Emergency physicians commonly manage patients with acute respiratory failure who require assisted mechanical ventilation. Several different modes of positive pressure mechanical ventilation can be used to manage these patients when they present to the emergency department. These modes of ventilation have evolved over the last three decades. A comprehensive review ...

An occlusive biological dressing, the Hyphecan cap, was evaluated in the management of full-thickness pulp defects of fingers and thumb in 20 consecutive patients. The cap was applied directly to the tip of the injured finger and allowed to separate gradually over the course of several weeks as new skin ...

It is common practice for emergency physicians to provide i.v. vitamin replacements for alcoholics who present to the emergency department (ED). This article describes vitamin deficiencies in alcoholics and reviews the utility and utilization of vitamins in the emergency department. We conclude that the current data do not support the ...

STUDY OBJECTIVE: To describe the geographic distribution of practice locations for 1995 emergency medicine residency graduates and factors that are important to residents in their choice of practice location. METHODS: Self-administered questionnaires were distributed to Emergency medicine residents who graduated in 1995. The survey ascertained practice city and state, resident ...

Information needs for emergency medicine research and for practice are closely related. A well-developed information system can serve both, allowing data gathered in one setting to be used for the other. To produce the best environment for emergency medicine research, providers should support data standards, promote education in data analysis, ...

OBJECTIVES: To investigate the relation between out of hours activity of general practice and accident and emergency services with deprivation and distance from accident and emergency department. DESIGN: Six month longitudinal study. SETTING: Six general practices and the sole accident and emergency department in Nottingham. SUBJECTS: 4745 out of hours ...

BACKGROUND AND OBJECTIVES: Prior research has demonstrated a change in Advanced Life Support in Obstetrics (ALSO) course attendees' reported comfort with managing specific obstetrical emergencies and procedures before and immediately after participation in an ALSO course. Assessment of longer-term stability of these changes has not been performed. This study measured ...

The emergency department of the future will require the effective integration of information technologies into clinical care. This article proposes strategies for improving information management in emergency medicine to facilitate patient care, public health surveillance, clinical research, medical education, and health care management. Cordell WH, Overhage JM, Waeckerle JF, for ...

STUDY OBJECTIVE: The Science Citation Index "impact factor" is the only available quantitative estimate of a journal's scientific contributions. However, the derivation of this factor contains an intrinsic bias that underestimates the impact of emergency medicine journals. We wished to test the hypothesis that use of an alternative criterion standard ...

STUDY OBJECTIVE: The "impact factor" published in Science Citation Index (SCI) is widely used in the scientific community to measure the relative importance of a medical journal. In contrast to all other indicators of academic growth in emergency medicine, impact factors for emergency medicine journals have remained low and unchanged ...

Emergency Medicine is considered the neglected specialty of contemporary medicine, although it is widely acknowledged that improvement in the outcome of the acutely and critically ill depends on its timely and effective management during the critical first hour [1], the so called "golden hour". The crucial question therefore is whether ...

BACKGROUND AND PURPOSE: Little is known about the practice of manipulation by UK physiotherapists. This study was conducted to discover current practice of, and attitudes towards, manipulation among UK manipulative therapists. METHODS: A postal questionnaire was sent to 300 UK manipulative therapists who were members of two professional associations representing ...

The author reviews the evolution of emergency psychiatric practice over the past 20 years--from the concept of high-dose antipsychotic medication to the more rational treatment approach for acute psychosis made possible by modern pharmacodynamic insight and the availability of new pharmacotherapeutic agents. A decision tree for current practice in the ...

This paper, the second in a series of state-of-the art reviews, examines the evolution and possible medium-term future of information technology (IT) in disaster management. Until the end of the 1970s, civilian application of IT to disaster management was confined to a few specialised departments of universities, large companies and ...

This project reports the publication of a variety of existing curricular resources for emergency medicine on the global Internet in a format that allows hypertext links between related material, timely updates, and end-user feedback. Curricular elements were converted to Hypertext Markup Language with extensive links between related content. The completed ...

The use of ultrasonography, traditionally performed by radiologists, is becoming increasingly widespread in emergency medicine. Consequently, much debate has evolved over whether emergency medicine physicians are qualified to provide this service, and the criteria by which training and credentialing can be achieved. This article discusses training and credentialing guidelines, paths ...

The internet is a communications and information tool which has recently entered the world of accident and emergency (A&E) medicine. It is a worldwide instrument facilitating the dissemination of ideas and clinical information in the specialty. It is being embraced by all disciplines involved in A&E medicine. Part I introduces ...

