This Article Corrects: “Effectiveness of a Pediatric Emergency Medicine Curriculum in a Public Tanzanian Referral Hospital”
This Article Corrects: “Effectiveness of a Pediatric Emergency Medicine Curriculum in a Public Tanzanian Referral Hospital” (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - January 18, 2020 Category: Emergency Medicine Source Type: research

Tricuspid Annular Plane of Systolic Excursion for the Evaluation of Patients with Severe Sepsis and Septic Shock
Introduction:Sepsis is a systemic infection that can rapidly progress into multi organ failure and shock if left untreated. Previous studies have demonstrated the utility of point of care ultrasound (POCUS) in the evaluation of patients with sepsis. However, limited data exists on the evaluation of the tricuspid annular plane of systolic excursion (TAPSE) in patients with sepsis.Methods: We prospectively enrolled patients who presented to the emergency department (ED) with concern for severe sepsis or septic shock in a pilot study. In patients that screened positive, the treating physician then performed POCUS to measure t...
Source: Western Journal of Emergency Medicine - January 14, 2020 Category: Emergency Medicine Source Type: research

CDEM/CORD Special Education Issue 21.1
Clerkship Directors in Emergency Medicine (CDEM)/Council of Residency Directors in Emergency Medicine (CORD) Special Issue in Educational Research and Practice (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - December 21, 2019 Category: Emergency Medicine Source Type: research

Critical Electrocardiogram Curriculum: Setting the Standard for Flipped-Classroom EKG Instruction
Introduction:Electrocardiogram (EKG) interpretation is integral to emergency medicine (EM).1 In 2003 Ginde et al. found 48% of emergency medicine (EM) residency directors supported creating a national EKG curriculum.2 No formal national curriculum exists, and it is unknown whether residents gain sufficient skill from clinical exposure alone.Methods:The authors sought to assess the value of this EKG curriculum, which provides exposure to critical EKG patterns, a framework for EKG interpretation when the diagnosis is not obvious, and implementation guidelines and open access to any interested residency. The Foundations of Em...
Source: Western Journal of Emergency Medicine - December 19, 2019 Category: Emergency Medicine Source Type: research

What ’s All the Chatter? A Mixed-Methods Analysis of Emergency Physicians’ Tweets
We present descriptive tweet characteristics and noteworthy themes.Results:We analyzed 1375 unique tweets from 57 unique users, representing 93% of the influential... (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - December 10, 2019 Category: Emergency Medicine Source Type: research

Misunderstanding the Match: Do Students Create Rank Lists Based on True Preferences?
The objective of this study was to determine whether medical students consistently make rank lists that reflect their true preferences.Methods: A voluntary online survey was sent to third-year students at a single midwestern medical school. Students were given hypothetical scenarios that either should or should not affect their true residency preferences and rated the importance of six factors to their final rank list. The survey was edited by a group of education scholars and revised based on feedback from a pilot with current postgraduate year 1 residents.Results:Of 175 students surveyed, 140 (80%) responded; 63% (88/140...
Source: Western Journal of Emergency Medicine - December 10, 2019 Category: Emergency Medicine Source Type: research

Diving In: Experiential Learning about Research
(Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - December 10, 2019 Category: Emergency Medicine Source Type: research

Efficacy of and Satisfaction with an In-house Developed Natural Rubber Cardiopulmonary Resuscitation Manikin
Introduction:A barrier to cardiopulmonary resuscitation (CPR) training in low-income countries is limitedresources. Our goal was to build a CPR training model of simple design that would provide a goodfeedback system.Methods: We developed a low-cost, Basic Life Support training manikin made entirely of natural rubber.Our in-house manikin provides feedback when performing correct chest compression and rescuebreathing. The properties of the manikin were tested using simulated chest compression in a laboratoryand compared with a commercial manikin. Forty healthy nurse volunteers with CPR experienceperformed CPR in both types ...
Source: Western Journal of Emergency Medicine - December 9, 2019 Category: Emergency Medicine Source Type: research

