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Asian Pacific Journal of Tropical medicine 2021年第4期14卷 145-156页

作者： Weiyong Sheng Biao Chen Shanjie Fan Zhuanglin Zeng Ying Zhou Kunpeng Huang Xing Cheng Chunyan Cao Banghong Da Ning Zhou Qidi Zhou Qinghua Wang Jun Guo Peng Sun Chuanzhu Lv Xiaoling Fu Jinxiang Zhang Chinese Society of emergency medicine(CSEM) Wuhan Society of Emergency Medicine(WSEM)China

The outbreak of coronavirus disease 2019(COVID-19)was declared a global public health emergency on 31 January *** medicine procedures in emergency Department should be optimized to cope with the current COVID-19 pandemic by providing subspecialty services,reducing the spread of nosocomial infections,and promoting its capabilities to handle emerging ***,the Chinese Society of emergency medicine and Wuhan Society of emergency medicine drafted this consensus together to address concerns of medical staffs who work in emergency *** on in-depth review of COVID-19 diagnosis and treatment plans,literatures,as well as management approval,this consensus proposes recommendations for improving the rationalization and efficiency of emergency processes,reducing the risk of nosocomial infections,preventing hospital viral transmission,and ensuring patient safety.

关键词： COVID-19 emergency medicine Optimization Control Consensue

emergency medicine residencies structure of trainees'administrative experience:A cross-sectional survey

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World Journal of emergency medicine 2018年第3期9卷 187-190页

作者： Kelly Williamson Jeremy Branzetti Navneet Cheema Amer Aldeen Department of emergency medicine Advocate Christ Medical CenterOak LawnIllinois 60453USA Department of emergency medicine NYU Langone HealthNew YorkNY 10016USA Department of emergency medicine University of ChicagoChicagoIllinois 60637USA US Acute Care Solutions CantonOhio 44718USA

BACKGROUND:While the Accreditation Council for Graduate Medical Education(ACGME)mandates that emergency medicine residencies provide an educational curriculum that includes administrative seminars and morbidity and mortality conference,there is significant variation as to how administrative topics are implemented into training *** seek to determine the prevalence of dedicated administrative rotations and details about the components of the ***:In this descriptive study,a 12-question survey was distributed via the CORD listserv;each member program was asked questions concerning the presence of an administrative rotation and details about its *** responses were then analyzed with simple descriptive ***:A total of 114 of the 168 programs responded,leading to a 68%response *** responders,73%have a dedicated administrative rotation(95%CI 64.0 to 80.4).The content areas covered by the majority of programs with a dedicated program include performance improvement(n=68),patient safety(n=64),ED operations(n=58),patient satisfaction(n=54),billing and coding(n=47),and inter-professional collaboration(n=43).Experiential learning activities include review of patient safety reports(n=66)and addressing patient complaints(n=45).Most of the teaching on the rotation is either in-person(n=65)and/or self-directed reading assignments(n=48).The most commonly attended meetings during the rotation include performance improvement(n=60),ED operations(n=59),and ED faculty(n=44).CONCLUSION:This paper provides an overview of the most commonly covered resident administrative experiences that can be a guide as we work to develop an ideal administrative curriculum for EM residents.

关键词： Graduate Medical Education Administration

The use of outcome feedback by emergency medicine physicians: Results of a physician survey

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World Journal of emergency medicine 2019年第1期10卷 14-18页

作者： Rakesh Gupta Isaac Siemens Sam Campbell Division of emergency medicine McMaster University Department of Family and Community medicine University of Toronto Department of emergency medicine Dalhousie University

BACKGROUND: Feedback on patient outcomes is invaluable to the practice of emergency medicine but examples of effective forms of feedback have not been well characterized in the literature. We describe one system of emergency department(ED) outcome feedback called the return visit report(RVR) and present the results of a survey assessing physicians' perceptions of this novel form of feedback. METHODS: An Opinio web-based survey was conducted in 81 emergency physicians(EPs) at three ***: Of the 81 physicians surveyed, 40(49%) responded. Most participants indicated that they frequently review their RVRs(83%), that RVRs are valuable to their practice of medicine(80%), and that RVRs alter their practice in future encounters(57%). Respondents reported seeking other forms of outcome feedback including speaking with other EPs(83%) and reviewing discharge summaries of admitted patients(87%). There was no correlation between demographic data and use of ***: EPs value RVRs as a form of feedback. RVRs could be improved by reducing the observational interval and optimizing report relevance and differential weighting.