Structural changes within the health system--particularly in the organization and financing of services--have made new and different opportunities available to physicians interested in management. What types of physicians are currently going into management? How do they compare to others who have been in management for a longer period of time ...

STUDY OBJECTIVE: Tenure was designed to guarantee academic freedom through lifelong job security. Productive research, especially in the basic sciences, is the main criterion for tenure at most institutions; therefore faculty in more clinically focused specialties may experience more difficulty obtaining tenure. We examined the relationship between academic emergency medicine ...

STUDY OBJECTIVE: To study the roles emergency physicians have in a clinical telemedicine network. METHODS: A descriptive analysis of telemedicine consultations conducted by emergency physicians at 1 year of operation of a private clinical telemedicine program. RESULTS: From February 1, 1995, to February 1, 1996, 190 clinical telemedicine consultations were ...

In the year under review, published work has concentrated on two main topics. The first is the etiology, pathophysiology, and natural history of paralytic and incomitant strabismus. No major studies were published but some interesting findings are discussed. The second is surgical results, largely assessed by uncontrolled retrospective data analysis. ...

The Combitube is currently being used in some prehospital cardiac arrest situations and in flight programs for management of airways in trauma patients, as well as in inpatient departments with limited availability to personnel experienced in intubation. The Combitube allows for quick intubation and for continuing airway access while the ...

Medical emergencies can arise in the dental office. Preparedness for these emergencies is predicated on an ability to rapidly recognize a problem and to effectively institute prompt and proper management. In all emergency situations, management is based on implementation of basic life support, as needed. The author describes the appropriate ...

Airway management in the operating room is the responsibility of anesthesiologists, although a variety of personnel may be responsible for airway management outside the operating room. We conducted a survey of anesthesia program directors regarding emergency airway management practices at their institutions. A questionnaire was sent to anesthesia program directors ...

OBJECTIVE: To assess the training that accident and emergency (A&E) senior house officers (SHOs) receive in dealing with eye emergencies, their own perceived level of confidence and competence in managing such cases, and the availability of appropriate equipment in their departments. METHODS: Prospective telephone survey using a standardised structured questionnaire. ...

The objective of this survey was to determine the percentage of unfunded studies published in the four major emergency medicine journals and to examine the sources in funded studies. This study was a retrospective survey of all issues of the four general emergency medicine journals in 1994. Funding was categorized ...

STUDY OBJECTIVE: To obtain current demographic data and information regarding the opinion of a stratified random sample of emergency physicians about the greatest current challenges facing emergency medicine. METHODS: An annual survey was conducted by the American Board of Emergency Medicine (ABEM) using a stratified random sample of 1,004 emergency ...

OBJECTIVE: This article describes a theoretical and practical assessment of the emergency management skills of South Australian paediatric trainees. The aim was to identify strengths and weaknesses so as to optimally orientate future training in this area, and to provide a baseline that could be used to assess effectiveness of ...

While supraventricular tachycardia is a common condition and seldom leads to serious consequences, it can be challenging to treat. Optimal management requires an accurate diagnosis, especially in the distinction between regular and irregular tachycardias; as well as an understanding of the mechanism responsible for the arrhythmia. In this article, the ...

BACKGROUND: Emergency medicine has been recognized as a specialty in western countries. However, in India, most hospitals and medical colleges have no provision for teaching this specialty. This study was done to assess the feasibility of incorporating emergency medicine in the undergraduate medical curriculum. METHODS: Sixty final year undergraduate students ...

The proliferation of sport or recreational divers over the last several decades has resulted in significant increases in the number of patients treated for diving-related emergencies. The treatment of these individuals is no longer confined to a small group of physicians with special training or experience. Rather, community emergency physicians ...

OBJECTIVES: To examine the contribution of general practice organisation, population characteristics and distance to practice attendance rates at four local accident and emergency departments. DESIGN: Practice-based study examining variations in accident and emergency department attendance rates in 105 practices, using routine data from the Family Health Services Authority (FHSA), the ...

Opportunities exist for graduates from the United Kingdom to undertake some of their emergency medicine training in Australia. Guidelines for graduates are presented on when to travel, how to find a position, what information one should obtain about a position, and how to acquire the necessary visa and medical registration. ...

Environmental auditing has emerged as a new industrial management tool in recent years. It involves a careful examination of the organization, management procedures, product development, and equipment for environmental protection. The purpose of an environmental audit, from the toxicological point of view, is to assure that the total risk to ...