Establishing an Elective Rotation Director and Its Effect on Elective Opportunities and Satisfaction
Elective rotations are valuable, allowing trainees to personalize their educational experience, focuson areas of weakness, and offer personal and professional development. Emergency medicine(EM) residency program elective rotations may be limited due to the absence of awareness ofopportunities and administrative support. We sought to increase the breadth of elective rotationopportunities, improve residents ’ satisfaction with their elective rotations, and enhance theopportunities for clinical training. To increase the breadth of our elective rotation opportunities, weestablished an elective rotation director—a ...
Source: Western Journal of Emergency Medicine - December 9, 2019 Category: Emergency Medicine Source Type: research

Early Impact of the Western Journal of Emergency Medicine CDEM/CORD Special Issue in Educational Research & amp; Practice
Introduction: In 2015, with a stated goal of disseminating best teaching practices and developing acommunity of educational scholars, the Council of Emergency Medicine Directors (CORD) and theClerkship Directors of Emergency Medicine (CDEM) created an annual Special Issue in EducationalResearch and Practice (Special Issue) in cooperation with theWestern Journal of Emergency Medicine.The intention of this study was to analyze the impact of this effort to date.Methods:Bibliometric data was gathered on all four special issues, 2015-2019, from the Web of Scienceand then verified with the eScholarship website. Authorship, acade...
Source: Western Journal of Emergency Medicine - December 9, 2019 Category: Emergency Medicine Source Type: research

Teaching Endotracheal Intubation Using a Cadaver Versus a Manikin-based Model: a Randomized Controlled Trial
Introduction: The optimal method to train novice learners to perform endotracheal intubation (ETI)is unknown. The study objective was to compare two models: unembalmed cadaver vs simulationmanikin.Methods: Fourth-year medical students, stratified by baseline ETI experience, were randomized 1:1to train on a cadaver or simulation manikin. Students were tested and video recorded on a separatecadaver; two reviewers, blinded to the intervention, assessed the videos. Primary outcome wastime to successful ETI, analyzed with a Cox proportional hazards model. Authors also comparedpercentage of glottic opening (POGO), number of ETI ...
Source: Western Journal of Emergency Medicine - December 9, 2019 Category: Emergency Medicine Source Type: research

Synchronous Online Journal Club Connects Subspecialty Trainees Across Geographic Barriers
Introduction:Journal club holds a well-respected place in medical education by promoting criticalreview of the literature and fostering scholarly discussions. Journal clubs are often not availableto trainees with niche interests due to the geographic limitations of subspecialty programs such assimulation, medical education, disaster medicine, ultrasound, global health, and women ’s health.Methods: A recurring online journal club was held on a quarterly basis to connect simulationfellows. An online conferencing program with screen-sharing capabilities served as the platform forthis scholarly exchange. Articles were pr...
Source: Western Journal of Emergency Medicine - December 9, 2019 Category: Emergency Medicine Source Type: research

The End of the Accidental Academician
(Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - December 9, 2019 Category: Emergency Medicine Source Type: research

Post-interview Thank-you Communications Influence Both Applicant and Residency Program Rank Lists in Emergency Medicine
The objective of this study was to assess the effect of thank-you communications onapplicant- and residency-program rank lists.Methods: Two anonymous, voluntary surveys were sent after the 2018 NRMP Match, one toapplicants who were offered an interview at a single academic site in the 2017-2018 Match cycle,and one to EM PDs nationwide. The surveys were designed in conjunction with a nationallyrecognizedsurvey center and piloted and revised based on feedback from residents and faculty.Results: Of 196 residency applicants, 97 (49.5%) responded to the survey. Of these, 73/95 (76.8%)reported sending thank-you communications. T...
Source: Western Journal of Emergency Medicine - December 9, 2019 Category: Emergency Medicine Source Type: research

Exploring Action Items to Address Resident Mistreatment through an Educational Workshop
Mistreatment of trainees is common in the clinical learning environment. Resident mistreatmentis less frequently tracked than medical student mistreatment, but data suggest mistreatmentremains prevalent at the resident level. To address resident mistreatment, the authors developedan Educational Advance to engage emergency medicine residents and faculty in understandingand improving their learning environment. The authors designed a small-group session withthe following goals: 1) Develop a shared understanding of mistreatment and its magnitude; 2)Recognize the prevalence of resident mistreatment data and identify the most c...
Source: Western Journal of Emergency Medicine - December 9, 2019 Category: Emergency Medicine Source Type: research