关键词： Return visit reports emergency medicine Outcome feedback emergency department information system

emergency medicine as a growing career in Iran： an Internet-based survey

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World Journal of emergency medicine 2016年第3期7卷 196-202页

作者： Shcrvin Farahmand Ehsan Karimialavijeh Hojjat Sheikh Mottahar Vahedi Amirhossein Jahanshir Department of emergency medicine Imam Khomeini Hospital Tehran University of Medical Sciences Tehran 14117- 13137 Iran Department of emergency medicine Shariati Hospital Tehran University of Medical Sciences Tehran 14117-13137 Iran

BACKGROUND: In Iran, few studies have evaluated emergency medicine as a career option. In the present study, we aimed to find out how Iranian emergency-medicine specialists view their specialty as a ***: Following a qualitative study, a Likert-scale questionnaire was developed. Iranian emergency physician specialists who had at least two years' job experience were contacted via email. A uniform link to a Web-based survey and a cover letter that explained the survey were sent to the recipients. We used the Kruskal-Wallis test and post hoc analysis to determine the differences between demographic ***: A total of 109 eligible responses were received, a response rate of 72.63%. Of the responders, 57.8% were 30–40 years of age, 86.2% were male, 86.2% were single, 84.4% were faculty members and 90.8% had fewer than 10 years' job experience. The main problems occurring during the career of Iranian emergency physicians were: insuffi cient income, inadequate recognition of the specialty by the community, inadequate union support, insecurity in the emergency wards, overcrowding, job stresses and night shifts. Despite insufficiency of income, Iranian emergency physicians(EPs) did not care about the financial benefits of patient care. Academic activity had positive effects on the perspectives of Iranian emergency physicians regarding their ***: Iranian emergency physicians and leaders in emergency medicine should struggle to improve the present situation, aiming at an ideal state.

关键词： emergency medicine Career Survey

Outcomes and impact of an advanced clinical ultrasound track in an emergency medicine residency

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World Journal of emergency medicine 2024年第6期15卷 486-489页

作者： Charles W.Kropf David A.Haidar Ryan V.Tucker William Peterson Neil Khanna Rob D.Huang Christopher M.Fung Nik Theyyunni Department of emergency medicine University of Michigan Medical SchoolMichigan 48109USA Department of emergency medicine University of ColoradoColorado 80045USA Department of emergency medicine Henry Ford Health SystemMichigan 48109USA

Point-of-care ultrasound(POCUS)is a core component of emergency medicine(EM)residency training used to guide medical decision making and to enhance procedural competence.[1-3]Many repetitions of POCUS exams are required to achieve competency,and it is difficult to quantify a minimum needed to achieve mastery.[4,5]For EM residents whose career goals require greater depth of knowledge and skill in POCUS,educators can consider expanded training through a professional development track.

关键词： repetition expanded impact

Perceptions of emergency medicine residents on the quality of residency training in the United States and Saudi Arabia

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World Journal of emergency medicine 2018年第1期9卷 5-12页

作者： Ahmad Aalam Mark Zocchi Khalid Alyami Abdullah Shalabi Abdullah Bakhsh Asaad Alsufyani Abdulrahman Sabbagh Mohammed Alshahrani Jesse M.Pines Department of emergency medicine King Abdulaziz University Department of emergency medicine The George Washington University Center for Healthcare Innovation and Policy Research The George Washington University Department of Pediatrics University of Dammam Department of emergency medicine King Abdulaziz Medical City National Guard Hospital Department of emergency medicine University of Toledo Department of emergency medicine King Fahad Medical City

