Review of emergency preparedness in the office setting: How best to prepare based on your practice and patient demographic characteristics.

OBJECTIVE: To outline an approach to assessing the risk of emergencies in one's medical practice and determining the equipment and medications required for emergencies and the necessary staff training to meet this important facet of patient care. SOURCES OF INFORMATION: The emergency preparedness recommendations presented in this article are based on data collected from family physicians' current preparedness plans, formal physician evaluation and informal feedback provided after 2 large group presentations, and the authors' expertise in areas including family medicine, emergency medicine, prehospital care, and pharmacology. MAIN MESSAGE: Delineating risk based on practice profile, location, and demographic characteristics will inform the development of an appropriate plan to meet both public expectations and professional obligations. Reviewing the plan or having a practice drill of the plan once developed will improve the process in the event of an emergency. It is also essential to have medication and equipment checked periodically for expiry dates and proper functioning. CONCLUSION: Physicians will encounter office emergencies at some time in their practice. Appropriate risk assessment, planning, and preparedness will allow the provision of high-quality care, safety for staff members, the best patient outcomes, and the reward of having managed a time-sensitive problem in an efficient and effective manner.

Revue de la préparation aux situations d'urgence à la clinique: Comment mieux se préparer en fonction de votre pratique et des caractéristiques démographiques de vos patients.

OBJECTIF: Présenter une approche pour évaluer les risques d'urgences dans sa propre clinique médicale, et déterminer le matériel et les médicaments nécessaires pour de telles urgences, de même que la formation du personnel requise pour aborder cette importante facette des soins aux patients. SOURCES DE L'INFORMATION: Les recommandations sur la préparation aux urgences dans cet article se fondent sur des données colligées à partir de plans de préparation aux urgences déjà existants chez les médecins de famille, d'une évaluation formelle faite par des médecins et d'une rétroaction informelle fournie à la suite de 2 présentations à de grands groupes, de même que sur l'expertise des auteurs dans des domaines comme la médecine familiale, la médecine d'urgence, les soins préhospitaliers et la pharmacologie. MESSAGE PRINCIPAL: La définition des risques en fonction du profil, de l'emplacement et des caractéristiques démographiques de la pratique éclairera l'élaboration d'un plan approprié pour répondre à la fois aux attentes de la population et aux obligations professionnelles. La révision du plan ou un exercice d'entraînement une fois qu'il est élaboré améliorera le processus dans l'éventualité d'une urgence. Il est aussi essentiel de vérifier périodiquement les dates de péremption des médicaments et le bon fonctionnement du matériel. CONCLUSION: À un moment ou l'autre, les médecins auront à faire face à des urgences à leur clinique. Une évaluation des risques, une planification et un état de préparation appropriés leur permettront de fournir des soins de grande qualité, d'assurer la sécurité de leur personnel, d'obtenir les meilleurs résultats pour les patients et de ressentir la satisfaction d'avoir géré un problème urgent d'une manière efficiente et efficace.

Organ and tissue donation from poisoned patients in the emergency department: A Canadian emergency physician survey.

OBJECTIVES: Screening for organ and tissue donation is an essential skill for emergency physicians. In 2015, 4,631 Canadians were on a waiting list for a transplant, and 262 died while waiting. Canada's donation rates are less than half of comparable countries, so it is essential to explore strategies to improve the referral of donors. Poisoned patients may be one such underutilized source for donation. This study explores physician practices and perceptions regarding the referral of poisoned patients as donors. METHODS: In this cross-sectional unidirectional survey, 1,471 physician members of the Canadian Association of Emergency Physicians were invited to participate. Physicians were presented with 20 scenarios and asked whether they would refer the patient as a potential organ or tissue donor. Results were reported descriptively, and associations between demographics and referral patterns were assessed. RESULTS: Physicians totalling 208 participated in the organ or tissue donation scenarios (14.1%); 75% of scenarios involving poisoning were referred for organ or tissue donation, compared with 92% in a non-poisoning scenario. Poisons associated with lower referrals included sedatives, acetaminophen, chemical exposure, and organophosphates. A total of 175 physicians completed the demographic survey (11.9%). Characteristics associated with increased referrals included previous referral experience, donation training, donation support, >10 years of service, urban practice, emergency medicine certification, and male gender. CONCLUSIONS: Scenarios involving poisoning were referred less often when compared with an ideal scenario. Because poisoning is not a contraindication for referral, this represents a potential source of donors. Targeted training and referral support may help improve donation rates in this demographic.

Paramedic Learning Style Preferences and Continuing Medical Education Activities: A Cross-Sectional Survey Study.

BACKGROUND: Paramedics participate in continuing medical education (CME) to maintain their skills and knowledge. An understanding of learning styles is important for education to be effective. This study examined the preferred learning styles of ground ambulance paramedics and describes how their preferred learning styles relate to the elective CME activities these paramedics attend. METHODS: All paramedics (n=1,036) employed in a provincial ground ambulance service were invited to participate in a survey containing three parts: demographics, learning style assessed by the Kolb Learning Style Inventory (LSI), and elective CME activity. RESULTS: 260 paramedics (25%) participated in the survey. Preferred learning styles were: assimilator, 28%; diverger, 25%; converger, 24%; and accommodator, 23%. Advanced life support (ALS) providers had a higher proportion of assimilators (36%), and basic life support (BLS) providers had a higher proportion of divergers (30%). The learning style categories of CME activities attended by paramedics were: assimilators, 25%; divergers, 26%; convergers, 25%; and accommodators, 24%. CONCLUSION: These results suggest that paramedics are a diverse group of learners, and learning style differs within their demographics. Paramedics attend CME activities that complement all learning styles. Organizations providing education opportunities to paramedics should consider paramedics a diverse learning group when designing their CME programs.