Can J Emerg Med
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The trainee in difficulty is someone who is either marginal or at risk of failing in his or her clinical performance. Dealing effectively with these learners can pose problems even for seasoned medical educators. This article discusses some of the common mistakes made by educators in dealing with the trainee in difficulty and offers suggestions for a systematic approach. Further, the roles of faculty, including the program director and associate dean's office, and some of the legal issues are described.
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Previous studies have shown a low but meaningful survival rate in cases of prehospital cardiac arrest with an initial rhythm of asystole. There may be, however, an identifiable subgroup in which resuscitation efforts are futile. This study identified potential field criteria for predicting 100% nonsurvival when the presenting rhythm is asystole in a Basic Life Support-Defibrillation (BLS-D) system. ⋯ In a BLS-D system, there is a very low but measurable survival rate for prehospital asystolic cardiac arrest. CRIs of over 8 minutes were associated with 100% nonsurvival, whereas unwitnessed arrests with no bystander CPR were not. These data add to the growing literature that will help guide ethical decision-making for protocol development in emergency medical services systems.