Articles: emergency-medicine.
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The elderly consume medical services in an amount disproportionate to their number. Disability and dementia are commonly underdiagnosed and misunderstood in any emergency department setting. Educating emergency physicians regarding the evaluation of dementia, disability, and abuse is crucial to appropriate management and optimal outcome of these clinical problems.
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Aust J Rural Health · May 1999
The emergency medicine training needs of rural general practitioners.
This study aimed to identify the emergency medicine training needs of rural general practitioners (GPs) in the catchment area of the Hunter Rural Division of General Practice. The GPs were surveyed using a questionnaire in which they were asked about their confidence levels in a number of specific emergency medicine skills, and about the areas of emergency medicine that they saw as priorities for upskilling. ⋯ These emergency medicine domains were also seen as high priorities for upskilling by the majority of the respondents. The study shows that rural doctors need the opportunity to access emergency medicine training that provides upskilling not only in the management of clinical problems, but also in practical procedures.
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Ethical issues in emergency medicine often are accompanied by legal issues. Although the legal aspects of an ethical problem are important factors to take into consideration, the law may not directly address the problem, and following the law does not always ensure an ethical outcome. Emergency physicians should have an understanding of ethics and law, understand the legal aspects of bioethical issues in emergency medicine, and finally have a guide to analyze ethical issues, including the consideration of legal issues that may have an impact on the case.
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Different types of advance directives invite varying interpretation from emergency care professionals. As informed consent of a patient is not always possible to procure in emergency situations, advance directives can provide useful guidelines for clinicians' decision-making processes regarding individual patient care. Specifically communicated instructions establish a course of aggressive or nonaggressive treatment, while general wishes leave the emergency department physician to assume an innate understanding of individual patients while undertaking an active role in decision-making for that patient's care. This article explores the relationship between advance care directives and the emergency department.