BACKGROUND: We compare educational environments(i.e. physical, emotional and intellectual experiences) of emergency medicine(EM) residents training in the United States of America(USA) and Saudi Arabia(SA).METHODS: A cross-sectional survey study was conducted using an adapted version of the validated Postgraduate Hospital Educational Environment Measure(PHEEM) survey instrument from April 2015 through June 2016 to compare educational environments in all emergency medicine residency programs in SA and three selected programs in the USA with a history of training Saudi physicians. Overall scores were compared across programs, and for subscales(autonomy, teaching, and social Support), using chi-squared, t-tests, and analysis of ***: A total of 219 surveys were returned for 260 residents across six programs(3 SA, 3 USA), with a response rate of 84%. Program-specific response rates varied from 79%–100%. All six residencies were qualitatively rated as "more positive than negative but room for improvement". Quantitative PHEEM scores for the USA programs were significantly higher: 118.7 compared to 109.9 for SA, P=0.001. In subscales, perceptions of social support were not different between the two countries(P=0.243); however, role autonomy(Pemergency medicine residency programs in SA and the three USA programs studied perceive their training as high quality in general, but with room for improvements. USA residency programs scored higher in overall quality. This was driven by more favorable perceptions of role autonomy and teaching. Understanding how residents perceive their programs may help drive targeted quality improvement efforts.

关键词： emergency medicine residents Residency training United States of America Saudi Arabia

emergency medicine providers＇ opioid prescribing practices stratified by gender, age, and years in practice

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World Journal of emergency medicine 2016年第2期7卷 106-110页

作者： Shawn M. Varney Vikhyat S. Bebarta Lisa M. Mannina Rosemarie G. Ramos Victoria J. Ganem Katherine R. Carey Department of emergency medicine University of Texas Health Science Center San Antonio 78229 USA Department of emergency medicine University of Colorado School of Medicine Aurora 80045 USA Department of emergency medicine Mike O'Callaghan Federal Medical Center Nellis 89191 USA Air Force Enroute Care Research Center Fort Sam Houston 78208 USA The Geneva Foundation Tacoma 98402 USA

BACKGROUND: emergency medicine providers(EMPs) prescribe about 25% of opioids, but the effect of EMP risk perception on decisions to prescribe opioids is unknown. This study was undertaken to identify factors that infl uence EMP risk and opioid prescribing ***: We distributed an anonymous questionnaire to EMPs at a military trauma and referral center. Response frequencies and distributions were assessed for independence using the Chi-square ***: Eighty-nine EMPs completed the questionnaire(100% response). Respondents were primarily younger male physicians(80%) in practice under fi ve years(55%). Male EMPs were more likely to prescribe more opioid tablets than female ones both when and when not concerned for opioid misuse(P<0.001, P<0.007, respectively). Of the providers, 70% stated that patient age would inf luence their prescribing decisions. Hydrocodone and oxycodone were the opioids prescribed most frequently. About 60% of the providers reported changing their prescribing behavior would not prevent opioid misuse. Additionally, 40% of the providers believed at least 10% of patients seen at this military ED misused ***: Female EM providers reported prescribing fewer opioid tablets. Patient age infl uenced prescribing behavior, but the effect is unknown. Finally, EM providers reported that altering their prescribing behavior would not prevent prescription opioid misuse.

关键词： Prescription opioid misuse emergency medicine provider Prescribing practices

German critical incident reporting system database of prehospital emergency medicine: Analysis of reported communication and medication errors between 2005–2015

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World Journal of emergency medicine 2016年第2期7卷 90-96页

作者： Christian Hohenstein Thomas Fleischmann Peter Rupp Dorothea Hempel Sophia Wilk Johannes Winning Department of emergency medicine University Hospital Jena Department of emergency medicine Westküstenklinikum Heide Department of emergency medicine Ubbo-Emmius-Klinik Department of Gastroenterology University Hospital Jena Department of Anaesthesiology and Intensive Care medicine University Hospital Jena

BACKGROUND: Communication failure in prehospital emergency medicine can affect patient safety as it does in other areas of medicine as well. We analyzed the database of the critical incident reporting system for prehospital emergency medicine in Germany retrospectively regarding communication ***: Experts of prehospital emergency medicine and risk management screened the database for verbal communication failure, non-verbal communication failure and missing communication at ***: Between 2005 and 2015, 845 reports were analyzed, of which 247 reports were considered to be related to communication failure. An arbitrary classifi cation resulted in six different kinds: 1) no acknowledgement of a suggestion; 2) medication error; 3) miscommunication with dispatcher; 4) utterance heard/understood improperly; 5) missing information transfer between two persons; and 6) other communication ***: Communication defi cits can lead to critical incidents in prehospital emergency medicine and are a very important aspect in patient safety.

