Articles: emergency-medicine.
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The objective expression of the state of knowledge of 6th year students of the Faculty of General Medicine in the field of emergency care is an important factor in the evaluation of their preparation for the medical profession, regardless of the specialty they choose. Knowledge of these data is essential for improvement of undergraduate teaching of emergency care. Suitable application of computer technique can supplement the possibilities how to achieve this. The application of so-called model situations on personal computers makes it possible to extend training of decision taking to all spheres of medical training.
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Whether it's indigent care, cost containment, transfer laws, financially wary HMOs, overcrowding, reimbursement, or emergency-department inefficiency, the factors "putting the squeeze" on emergency medicine seem to multiply with each new survey. These pressures, the authors feel, are not only weakening the provision of emergency care but also strengthening the argument for a national health plan.
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The emergency department is the focal point for many social ills, not the least of which is substance abuse. We conducted a study to determine to what degree substance abuse education is taught in emergency medicine residency training programs. A set of educational objectives was developed by a task force composed of representatives of the American College of Emergency Physicians, the Society of Teachers of Emergency Medicine, and the University Association for Emergency Medicine. ⋯ The data revealed that such topics as narcotic prescription law, patterns of risk, and issues pertaining to substance abuse by physicians were covered by fewer than half of the programs responding. Respondents were generally satisfied with the adequacy of training of residents and faculty in the area of substance abuse; however, they were dissatisfied with the adequacy of available training materials. Recommendations for changes in graduate curriculum as well as avenues for further research are provided.
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Emergency physicians often encounter clinical situations in which medical resuscitation may not coincide with patient expectations. These situations present complicated medical, legal, and ethical dilemmas. The history of the patient's right to refuse treatment as it applies to resuscitative medical care is reviewed. Medical recognition of patient autonomy and legal precedents affirming it are discussed, as are the various types of advance directives, including the living will and durable power of attorney and their clinical uses.