A Multimodal Curriculum With Patient Feedback to Improve Medical Student Communication: Pilot Study
The objective of this study was todevelop a multimodal curriculum including direct patient feedback and assess whether it improvescommunication skills as measured by the Communication Assessment Tool (CAT) in fourth-yearmedical students during an emergency medicine (EM) clerkship.Methods: This was a prospective, randomized trial of fourth-year students in an EM clerkship atan academic medical center from 2016-2017. We developed a multimodal curriculum to teachcommunication skills consisting of 1) an asynchronous video on communication skills, and 2)direct patient feedback from the CAT, a 15-question tool with validity evid...
Source: Western Journal of Emergency Medicine - December 9, 2019 Category: Emergency Medicine Source Type: research

Difficult Delivery and Neonatal Resuscitation: A Novel Simulation for Emergency Medicine Residents
Introduction: Newborn delivery and resuscitation are rare, but essential, emergency medicine (EM) skills. We evaluated the effect of simulation on EM residents ’ knowledge, confidence, and clinical skills in managing shoulder dystocia and neonatal resuscitation.Methods:We developed a novel simulation that integrates a shoulder dystocia with neonatal resuscitation and studied a convenience sample of EM residents. Each 15-minute simulation was run with one learner, a simulated nurse, and a standardized patient in situ in the emergency department. The learner was required to reduce a shoulder dystocia and then perform n...
Source: Western Journal of Emergency Medicine - December 9, 2019 Category: Emergency Medicine Source Type: research

Usability of Learning Moment: Features of an E-learning Tool That Maximize Adoption by Students
Introduction: E-learning is widely used in medical education. To maximize the potential of E-learning tools,every effort should be made to encourage adoption by optimizing usability. We created Learning Moment(LM), a web-based application that integrates principles of asynchronous learning and learning portfolios intoa platform on which students can document and share learning experiences that occur during clinical work.We sought to evaluate the usability of LM and identify features that optimize adoption by users.Methods: We implemented LM in August 2016 at a busy, urban, tertiary care emergency department thathosts an em...
Source: Western Journal of Emergency Medicine - December 9, 2019 Category: Emergency Medicine Source Type: research

Targeting Implicit Bias in Medicine: Lessons from Art and Archaeology
Implicit bias training is not currently a required component of residency education, yet implicit biasin medicine exists and may influence care provided to patients. We propose an innovative exercisethat allows trainees to explore implicit bias outside of the clinical environment, in an interdisciplinarymanner with museum anthropologists and archaeologists. The curriculum was designed with leadersat the Penn Museum and focuses on differentiating between objective and subjective assessmentsof historical objects. The first part of the exercise consists of a pre-brief, to introduce trainees tobias through the lens of an anthr...
Source: Western Journal of Emergency Medicine - December 9, 2019 Category: Emergency Medicine Source Type: research

Maggots, Mucous and Monkey Meat: Does Disgust Sensitivity Affect Case Mix Seen During Residency?
The objective of this study was to determine whether emergenc yphysicians with higher disgust sensitivity see fewer “disgusting” cases during training.Methods: All EM residents at a midsize urban EM program were eligible to complete the DisgustScale Revised (DS-R). We preidentified cases as “disgust elicitors” based on diagnoses likely toinduce disgust due to physician exposure to bodily fluids, anogenital anatomy, or gross deformity.The “disgust elicitor” case percent was determined by “disgust elicitor” cases seen as the primaryresident divided by the number of cases seen t...
Source: Western Journal of Emergency Medicine - December 9, 2019 Category: Emergency Medicine Source Type: research

