Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2004
Multicenter StudyIncorrect instruction in the use of the Valsalva manoeuvre for paroxysmal supra-ventricular tachycardia is common.
Success rates for the Valsalva manoeuvre (VM) in treatment of paroxysmal supraventricular tachycardia (SVT) vary with performance technique. This study aimed to assess whether ED doctors instruct their patients to perform the recommended VM technique (supine position for 15 s). ⋯ Few ED doctors correctly instruct their patients in the VM technique recommended for management of SVT. Hence, maximal vagal tone and SVT conversion rates may not be achieved in many cases. The use of the recommended VM technique is encouraged.
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Emerg Med Australas · Aug 2004
Review Comparative StudyThe role of physician staffing of helicopter emergency medical services in prehospital trauma response.
The crewing of Helicopter Emergency Medical Service (HEMS) for scene response to trauma patients is generally considered to be controversial, particularly regarding the role of physicians. This is reflected in HEMS in Australia with some services utilizing physician crewing for all prehospital missions. Others however, use physicians for selected missions only whilst others do not use physicians at all. ⋯ Studies were excluded if they compared physician teams with basic life support teams (BLS) teams rather than paramedics. Ambulance officers were considered to be paramedics where they were able to administer intravenous fluids and use a method of airway management beyond bag-valve-mask ventilation. Studies were excluded if the skill set of the ambulance team was not defined, the level of staffing of the helicopter service was not stated, team composition varied without reporting outcomes for each team type, patient outcome data were not reported, or the majority of the transports were interhospital rather than prehospital transports.
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Emerg Med Australas · Aug 2004
Why don't trainees pass the emergency medicine fellowship examination?
The pass rate in the Australasian College for Emergency Medicine Fellowship exams between 1996 and 2003 inclusive averaged 61%, substantially lower than that of other specialties with comparable training structures. The explanation for this pass rate, which many would judge as unacceptably low, is likely to be multi-factorial. Possible factors that should be considered include trainee selection, training programme structure, the impact of the Director of Emergency Medicine Training, examination preparation, examination validity and examination reliability. Each of these potential factors needs to be addressed in a systematic fashion in the context of inevitable and increasing internal and external scrutiny of the outcomes of our training programme.