The western journal of emergency medicine
-
Community-associated methicillin resistant Staphylococcus aureus (CA-MRSA) has emerged as the most common cause of skin and soft-tissue infections (SSTI) in the United States. A nearly three-fold increase in SSTI visit rates had been documented in the nation's emergency departments (ED). The objective of this study was to determine characteristics associated with ED performance of incision and drainage (I+D) and use of adjuvant antibiotics in the management of skin and soft tissue infections (SSTI). ⋯ Clinical management of most SSTIs in the U.S. involves adjuvant antibiotics, regardless of I+D. Although not necessarily indicated, CA-MRSA effective therapy is being used for drained SSTI.
-
Observational Study
Analysis of medication errors in simulated pediatric resuscitation by residents.
The objective of our study was to estimate the incidence of prescribing medication errors specifically made by a trainee and identify factors associated with these errors during the simulated resuscitation of a critically ill child. ⋯ Our results indicate that the presence of a clinical pharmacist during the resuscitation of a critically ill child reduces the medication errors made by resident physician trainees.
-
Observational Study
Emergency physician awareness of prehospital procedures and medications.
Maintaining patient safety during transition from prehospital to emergency department (ED) care depends on effective handoff communication between providers. We sought to determine emergency physicians' (EP) knowledge of the care provided by paramedics in terms of both procedures and medications, and whether the use of a verbal report improved physician accuracy. ⋯ EPs in our ED were unaware of many prehospital procedures and medications regardless of the method used to provide this information. The addition of a verbal hand-off report resulted in a modest improvement in overall accuracy.
-
The standard letter of recommendation in emergency medicine (SLOR) was developed to standardize the evaluation of applicants, improve inter-rater reliability, and discourage grade inflation. The primary objective of this study was to describe the distribution of categorical variables on the SLOR in order to characterize scoring tendencies of writers. ⋯ SLOR letter writers do not use the full spectrum of categories for each variable proportionately. Despite the attempt to discourage grade inflation, nearly all variable responses on the SLOR are in the top two categories. Writers use the lowest categories less than 2% of the time. Program Directors should consider tendencies of SLOR writers when reviewing SLORs of potential applicants to their programs.
-
The demands of our rapidly expanding older population strain many emergency departments (EDs), and older patients experience disproportionately high adverse health outcomes. Trainee attitude is key in improving care for older adults. There is negligible knowledge of baseline emergency medicine (EM) resident attitudes regarding elder patients. Awareness of baseline attitudes can serve to better structure training for improved care of older adults. The objective of the study is to identify baseline EM resident attitudes toward older adults using a validated attitude scale and multidimensional analysis. ⋯ EM residents demonstrate an overall positive attitude towards the care of older adults. We noted a longitudinal hardening of attitude in social values, which are more negative in successive PGY-year levels.