A Roadmap for the Student Pursuing a Career in Pediatric Emergency Medicine
We present a comparative analysis of training pathways highlighting majorcurricular differences to aid in students ’ understanding of these training options.Methods: All currently credentialed training programs for each pathway with curricula publishedon their websites were included. We analyzed dedicated educational units (EU) core to all threepathways: emergency department (ED), pediatric-only ED, critical care, and research. Minimumrequirements for primary residencies were assumed for fellowship trainees.Results: Of the 75 Peds-PEM,... (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - December 9, 2019 Category: Emergency Medicine Source Type: research

WestJEM Full-Text Issue
(Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - November 6, 2019 Category: Emergency Medicine Source Type: research

Incidence of Clostridium difficile Infection After Sepsis Protocol Antibiotics
This study was designed toinvestigate those concerns by focusing on in-hospital Clostridium difficile infection (CDI), which is a knowncomplication of exposure to antibiotics.Methods: Our emergency department (ED) recently implemented a protocol to help combat sepsis andincrease compliance with the 2017 Sepsis CMS Core Measures (SEP-1) guidelines. In this single-center,retrospective cohort analysis we queried the electronic health record to gather data on nosocomial CDIand antibiotics prescribed over a five-year period to analyze the effect of the introduction of a sepsisprotocol order set. The primary goal of this study w...
Source: Western Journal of Emergency Medicine - October 25, 2019 Category: Emergency Medicine Source Type: research

Diagnosis of Acute Heart Failure in the Emergency Department: An Evidence-Based Review
Heart failure is a common presentation to the emergency department (ED), which can be confusedwith other clinical conditions. This review provides an evidence-based summary of the currentED evaluation of heart failure. Acute heart failure is the gradual or rapid decompensation of heartfailure, resulting from either fluid overload or maldistribution. Typical symptoms can include dyspnea,orthopnea, or systemic edema. The physical examination may reveal pulmonary rales, an S3 heartsound, or extremity edema. However, physical examination findings are often not sensitive or specific.ED assessments may include electrocardiogram,...
Source: Western Journal of Emergency Medicine - October 24, 2019 Category: Emergency Medicine Source Type: research

Identifying Emergency Department Symptom-Based Diagnoses with the Unified Medical Language System
We describe a method for automated identificationof SBDs from ICD-10 codes using the Unified Medical Language System (UMLS) Metathesaurus.Methods: We mapped discharge diagnosis, with use of ICD-10 codes from a one-month period ofED discharges at an urban, academic ED to UMLS concepts and semantic types. Two physicianreviewers independently manually identified all discharge diagnoses consistent with SBDs. Wecalculated inter-rater reliability for manual review and the sensitivity and specificity for our automatedprocess for identifying SBDs against this “gold standard.”Results: We identified... (Source: Western J...
Source: Western Journal of Emergency Medicine - October 24, 2019 Category: Emergency Medicine Source Type: research

Status of Emergency Signal Functions in Myanmar Hospitals: A Cross-Sectional Survey
Introduction: Low- and middle-income countries (LMICs) have a large percentage of globalmortality and morbidity rates from non-communicable diseases, including trauma. Theestablishment and development of emergency care systems is crucial for addressing thisproblem. Defining gaps in the resources and capacity to provide emergency healthcare in LMICsis essential for proper design and operation of ECS (emergency care services) reinforcementprograms. Myanmar has particular challenges with road access for providing timely emergencymedical care, and a shortage of trained health workers. To examine the ECS capacity in Myanmar,we ...
Source: Western Journal of Emergency Medicine - October 24, 2019 Category: Emergency Medicine Source Type: research

Impact of an Extraglottic Device on Pediatric Airway Management in an Urban Prehospital System
Introduction:Prehospital pediatric endotracheal intubation has lower first-pass success rates compared to adult intubations and in general may not offer a survival benefit. Increasingly, emergency medical services (EMS) systems are deploying prehospital extraglottic airways (EGA) for primary pediatric airway management, yet little is known about their efficacy. We evaluated the impact of a pediatric prehospital airway management protocol change, inclusive of EGAs, on airway management and patient outcomes in children in cardiac arrest or respiratory failure.Methods: Using data from a large, metropolitan, fire-based EMS ser...
Source: Western Journal of Emergency Medicine - October 22, 2019 Category: Emergency Medicine Source Type: research

