Articles: emergency-medicine.
-
This is the 34th article in a continuing series of objectives to direct emergency medicine resident experiences on off-service rotations. Abdominal and gastrointestinal complaints are common problems in the emergency department and often lead to consultation with a surgeon. Because an understanding of the principles of surgical diagnosis and treatment is an essential component of the practice of emergency medicine, residents rotating on surgical services require specific goals and objectives to emphasize early patient assessment, identification of the possible need for surgery, and a basic understanding of definitive management.
-
The objective of this study was to determine the degree of association of self-estimated scholastic standing (self-rank) with an independent evaluation of the dean's letter (dean's letter score). Applicants to our emergency medicine residency program were asked to estimate their scholastic standing on the application form. A blinded independent review of the dean's letter for each applicant was performed, and the letter was scored. ⋯ There was also an appreciable relationship between self-rank and final rank in the NRMP Match. Self-rank of scholastic standing by applicants to an emergency medicine residency is strongly associated with dean's letter information. Self-rank may be useful during early screening of applications before dean's letters are available.
-
In an attempt to develop a model to measure the competence of physicians providing emergency care under difficult field conditions, 75 Israeli army medical corps physicians were evaluated through the use of four instruments: a debriefing interview, peer assessment, self-assessment and written examination. The special on-site assessment model was designed to examine actual events, enabling an assessment of performance in real situations rather than simulated cases. ⋯ It was concluded that it is advantageous to use a combination of knowledge (written examination) and performance (peer assessment or self-assessment) measures in order to arrive at a more comprehensive assessment of competence. In addition, the written examination format should be expanded and developed to include more clinical vignettes requiring treatment decisions, making this instrument a more clinically oriented measure of physician competence in trauma care.
-
The Core Content for Emergency Medicine (EM) recommends that all emergency physicians be trained to manage the airway, including administering paralytic agents for endotracheal intubation. This study analyzed compliance with the recommendations by reviewing airway management practices at EM residencies. All 96 EM residency directors were sent a 10-item survey characterizing airway management practices at residency-affiliated emergency departments (EDs). ⋯ The majority of EM residencies are complying with the Core Content recommendations by actively performing intubations using paralytic agents. Anesthesiologists are infrequently consulted in residency-affiliated EDs. Quality assurance of ED intubations is not rigorously monitored by emergency and anesthesiology departments.
-
At this writing, a collaborative partnership has been in place for 30 months between the Boston University Medical Center, the University of Massachusetts Medical Center, the Armenian Ministry of Health, and the Emergency Hospital of Yerevan, Armenia, to improve emergency and trauma care in that city. Fifty-five individuals have traveled to and from the Emergency Hospital, the partner hospital. The collaboration has led to the creation of the Emergency Medical Services Institute (EMSI) at Emergency Hospital, an 800-bed facility that serves as a trauma center and as base for the Yerevan ambulance system. ⋯ To date, 45 nurses have graduated from a 400-hour training program. This partnership program chose an education initiative as the vehicle for interaction between the United States and the formerly Soviet-directed Armenian health care system. Officials of the partner hospital requested assistance in upgrading the skills of its abundant emergency care workforce, citing cardiovascular disease, trauma, and accidents as leading causes of death and disability in Armenia.(ABSTRACT TRUNCATED AT 250 WORDS)