Psychotherapy is likely to play a minor or nonexistent role in the future general psychiatrist's training and practice. However, the component skills of recognition and management of the countertransference will remain important. Because psychotherapy training and supervision have been the venues for countertransference learning, the field is in danger of ...

STUDY OBJECTIVE: To determine emergency medicine residents' perspectives and opinions concerning the relevance of injury prevention to emergency medicine and their exposure to formal instruction and readings in this subspecialty area. METHODS: A survey was mailed between November 1992 and February 1993 to all 461 residents and 1992 graduates of ...

Reflective practice has emerged in the U.K. and beyond as an important issue not just in nursing but in many other professions. However, it remains problematic; it is difficult to conceptualize and many aspects of it are open to debate. Reflective practice is also contentious because, at a fundamental level, ...

INTRODUCTION: The institution of an emergency medicine residency in a university-affiliated Level 1 trauma center in July 1993 provided a challenge to develop a curriculum and on-line learning experience for emergency medicine residents in a well-established helicopter program. The purpose of this study was to survey flight crew members, emergency ...

Severe Raynaud's phenomenon is manifested by recurrent painful attacks often associated with digital ulcers, ischemic demarcation and amputation. Usually, a secondary disease process can be defined as a cause of severe Raynaud's phenomenon. Principles of management include treating the events as a medical emergency, carefully diagnosing and treating the underlying ...

Avoidable deaths from asthma continue, even in hospital. Since the management of acute severe asthma is often initiated in the Accident and Emergency department, it is crucial that staff there have adequate knowledge. An anonymous questionnaire, containing items based on chart 6 of the UK guidelines, was completed by 66 ...

OBJECTIVES: To determine the frequency of emergencies in pediatric practices, assess office emergency preparedness, and explore practitioner's reasons for levels of preparedness. DESIGN AND SETTING: Telephone survey of pediatric offices in Fairfield County, Connecticut. SAMPLE: Fifty-one (98%) of 52 offices participated, representing 481 staff. RESULTS: More than 2400 emergencies are ...

In recent years, provider credentialing has emerged as a quality initi ative for managed care organizations (MCOs). To satisfy the quality concerns of insurers, purchasers and patients, network officials are seeking industry accreditation, which requires credentialing. But while many organizations are conducting credentialing, it can be an underutilized and misunderstood ...

Hospital emergency units are submitted to a continuous intensive and polyvalent practice of medicine. In addition to the few experienced physicians, the medical staff is often made up of young and unskilled students and residents. The ability to reach at any time a wide and flexible knowledge is of the ...

This is the 36th and final article in a series of objectives to direct emergency medicine resident experiences on off-service rotations. An understanding of the principles of surgical diagnosis and treatment is an essential component of the practice of emergency medicine. Emergency medicine residents rotating on surgical services require specific ...

The command and control approach is compared with the Emergent Human Resources Model (EHRM) approach to emergency management. Four decades of systematic research shows that a rigid, bureaucratic command and control approach to emergency management generally leads to an ineffective emergency response. Previous studies and our own research suggest that ...

A rare case of a huge carcinoma of the cervix leading to sudden uterovaginal prolapse and incarcerated procidentia, in a postmenopausal woman is presented. The woman presented as an emergency with severe distress. The problem was successfully managed by reducing the uterovaginal prolapse under deep sedation and starting radiotherapy as ...

Future specialty training requirements for emergency medicine may include adequately documented records of procedures and resuscitations performed. A computer database was developed to track these data and to report the experience of one graduating class of nine emergency medicine residents. This study was a prospective survey conducted at a community ...

This is the 35th article in a continuing series of objectives to direct emergency medicine resident experiences on off-service rotations. Vascular and urological complaints are common problems in the emergency department and often lead to consultation with a surgeon. Because an understanding of the principles of surgical diagnosis and treatment ...

This is the 34th article in a continuing series of objectives to direct emergency medicine resident experiences on off-service rotations. Abdominal and gastrointestinal complaints are common problems in the emergency department and often lead to consultation with a surgeon. Because an understanding of the principles of surgical diagnosis and treatment ...

The Core Content for Emergency Medicine (EM) recommends that all emergency physicians be trained to manage the airway, including administering paralytic agents for endotracheal intubation. This study analyzed compliance with the recommendations by reviewing airway management practices at EM residencies. All 96 EM residency directors were sent a 10-item survey ...