Articles: emergency-medicine.
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Despite awake tracheal intubation being considered the safest method of intubation for patients with predicted difficult airways, there is limited evidence and poor availability of training interventions to assist emergency medicine physicians achieve competency in this technique. Here, we describe a novel, cadaver-based course for emergency medicine physicians to acquire skills in awake tracheal intubation. A convenience sample of 15 emergency medicine physicians from across Canada participated in the pilot course. ⋯ Three physicians reported successfully performing awake tracheal intubation in the emergency department during the 3-6-month follow-up period. Expansion of similar courses could help emergency medicine physicians acquire the skills necessary to safely perform awake tracheal intubation. Future studies should focus on optimizing training protocols, with a focus on practical methods to improve long-term skill retention.
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This study aimed to examine how physician performance metrics are affected by the speed of other attendings (co-attendings) concurrently staffing the ED. ⋯ This study examines the association between attending and co-attending speed on physician performance and finds that physicians become faster when a slow co-attending is present and slow down when a fast co-attending is present. How this study might affect research, practice or policy: Physician behavior does not exist in isolation and how an entire ED is staffed may have implications for throughput.
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This initiative assessed the integration of the Human Factors Analysis and Classification System, adapted from aviation, into emergency medicine morbidity and mortality rounds. The objective was to determine whether incorporating the Human Factors Analysis and Classification System could lead to a perceived increase in the overall quality of morbidity and mortality presentations through the standardization of classifying cause factors of medical errors. ⋯ Integrating the Human Factors Analysis and Classification System into morbidity and mortality rounds in the Department of Emergency Medicine was well-received and led to a perceived increase in the quality of cause factor identification. Both presenters and audience members endorsed the use of the Human Factors Analysis and Classification System, suggesting its desirability for sustained integration. The results of this study pave the way for future quality improvement initiatives, including the adaptability of the Human Factors Analysis and Classification System across various medical departments and its potential to enhance cause factor classification in morbidity and mortality rounds.