Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Clinical and economic factors associated with ambulance use to the emergency department.
Concern about ambulance diversion and emergency department (ED) overcrowding has increased scrutiny of ambulance use. Knowledge is limited, however, about clinical and economic factors associated with ambulance use compared to other arrival methods. ⋯ Ambulance use was related to severity of injury or illness, age, arrival time, and payer status. Patients arriving by ambulance were more likely to be acutely sick and severely injured and had longer ED length of stay and higher average costs, but they were less likely to have private managed care or to leave the ED against medical advice, compared to patients arriving by independent means.
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Bedside teaching is a valuable instructional method that facilitates the development of history and physical examination skills, the modeling of professional behaviors, and the direct observation of learners. The emergency department (ED) is an ideal environment for the practice of bedside teaching, because its high patient volume, increased acuity of illness, and variety of pathology provide plentiful patient-centered teaching opportunities. ⋯ The authors propose several practical strategies to increase bedside teaching by academic emergency physicians (EPs). These techniques emphasize careful preparation and a focused teaching approach to overcome the inherent challenges of a typically busy ED shift.