关键词： Critical incident reporting system Prehospital emergency medicine Communication error Medication error

Simulation-based assessment for the emergency medicine milestones: a national survey of simulation experts and program directors

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World Journal of emergency medicine 2024年第4期15卷 301-305页

作者： Afrah A Ali Ashley Crimmins Hegang Chen Danya Khoujah Department of emergency medicine University of Maryland School of MedicineBaltimore 21201USA Department of Epidemiology and Public Health University of Maryland School of MedicineBaltimore 21201USA Department of emergency medicine AdventHealth TampaTampa 33606USA

The focus of outcome-based education has shifted from the process of training to the end“product”of *** has necessitated a reframing of the teaching,learning,and ***,in 2013,the Accreditation Council for Graduate Medical Education(ACGME)implemented the educational milestones for all accredited residencies and fellowship programs.[1]The milestones have been described as“developmentally based,specialty-specific achievements that residents are expected to demonstrate at established intervals as they progress through training.”[1]Milestones are based on the six core competencies established by the ACGME and American Board of Medical Specialties(ABMS),which consist of medical knowledge(MK),patient care(PC),interpersonal and communication skills(ICS),practice-based learning and improvement(PBLI),professionalism(PROF),and systems-based practice(SBP).[2,3]ACGME,in conjunction with the American Board of emergency medicine(ABEM),drafted 23 detailed subcompetencies relevant to emergency medicine(EM).[4]

关键词： Miles milestone education

Comparison of exogenous melatonin versus placebo on sleep efficiency in emergency medicine residents working night shifts： A randomized trial

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World Journal of emergency medicine 2018年第4期9卷 282-287页

作者： Shcrvin Farahmand Masoume Vafaeian Elnaz Vahidi Atefeh Abdollahi Shahram Baghcri-Hariri Ahmad Reza Dehpour emergency medicine Department Imam Khomeini Hospital Tehran University of Medical Sciences Tehran Iran emergency medicine Department Shariati Hospital Tehran University of Medical Sciences Tehran Iran emergency medicine Department Sina Hospital Tehran University of Medical Sciences Tehran Iran Department of Pharmacology Tehran University of Medical Sciences Tehran Iran

BACKGROUND: Sleep deprivation resulting from night shifts, is a major cause of burnout among physicians. Exogenous melatonin may improve sleep quality in night-shift workers. The study aims to compare the effectiveness of melatonin versus placebo on sleep effi ciency in emergency medicine(EM) residents. METHODS: A randomized, double-blind, replicated crossover trial was performed on EM residents. This study consisted of 4 phases within a month with intervention periods of 2 nights and washouts of 6 days. In our study, EM residents had nine-hour shifts on 6 consecutive days, 2 mornings, 2 evenings and 2 nights and then 2 days off. At the end of shifts' cycle, 24 EM residents were given 3 mg melatonin or placebo(12 in each arm of the study) for 2 consecutive nights after the second night shift with crossover to the other arm after a six-day off drug. This crossover intervention was repeated for two more another time. Finally, we created 48 cases and comparisons in each arm. Different items related to sleep quality were assessed and compared both within the same group and between the two groups. RESULTS: In the melatonin group, daytime sleepiness(calculated by Karolinska Sleep Scale) had a signifi cant reduction after taking the second dose of drug(P=0.003) but the same result was not observed when comparing the 2 groups. Mood status(calculated by Profile of Mood States) showed no remarkable difference between the 2 groups. CONCLUSION: Melatonin might have a limited benefi t on sleep quality in EM residents working night shifts.

关键词： Melatonin Placebo emergency medicine Night shift Sleep