Articles: emergency-medicine.
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An emergency medical services (EMS) curriculum, as developed by the SAEM Emergency Medical Services Committee, is provided for the training of emergency medicine residents in EMS.
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This study reviewed 549 malpractice claims filed against emergency physicians in Massachusetts from 1975 through 1993, with a total of $39,168,891 of indemnity and expense spent on the 549 closed claims. High-risk diagnostic categories (chest pain, abdominal pain, wounds, fractures, pediatric fever/meningitis, epiglottitis, central nervous system bleeding, and abdominal aortic aneurysm) accounted for 63.75% of all closed claims and 64.23% of the total indemnity and expense spent on closed claims. Missed myocardial infarction (chest pain) claims accounted for 25.47% of the total cost of closed claims but only 10.38% of closed claims. ⋯ The frequency of high-risk claims decreased in the post-1988 group, largely because of the decline in fracture and wound claims. The category of missed myocardial infarction had a larger percentage of claims closed with indemnity payment than without indemnity payment. This parameter may serve as a marker for the overall seriousness of claims associated with a particular allegation, unlike the average cost per claim, which may be skewed by a few large awards.
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To determine emergency medicine residents' perspectives and opinions concerning the relevance of injury prevention to emergency medicine and their exposure to formal instruction and readings in this subspecialty area. ⋯ Although most emergency medicine residents consider injury prevention pertinent to emergency medicine and important to their training, most perceived a lack of formal instruction on injury prevention during their training and did not consistently read articles on this subspecialty area.
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This study examined the concordance of radiographic readings between emergency department (ED) attending physicians and radiologists in a community teaching hospital. In addition, the incidents of misinterpretations leading to an alteration in patient care were also reviewed. All radiographs obtained from January through October 1993 were initially interpreted by ED attending physicians with subsequent final review by attending radiology staff. ⋯ The most frequently obtained radiographs included: chest, 7,012 (0.33% MR-FU); cervical spine, 1,112 (0.18% MR-FU); ankle, 758 (0.66% MR-FU); knee, 633 (0.32% MR-FU); and foot, 621 (0.97% MR-FU). In this study, 99.0% of all emergency department radiographs were read correctly on initial review by ED attending physicians. Of all misread radiographs, less than half (46%) were deemed clinically significant and required a follow-up intervention.
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We sought to develop a unique educational course for emergency medicine residents that provides the essential knowledge, the practical skills, and the motivation to complete a research project during the residency. A 5-day mandatory course was designed for first-year emergency medicine residents. Unique features of the curriculum include 1) didactic lectures paired with workshops teaching practical skills and 2) the use of a hypothetical research question ("mock project") that is utilized for practical experience at each step and results in an oral presentation of the completed research project. ⋯ Residents' final course presentations were given ratings of "above average" to "superior" by all observing faculty members. Finally, 87.5% of the residents felt that developing a mock project during the course ("hands-on" experience) increased their confidence and interest in conducting future academic research. Thus, an introductory course in research methodology that utilizes didactic lectures paired with appropriate practical workshops and incorporates completion of a mock research project may provide an effective method for teaching emergency medicine residents to conduct research.