The western journal of emergency medicine
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Observational Study
Geospatial Analysis of Pediatric EMS Run Density and Endotracheal Intubation.
The association between geographic factors, including transport distance, and pediatric emergency medical services (EMS) run clustering on out-of-hospital pediatric endotracheal intubation is unclear. The objective of this study was to determine if endotracheal intubation procedures are more likely to occur at greater distances from the hospital and near clusters of pediatric calls. ⋯ In this geographically diverse county the location of intubation procedures was similar to the clustering of pediatric EMS calls, and increased distance from the hospital was associated with reduced odds of intubation after controlling for several potential confounding variables.
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Scholarship is an essential part of academic success. Junior faculty members are often unfamiliar with the grounding literature that defines educational scholarship. In this article, the authors aim to summarize five key papers which outline education scholarship in the setting of academic contributions for emerging clinician educators. ⋯ Five papers on education scholarship, deemed essential by the authors' consensus process, are presented in this paper. These papers may help provide the foundational background to help junior faculty members gain a grasp of the academic scholarly environment. This list may also inform senior faculty and faculty developers on the needs of junior educators in the nascent stages of their careers.
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Unilateral leg swelling with suspicion of deep venous thrombosis (DVT) is a common emergency department (ED) presentation. Proximal DVT (thrombus in the popliteal or femoral veins) can usually be diagnosed and treated at the initial ED encounter. When proximal DVT has been ruled out, isolated calf-vein deep venous thrombosis (IC-DVT) often remains a consideration. The current standard for the diagnosis of IC-DVT is whole-leg vascular duplex ultrasonography (WLUS), a test that is unavailable in many hospitals outside normal business hours. When WLUS is not available from the ED, recommendations for managing suspected IC-DVT vary. The objectives of the study is to use current evidence and recommendations to (1) propose a diagnostic algorithm for IC-DVT when definitive testing (WLUS) is unavailable; and (2) summarize the controversy surrounding IC-DVT treatment. ⋯ When IC-DVT is not ruled out in the ED, the suggested algorithm, although not prospectively validated by a controlled study, offers an approach to diagnosis that is consistent with current data and recommendations. When IC-DVT is diagnosed, current references suggest that a decision between anticoagulation and continued follow-up outpatient testing can be based on shared decision-making. The risks of proximal progression and life-threatening embolization should be balanced against the generally more benign natural history of such thrombi, and an individual patient's risk factors for both thrombus propagation and complications of anticoagulation.
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Comparative Study Observational Study
Comparison of Result Times Between Urine and Whole Blood Point-of-care Pregnancy Testing.
Point-of-care (POC) pregnancy testing is commonly performed in the emergency department (ED). One prior study demonstrated equivalent accuracy between urine and whole blood for one common brand of POC pregnancy testing. Our study sought to determine the difference in result times when comparing whole blood versus urine for the same brand of POC pregnancy testing. ⋯ Our results suggest that the use of whole blood in place of urine for bedside pregnancy testing may reduce the total result turnaround time without significant changes in accuracy in this single-center study.