting EM interns was associated with a reduction in opioid prescribing in the ED and at discharge. This may be an effective way to influence early prescribing patterns and best practices of EM interns.
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Blacks in the United States experience greater persistent pain than non-Hispanic Whites across a range of medical conditions, but to our knowledge no longitudinal studies have examined the risk factors or incidence of persistent pain among Blacks experiencing common traumatic stress exposures such as after a motor vehicle collision (MVC). We evaluated the incidence and predictors of moderate to severe axial musculoskeletal pain (MSAP) and widespread pain six weeks after a MVC in a large cohort of Black adults presenting to the emergency department (ED) for care. ⋯ These data indicate that Blacks presenting to the ED for evaluation after MVCs are at high risk for persistent and widespread musculoskeletal pain. Preventive interventions are needed to improve outcomes for this high-risk group.
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Medical and physician assistant (PA) students are often required to have Basic Life Support (BLS) education prior to engaging in patient care. Given the potential role of students in resuscitations, it is imperative to ensure that current BLS training prepares students to provide effective cardiopulmonary resuscitation (CPR). The objective of this study was to assess whether current BLS training produces student providers who can deliver BLS in an American Heart Association (AHA) guideline-adherent manner. ⋯ Following BLS training, medical and PA students met a majority of AHA compressions guidelines, but not ventilations guidelines, for over 70% of CPR cycles. Maintaining compression depth and providing appropriate ventilation volumes represent areas of improvement. Conducting regular practice and involving students in real-life CPR may improve performance.
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Physician assistants (PA) are an important part of emergency department healthcare delivery and are increasingly seeking specialty-specific postgraduate training. Our goal was to pilot the implementation of a PA postgraduate program within an existing physician residency program and produce emergency medicine-PA (EM-PA) graduates of comparable skill to their physician counterparts who have received the equivalent length of EM residency training to date (evaluated at the end of first year of EM training). The curriculum was based on the Society for Emergency Medicine Physician Assistants (SEMPA) recommendations with a special focus on side-by-side training with EM resident physicians. ⋯ We found comparable evaluations between first-year EM-PA and physician trainee cohorts. This program serves as a pilot study to demonstrate the feasibility of collocating clinical and didactic programming for physicians and EM-PAs during their postgraduate training. This brief innovation report outlines the logistics of the clinical and didactic curriculum and provides a summary of outcomes evaluated.
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The coronavirus disease 2019 pandemic forced a rapid transition of in-class residency conferences to online residency conferences; little is known about learners' perceptions of this new didactic environment. Understanding learners' perceptions of virtual classrooms can help inform current and future best practices for online, synchronous, graduate medical education. ⋯ Synchronous online residency conferences were associated with decreased engagement and attention by learners. Simple methods to increase interactivity may help improve the online classroom experience and cultivate novel teaching environments that better support current learning styles.