Articles: emergency-medicine.
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Pediatric emergency care · Dec 1999
Response to child abuse in the pediatric emergency department: need for continued education.
Child abuse is a leading pediatric public health problem. Pediatric emergency physicians are on the front line to identify and respond to child abuse. The physician's response to suspected child abuse cases is influenced by educational content and experience. ⋯ Significant training gaps in postgraduate medical education on response to child abuse for the pediatric emergency subspecialist are identified, as well as perceived obstacles to effective response, which may have implications for designing future curricula.
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In 1996, the Food and Drug Administration released its Final Rule for Waiver of Informed Consent in Certain Emergency Research Circumstances (the Final Rule). The Department of Health and Human Services (DHHS) also released an update of its regulations related to waiver of informed consent in emergency research. These new regulations allow resuscitation research to proceed with a waiver of informed consent under very narrow and specific clinical research circumstances. ⋯ Although this was intentional on the part of the federal regulators so that individual protocols and research environments would direct the development of these patient safeguards, the lack of specific guidance has led to confusion on the appropriate implementation of the new regulations. This article reviews some of the key concepts of the Final Rule, with suggestions on their purpose and meaning. It also reviews the studies that have been approved to date to proceed with waiver of informed consent, and offers suggestions for the process of implementing the requirements of the Final Rule for research involving patients who are unable to give prospective informed consent.