Challenges Related to the Implementation of an EMS-Administered, Large Vessel Occlusion Stroke Score
This study examines the integration of a modified Rapid Arterial oCcclusion Evaluation (mRACE) score into an existing stroke treatment protocol.Methods: We performed a retrospective review of EMS and hospital charts of patients transported to a single comprehensive stroke center. Adult patients with an EMS provider impression of “stroke/TIA,” “CVA,” or “neurological problem” were included for analysis. EMS protocols mandated the use of the Cincinnati Prehospital Stroke Score (CPSS). The novel protocol authorized the use of the mRACE score to identify candidates for triage directly... (So...
Source: Western Journal of Emergency Medicine - October 21, 2019 Category: Emergency Medicine Source Type: research

Response to “Alternatives to Rapid Sequence Intubation: Contemporary Airway Management with Ketamine”: Ketamine as Monotherapy in Difficult Airways Is Not Ready for Prime Time
Response to “Alternatives to Rapid Sequence Intubation: Contemporary Airway Management with Ketamine”: Ketamine as Monotherapy in Difficult Airways Is Not Ready for Prime Time (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - October 18, 2019 Category: Emergency Medicine Source Type: research

Author Response to: “Ketamine as Monotherapy in Difficult Airways Is Not Ready for Prime Time”
Author Response to: “Ketamine as Monotherapy in Difficult Airways Is Not Ready for Prime Time” (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - October 17, 2019 Category: Emergency Medicine Source Type: research

Ketamine as Monotherapy in Difficult Airways Is Not Ready for Prime Time
Ketamine as Monotherapy in Difficult Airways Is Not Ready for Prime Time (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - October 17, 2019 Category: Emergency Medicine Source Type: research

The Standardized Letter of Evaluation Narrative: Differences in Language Use by Gender
The objective of this study is to examine differences in language used to describe men and women applicants within the SLOE narrative.Methods: All applicants to a four-year academic EM residency program within a single application year with a first rotation SLOE available were included in the sample. We used the Linguistic Inquiry and Word Count (LIWC) program to analyze word frequency within 16 categories. Descriptive statistics, chi-squared, and t-tests were used to describe the sample; gender differences in word frequency were tested for using Mann-Whitney U tests.Results: Of 1117 applicants to the residency program, 82...
Source: Western Journal of Emergency Medicine - October 17, 2019 Category: Emergency Medicine Source Type: research

The Best Technique Is the Technique You ’re Best At Author Response to: “Ketamine as Monotherapy in Difficult Airways Is Not Ready for Prime Time”
The Best Technique Is the Technique You ’re Best At Author Response to: “Ketamine as Monotherapy in Difficult Airways Is Not Ready for Prime Time” (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - October 17, 2019 Category: Emergency Medicine Source Type: research

Safety of Tiered-Dispatch for 911 Calls for Abdominal Pain
The objective of this study was to determine thesafety of BLS-only dispatch to abdominal pain by determining the frequency of time-sensitive events.Methods: This was a retrospective review of electronic health records of one emergency medicalservice provider agency from May 2015-2018. Inclusion criteria were a... (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - October 17, 2019 Category: Emergency Medicine Source Type: research

Vitamin D Deficiency and Long-Term Cognitive Impairment Among Older Adult Emergency Department Patients
Introduction:Approximately 16% of acutely ill older adults develop new, long-term cognitive impairment (LTCI), many of whom initially seek care in the emergency department (ED). Currently, no effective interventions exist to prevent LTCI after an acute illness. Identifying early and modifiable risk factors for LTCI is the first step toward effective therapy. We hypothesized that Vitamin D deficiency at ED presentation was associated with LTCI in older adults.Methods: This was an observational analysis of a prospective cohort study that enrolled ED patients ≥ 65 years old who were admitted to the hospital for an acute il...
Source: Western Journal of Emergency Medicine - October 17, 2019 Category: Emergency Medicine Source Type: research

