Articles: emergency-medicine.
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Australas Emerg Nurs J · Nov 2014
Multicenter StudyManagement of patients on chemotherapeutic treatment for advanced cancer with acute conditions in the emergency department.
Chemotherapy is increasingly used in people with advanced cancer to palliate symptoms and improve survival. New Zealand provides medical oncology services in a Hub and Spoke model, with an increasing emphasis on delivering treatment at out-patient spoke services, where after hours and urgent care is provided by the Emergency Department (ED). This study sought to describe the factors that influenced the care and clinical decision-making of this group of patients in the ED. ⋯ A more collaborative relationship between Oncology and ED nurses may support the provision of emergency care within the context of active cancer treatment.
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Multicenter Study
Factors Associated With Burnout During Emergency Medicine Residency.
While the prevalence of burnout in practicing emergency physicians has been studied, little is known of the prevalence and risk factors in emergency medicine (EM) residents. The aim of this study was to assess the prevalence of burnout among EM residents and the individual-level factors associated with burnout. ⋯ Burnout is highly prevalent in EM residents. Interventions should be targeted at 1) improving resident autonomy in the emergency department where possible, 2) supervision and instruction on medical decision-making that may affect or teach individuals to cope with risk tolerance, and 3) social supports to reduce work-home conflicts during training.
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Randomized Controlled Trial Multicenter Study
Pediatric Emergency Medicine Asynchronous E-learning: A Multicenter Randomized Controlled Solomon Four-group Study.
Asynchronous e-learning allows for targeted teaching, particularly advantageous when bedside and didactic education is insufficient. An asynchronous e-learning curriculum has not been studied across multiple centers in the context of a clinical rotation. We hypothesize that an asynchronous e-learning curriculum during the pediatric emergency medicine (EM) rotation improves medical knowledge among residents and students across multiple participating centers. ⋯ Asynchronous e-learning is an effective educational tool to improve knowledge in a clinical rotation. Web-based asynchronous e-learning is a promising modality to standardize education among multiple institutions with common curricula, particularly in clinical rotations where scheduling difficulties, seasonality, and variable experiences limit in-hospital learning.
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Multicenter Study
Novel ultrasound guidance system for real-time central venous cannulation: safety and efficacy.
Real-time ultrasound guidance is considered to be the standard of care for central venous access for non-emergent central lines. However, adoption has been slow, in part because of the technical challenges and time required to become proficient. The AxoTrack(®) system (Soma Access Systems, Greenville, SC) is a novel ultrasound guidance system recently cleared for human use by the United States Food and Drug Administration (FDA). ⋯ The AxoTrack(®) system was a safe and effective means of CVC that was used by a variety of health care practitioners.
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Contemp Clin Trials · May 2014
Randomized Controlled Trial Multicenter StudyStudy of Tomography Of Nephrolithiasis Evaluation (STONE): methodology, approach and rationale.
Urolithiasis (kidney stones) is a common reason for Emergency Department (ED) visits, accounting for nearly 1% of all visits in the United States. Computed tomography (CT) has become the most common imaging test for these patients but there are few comparative effectiveness data to support its use in comparison to ultrasound. This paper describes the rationale and methods of STONE (Study of Tomography Of Nephrolithiasis Evaluation), a pragmatic randomized comparative effectiveness trial comparing different imaging strategies for patients with suspected urolithiasis. ⋯ The detailed methodology of STONE will provide a roadmap for comparative effectiveness studies of diagnostic imaging conducted in an ED setting.