Morbidity and Mortality conference in Emergency Medicine.

BACKGROUND: Morbidity and Mortality conferences (M&M) are used to meet many of the Core Competencies required by the Accreditation Council of Graduate Medical Education for residency training programs. This study seeks to describe and quantify different types of M&M conferences among Emergency Medicine (EM) training programs. METHODS: A confidential survey was e-mailed to the Program Directors (PD) or Assistant PD of all United States (US) Emergency Medicine residency training programs with functional e-mail addresses listed in the Society for Academic Emergency Medicine residency catalog. Descriptive statistics and 95% confidence (CI) intervals are reported. RESULTS: Of 124 surveys sent out, 89 (72%) completed surveys were returned. There were 88 programs (99%, CI 93-100%) that reported having an M&M. Conferences are held monthly at 67% (CI 57-76%) of programs. Cases for discussion are identified by an EM attending, quality assurance committee, or resident (70%, 57%, and 48%, respectively). Half of programs reported that > 40% of the cases involve systems errors. Twenty percent of programs report that > 40% of the cases involve deaths. Consultants are invited at 44% of programs, and 20% of programs specifically invite radiologists. If a medical error is identified in the M&M, 79% (70-86%) of programs have a protocol for addressing the error. CONCLUSION: EM training programs almost uniformly have an M&M, but these conferences vary in frequency, content, and attendance. Future studies are needed to investigate resident and faculty perceptions of M&M, its educational impact, and ways to improve the conference.

Ultrasound detection of abdominal aortic aneurysm.

US is becoming a widely used diagnostic and therapeutic tool in emergency medicine training and practice. Its use in detecting an AAA is efficient and practical and can occur concurrently with resuscitation. US of the abdominal aorta has been shown to be highly accurate for the detection of AAA and to decrease the time to operative repair of ruptured AAA. The emergency physician should consider using US to search for an AAA in any patient presenting with abdominal or back pain or with shock of unknown etiology.