Articles: emergency-medicine.
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The number of hours worked by residents in all specialties has become a controversial issue. Residents often are expected to competently conduct patient care activities and to take educational advantage of clinical experiences in spite of frequent fatigue and sleep deprivation. This survey of residency directors was designed to assess the scheduled clinical time for emergency medicine (EM) residents. ⋯ Emergency medicine resident schedules, as reported by residency directors, fall well within current specialty-specific requirements and compare favorably with the reported numbers for other specialties. However, because large ranges in scheduling parameters were reported, the data may be of value to residency directors, residents, and prospective residents. Most programs did not report a predictable schedule progression of shifts.
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Telecommunications from telephone and radio to two-way audio, video, facsimile (fax), and digital imaging via satellite transmission have been used in responses to disasters. Current and rapidly emerging communications technology offers the prospect of enormously expanded and more efficient application in predisaster, acute, and postdisaster rehabilitation activities. ⋯ Attention will also focus on telemedicine in education and training, disaster response exercises, development of comprehensive plans, and research. Finally, the essential relationship between the routine utilization of telemedicine in predisaster health care and effective employment in disaster situations will be discussed.
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Properly staffed and equipped EDs are essential to a modern system of health care. In a relatively brief period, emergency medicine has emerged as a major medical specialty. ⋯ If sufficient support for the specialty can be secured, the future of emergency medicine is bright. If not, the nature of emergency care in the United States will be profoundly changed for years to come.