To determine participant perceptions of Emergency Medicine Crisis Resource Management (EMCRM), a simulation-based crisis management course for emergency medicine.EMCRM was created using Anesthesia (ACRM) as template. Thirteen residents participated in one three pilot courses EMCRM; following didactic session on principles human error and management, the simulated department scenarios instructor-facilitated debriefing. The simulations involved computer-enhanced mannequin simulator...

Medical simulation is a rapidly expanding area within medical education. In 2005, the Society for Academic Emergency Medicine Simulation Task Force was created to ensure that and its members had adequate access information resources regarding this new important topic. One of objectives task force create research agenda use in emergency The authors present here consensus document from suggested areas research. These include opportunities study reflective experiential learning, behavioral team...

National guidelines call for door-to-imaging time (DIT) within 25 minutes suspected acute stroke patients. Studies examining factors that affect DIT have focused primarily on stroke-specific care processes and patient-specific factors. We hypothesized emergency department (ED) crowding is associated with longer DIT.We conducted a retrospective investigation of 1 year consecutive patients in our prospective Code Stroke registry, which included all ED team activations. The registry electronic...

Current health care literature cites communication breakdown and teamwork failures as primary threats to patient safety. The unique, dynamic environment of the emergency department (ED) complexity necessitate development strong interdisciplinary team skills among personnel. As part 2008 Academic Emergency Medicine Consensus Conference on "The Science Simulation in Healthcare," our workshop group identified key theory evidence-based recommendations for design implementation training programs....

Abstract The traditional system of clinical education in emergency medicine relies on practicing diagnostic, therapeutic, and procedural skills live patients. ethical, financial, practical weaknesses this are well recognized, but the alternatives that have been explored to date shown even greater flaws. However, ongoing progress area virtual reality computer‐enhanced simulation is now providing educational applications show tremendous promise overcoming most deficiencies associated with...

Abstract Objective Little is known about accuracy of provider self‐perception opioid prescribing. We hypothesized that an intervention asking emergency department ( ED ) providers to self‐identify their prescribing practices compared group norms—and subsequently providing them with actual data—would alter future controls. Methods This was a prospective, multicenter randomized trial in which all attending physicians, residents, and advanced practice at four s were randomly assigned either no...

Objective: To evaluate construct and content validity as well learners' perceptions of CathSim, a virtual reality intravenous (IV) insertion simulator. Methods: A prospective cohort study design was employed to determine validity, participant survey used ascertain user CathSim. Forty‐one attendings, residents, medical students in emergency medicine anesthesia attempted five simulated IV insertions on Subject performances were scored by the computer, subject simulator measured using Likert...

Emergency departments (EDs) are seeking ways to utilize existing resources more efficiently as they face rising numbers of patient visits. This study explored the impact on wait times and nursing resource demand from addition a fast track, or separate unit for low-acuity patients, in ED using queue-based Monte Carlo simulation MATLAB. The model integrated principles queueing theory expanded discrete event account time-based arrival rates. Additionally, occupancy were modeled analyzed...

Abstract Background Poor care access and lack of proper triage medical complaints leads to inappropriate use acute resources. Mobile integrated health (MIH) programs may offer a solution by providing adaptable on‐demand care. There is little information describing that manage undifferentiated in the community. The objective this study was assess safety feasibility an MIH program responds community older adults. Methods This prospective observational examining pilot program. Seven ambulatory...

<sec> <title>BACKGROUND</title> Suicide is one of the most pressing public health issues in United States, inflicting a devasting toll on families, communities, and society. Individuals with suicide risk often visit emergency departments (EDs) but setting has chronic shortages psychiatric care staffing, which results gaps best practices, prolonged length stay for patients unnecessary inpatient admissions. To improve behavioral prevention we implemented telehealth-based mental evaluations...

Abstract Safety-net emergency departments (EDs) are a critical component of the US health care system, delivering for patients in need, including vulnerable populations. EDs provide unscheduled acute 24 hours day, 7 days week, regardless person's ability to pay. In addition, have transformed beyond their traditional roles providing services and being centers regionalized trauma, cardiac, stroke care, also becoming stewards public by leading screening treatment efforts nonemergent conditions,...

Background Evaluation of neck trauma is a common reason for emergency department (ED) visits. There are several validated clinical decision rules, such as the National Emergency X-Radiography Utilization Study (NEXUS) Cervical Spine (C-spine) Rule, that can be used to risk stratify these patients and identify low-risk who do not require CT imaging. Overutilisation imaging exposes unnecessary radiation, impairs hospital throughput increases healthcare costs. Various audit-and-feedback...

Sepsis is a common, critical, time-sensitive medical emergency, with mortality rates of up to 56%. Early antibiotic administration cornerstone sepsis management, yet prehospital remains uncommon in the United States. This prospective observational study evaluated implementation protocol an urban EMS system. Patients were eligible for if they ≥18 years old, hypotensive (SBP < 90 mm Hg), and febrile or hypothermic (<96.8°F >100.4°F). Paramedics drew blood cultures administered...

Emergency Department (ED) boarding threatens patient safety. It is unclear whether differentially affects patients admitted to intensive care units (ICUs) versus non-ICU settings.We performed a 2-hospital, 18-month, cross-sectional, observational, descriptive study of adult from the ED. We used Kaplan-Meier estimation and Cox Proportional Hazards regression describe differences in time among who died during hospitalization those survived, controlling for covariates that could affect...