Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Jehovah's Witnesses refuse blood transfusions out of obedience to the Bible's command to all Christians to abstain from blood. The Witnesses take this scriptural injunction seriously and, of their own initiative, execute advance medical directive cards to communicate their refusal to medical personnel in the event of their incapacity. ⋯ Further, not only does Migden and Braen's analysis subordinate patient values to professional preference in all cases, but the heightened scrutiny protocol they propose is useless because it cannot possibly be implemented in the hypothetical they posit. Finally, their legal analysis is not well founded and practitioners who choose to follow it will do so at their peril.
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To compare amounts of in-hospital time use by PGY1 residents during rotations in emergency medicine (EM), internal medicine (IM), and surgery. This article reports the general study methodology and focuses on the educational aspects of residency time use. ⋯ The general breakdowns of clinical/service, educational, and personal time use by PGY1 residents are proportionately similar for the 3 service rotations. Patient-focused education is the primary mode of education for all services. In-hospital, self-education time is limited. Clinical teaching is largely by nonfaculty. The educational implications of these findings are discussed.
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To compare student performance after Multimedia ACLS Learning System (MM) education compared with that after standard (ST) ACLS education. ⋯ In medical students with no previous ACLS training, structured access to the multimedia ACLS Learning System provides immediate educational outcomes similar to those of a standard ACLS course. Multimedia computer-interactive learning should be enhanced with a short period of hands-on practice.
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Tangential gunshot wounds (TGSWs) to the head are gunshot wounds in which the bullet or bullet fragments do not penetrate the inner table of the skull. ⋯ In this series, 1 in 4 patients with a TGSW to the head had an ICH. All patients with TGSWs to the head should undergo head CT to rule out depressed skull fractures and ICH.