Predicting Emergency Department “Bouncebacks”: A Retrospective Cohort Analysis
Introduction: The short-term return visit rate among patients discharged from emergency departments (ED) is a quality metric and target for interventions. The ability to accurately identify which patients are more likely to revisit the ED could allow EDs and health systems to develop more focused interventions, but efforts to reduce revisits have not yet found success. Whether patients with a high number of ED visits are at increased risk of a return visit remains underexplored.Methods: This was a population-based, retrospective, cohort study using administrative data from a large physician partnership. We included patient...
Source: Western Journal of Emergency Medicine - October 16, 2019 Category: Emergency Medicine Source Type: research

Another Perspective on Cannabis and Emergency Medicine in Colorado
(Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - October 16, 2019 Category: Emergency Medicine Source Type: research

Barriers to accessing acute care for newly arrived refugees
Introduction: Over the past decade, the number of refugees arriving in the United States (U.S.) has increased dramatically. Refugees arrive with unmet health needs and may face barriers when seeking care. However, little is known about how refugees perceive and access care when acutely ill. The goal of this study was to understand barriers to access of acute care by newly arrived refugees, and identify potential improvements from refugees and resettlement agencies.Methods:This was an in-depth, qualitative interview study of refugees and employees from refugee resettlement and post-resettlement agencies in a city in the Nor...
Source: Western Journal of Emergency Medicine - October 16, 2019 Category: Emergency Medicine Source Type: research

Time Cost of Standardized Nursing Screens in the Emergency Department
Introduction: Various policies require that screening questions be asked of all patients who present to the emergency department (ED). No studies have previously examined the potential time costs of standardized screens. Our objective was to analyze the time nursing spent conducting standardized nursing screens and calculate the corresponding time cost.Methods: This was a prospective observational study of ED registered nurses (RN) performing triage assessments on adults presenting to the ED. A study author timed nurses while the RN asked five pre-selected questions from their current triage protocol. The time cost of each...
Source: Western Journal of Emergency Medicine - October 16, 2019 Category: Emergency Medicine Source Type: research

Predicting Emergency Department “Bouncebacks”: A Retrospective Cohort Analysis
Introduction: The short-term return visit rate among patients discharged from emergency departments (ED) is a quality metric and target for interventions. The ability to accurately identify which patients are more likely to revisit the ED could allow EDs and health systems to develop more focused interventions, but efforts to reduce revisits have not yet found success. Whether patients with a high number of ED visits are at increased risk of a return visit remains underexplored.Methods: This was a population-based, retrospective, cohort study using administrative data from a large physician partnership. We included patient...
Source: Western Journal of Emergency Medicine - October 16, 2019 Category: Emergency Medicine Source Type: research

Impact of Global Budget Revenue Policy on Emergency Department Efficiency in the State of Maryland
Introduction: On January 1, 2014, the State of Maryland implemented the Global Budget Revenue (GBR) program. We investigate the impact of GBR on length of stay (LOS) for inpatients in emergency departments (ED) in Maryland.Methods: We used the Hospital Compare data reports from the Centers for Medicare and Medicaid Services (CMS) and CMS Cost Reports Hospital Form 2552-10 from January 1, 2012 –March 31, 2016, with GBR hospitals from Maryland and hospitals from West Virginia (WV), Delaware (DE), and Rhode Island (RI). We implemented difference-in-differences analysis and investigated the impact of GBR implementation o...
Source: Western Journal of Emergency Medicine - October 15, 2019 Category: Emergency Medicine Source Type: research

Author Response to: “Randomized Controlled Trial of Simulation vs Standard Training for Teaching Medical Students High-quality Cardiopulmonary Resuscitation: The Methodological Issue”
Author Response to: “Randomized Controlled Trial of Simulation vs Standard Training for Teaching Medical Students High-quality Cardiopulmonary Resuscitation: The Methodological Issue” (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - October 14, 2019 Category: Emergency Medicine Source Type: research

Response to “Randomized Controlled Trial of Simulation vs Standard Training for Teaching Medical Students High-quality Cardiopulmonary Resuscitation: The Methodological Issue”
Response to “Randomized Controlled Trial of Simulation vs Standard Training for Teaching Medical Students High-quality Cardiopulmonary Resuscitation: The Methodological Issue” (Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - October 14, 2019 Category: Emergency Medicine Source Type: research

