Articles: emergency-medicine.
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Pediatr. Infect. Dis. J. · Nov 1991
Management of the febrile child: a survey of pediatric and emergency medicine residency directors.
We conducted a survey to determine whether there is uniformity in the training of residents regarding the management of febrile children. One hundred forty-three (62%) of 231 pediatric and 39 (53%) of the 73 emergency medicine residency directors responded. There was no uniformity in the definition of a fever. ⋯ Thirty percent of pediatric and 62% of emergency medicine residency directors teach that a blood culture should be obtained from a child with fever without source who is younger than 24 months of age (P less than 0.0005). Nonspecific tests are taught to be used to determine which febrile child should have a blood culture as follows: white blood cell count, 50%; differential, 20%; erythrocyte sedimentation rate, 13%; and C-reactive protein, 2%. There was little uniformity of teaching regarding the approach to the febrile child and there were significant differences in training by specialty.
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There are few data available regarding the emergency department practice of using recently dead patients (RDP) for practice and training in endotracheal intubation (ETI/RDP). We investigated several aspects of practice by means of a survey sent to all 5,397 emergency departments in the country. Of the 992 (18.3%) responses, 537 (54.1%) did practice ETI/RDP; 455 (45.8%) did not (P less than 0.005). ⋯ There was widespread agreement as to the educational value of the practice, although it was more favored in hospitals practicing ETI/RDP than those that do not: 411 of 418 (98%) hospitals practicing ETI/RDP agreed that it was an important component of medical education, as did 240 (80%) of institutions not practicing it (P less than 0.0001). Nearly equal percentages of teaching hospitals (53.8%) and nonteaching facilities (57.9%) engage in ETI/RDP (P = 0.35). Objections to ETI/RDP had been noted in 25% of the institutions where it was practiced.
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This is the ninth article in a continuing series for emergency medicine education. Ophthalmology is the topic. ⋯ This experience is often limited to a 2-week rotation. Therefore, clear goals and objectives take on a greater significance for the resident-in-training.
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The configuration of the air medical crew has been debated since the inception of hospital-based programs in the 1970s. Today, the majority of programs use non-physician crew members with a nurse/paramedic mix as the most common team. ⋯ The key to an effective air medical team, despite the configuration, is adequate training and ongoing flight experience. Unless future studies define the role of physicians on the medical team, the air medical crew configuration will be determined by each flight program based on their perception of individual needs and available resources.