Randomized Controlled Trial of Simulation vs Standard Training for Teaching Medical Students High-quality Cardiopulmonary Resuscitation: The Methodological Issue
(Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - October 14, 2019 Category: Emergency Medicine Source Type: research

Efficacy of a Short Role-Play Training on Breaking Bad News in the Emergency Department
Introduction: Breaking bad news (BBN) in the emergency department (ED) represents a challenging and stressful situation for physicians. Many medical students and residents feel stressed and uncomfortable with such situations because of insufficient training. Our randomized controlled study aimed to assess the efficacy of a four-hour BBN simulation-based training on perceived self-efficacy, the BBN process, and communication skills.Methods: Medical students and residents were randomized into a 160-hour ED clinical rotation without a formal BBN curriculum (control group [CG], n = 31) or a 156-hour ED clinical rotation and a ...
Source: Western Journal of Emergency Medicine - October 14, 2019 Category: Emergency Medicine Source Type: research

An Academic Relative Value Unit System: Do Transparency, Consensus, and Accountability Work?
Introduction:Academic medicine continues to struggle in its efforts to compensate scholarly productivity. Academic achievements receive less recognition compared to clinical work, evidenced by a lack of reduced clinical hours or financial incentive. Core departmental education responsibilities are often distributed inequitably across academic departments. An approach using an incentive program, which emphasizes transparency, equity, and consensus may help academic departments share core education responsibilities and reward scholarly activity.Methods: We launched a two-stage approach to confront the inequitable distributio...
Source: Western Journal of Emergency Medicine - October 14, 2019 Category: Emergency Medicine Source Type: research

Identifying and Overcoming Barriers to Resident Use of Point-of-Care Ultrasound
This study sought to identify and overcome barriers that could prevent resident physicians from performing POCUS during clinical shifts.Methods: This was a two-step process improvement study. First, a survey was deployed to all residents of a three-year academic residency program to identify barriers to clinical use of POCUS. This survey identified the perceived lack of a uniform documenting protocol as the most important barrier to performing POCUS on shift. Second, as an intervention to overcome this barrier, a streamlined documentation protocol was developed and presented to residents. The primary outcome was the number...
Source: Western Journal of Emergency Medicine - October 14, 2019 Category: Emergency Medicine Source Type: research

Musculoskeletal Injuries and Outcomes Pre- and Post- Emergency Medicine Training Program
Introduction: Musculoskeletal injuries (MSI) comprise a large portion of the trauma burden in low- and middle-income countries (LMIC). Rwanda recently launched its first emergency medicine training program (EMTP) at the University Teaching Hospital-Kigali (UTH-K), which may help to treat such injuries; yet no current epidemiological data is available on MSI in Rwanda.Methods: We conducted this pre-post study during two data collection periods at the UTH-K from November 2012 to July 2016. Data collection for MSI is limited and thus is specific to fractures. We included all patients with open, closed, or mixed fractures, her...
Source: Western Journal of Emergency Medicine - October 14, 2019 Category: Emergency Medicine Source Type: research

Emergency Department Recidivism by Older Adults: A Review of Risk Factors and Interventions
Our objective was to review risk factors predictive of older adult recidivism in the emergency department. Certain risk factors and themes commonly occurred in the literature. These recurring factors included increasing age, male gender, certain diagnoses (abdominal pain, traumatic injuries, and respiratory complaints), psychosocial factors (depression, anxiety, poor social support, and limited health literacy), and poor general health (cognitive health and physical functioning). Many of the identified risk factors are not easily modifiable posing a significant challenge in the quest to develop and implement effective inte...
Source: Western Journal of Emergency Medicine - October 14, 2019 Category: Emergency Medicine Source Type: research

Volume 20, Issue 5
(Source: Western Journal of Emergency Medicine)
Source: Western Journal of Emergency Medicine - September 3, 2019 Category: Emergency Medicine Source Type: research