Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 16 de 16
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
2.
West J Emerg Med ; 22(6): 1355-1359, 2021 10 26.
Artigo em Inglês | MEDLINE | ID: mdl-34787562

RESUMO

INTRODUCTION: Leadership positions occupied by women within academic emergency medicine have remained stagnant despite increasing numbers of women with faculty appointments. We distributed a multi-institutional survey to women faculty and residents to evaluate categorical characteristics contributing to success and differences between the two groups. METHODS: An institutional review board-approved electronic survey was distributed to women faculty and residents at eight institutions and were completed anonymously. We created survey questions to assess multiple categories: determination; resiliency; career support and obstacles; career aspiration; and gender discrimination. Most questions used a Likert five-point scale. Responses for each question and category were averaged and deemed significant if the average was greater than or equal to 4 in the affirmative, or less than or equal to 2 in the negative. We calculated proportions for binary questions. RESULTS: The overall response rate was 55.23% (95/172). The faculty response rate was 54.1% (59/109) and residents' response rate was 57.1% (36/63). Significant levels of resiliency were reported, with a mean score of 4.02. Childbearing and rearing were not significant barriers overall but were more commonly reported as barriers for faculty over residents (P <0.001). Obstacles reported included a lack of confidence during work-related negotiations and insufficient research experience. Notably, 68.4% (65/95) of respondents experienced gender discrimination and 9.5% (9/95) reported at least one encounter of sexual assault by a colleague or supervisor during their career. CONCLUSION: Targeted interventions to promote female leadership in academic emergency medicine include coaching on negotiation skills, improved resources and mentorship to support research, and enforcement of safe work environments. Female emergency physician resiliency is high and not a barrier to career advancement.


Assuntos
Medicina de Emergência , Médicas , Docentes , Docentes de Medicina , Feminino , Humanos , Liderança , Mentores , Sexismo
3.
Am J Emerg Med ; 45: 169-172, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33041137

RESUMO

BACKGROUND: Pulmonary embolus (PE) is associated with significant utilization of health resources. As patients can be risk-stratified, there is an opportunity for a subset of patients to be safely treated without hospitalization, thus reducing the associated costs of treatment. Our aim was to describe the population, treatment strategies, complications, and outcomes associated with outpatient management of PE following treatment in the ED. METHODS: This retrospective health records survey investigated a 4-year cohort of patients presenting with PE who were discharged to home. RESULTS: Data from 151 patients demonstrated that 78% (118/151) of patients were discharged directly home; 19% (28/151) were discharged following ED clinical decision unit observation. Treatment with a novel oral anticoagulant was provided in 40% of cases (61/151). Six patients (4%) experienced a medication-related complication; 26 (17%) had a return visit within 30 days. CONCLUSION: In this cohort of patients with PE, outpatient management was safe and effective for the large majority. Immediate and 30-day complications were few.


Assuntos
Assistência Ambulatorial/métodos , Anticoagulantes/uso terapêutico , Embolia Pulmonar/tratamento farmacológico , Administração Oral , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/administração & dosagem , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco
4.
J Fam Pract ; 68(10): 573-575, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31860703

RESUMO

Clinical findings and imaging studies revealed an additional cause for concern.


Assuntos
Refluxo Biliar/fisiopatologia , Refluxo Biliar/terapia , Vômito/fisiopatologia , Vômito/terapia , Humanos , Lactente , Recém-Nascido , Resultado do Tratamento
6.
West J Emerg Med ; 19(1): 41-48, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29383055

RESUMO

Introduction: Prior work links empathy and positive physician-patient relationships to improved healthcare outcomes. The objective of this study was to analyze a patient experience simulation for emergency medicine (EM) interns as a way to teach empathy and conscientious patient care. Methods: We conducted a qualitative descriptive study on an in situ, patient experience simulation held during EM residency orientation. Half the interns were patients brought into the emergency department (ED) by ambulance and half were family members. Interns then took part in focus groups that discussed the experience. Data collected during these focus groups were coded by two investigators using a grounded theory approach and constant comparative methodology. Results: We identified 10 major themes and 28 subthemes in the resulting qualitative data. Themes were in three broad categories: the experience as a patient or family member in the ED; application to current clinical practice; and evaluation of the exercise itself. Interns experienced firsthand the physical discomfort, emotional stress and confusion patients and families endure during the ED care process. They reflected on lessons learned, including the importance of good communication skills, frequent updates on care and timing, and being responsive to the needs and concerns of patients and families. All interns felt this was a valuable orientation experience. Conclusion: Conducting a patient experience simulation may be a practical and effective way to develop empathy in EM resident physicians. Additional research evaluating the effect of participation in the simulation over a longer time period and assessing the effects on residents' actual clinical care is warranted.


Assuntos
Medicina de Emergência/educação , Empatia , Internato e Residência/métodos , Simulação de Paciente , Relações Médico-Paciente , Educação de Pós-Graduação em Medicina , Serviço Hospitalar de Emergência , Feminino , Grupos Focais , Teoria Fundamentada , Humanos , Masculino , Assistência Centrada no Paciente , Pesquisa Qualitativa
8.
West J Emerg Med ; 18(5): 800-810, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28874931

RESUMO

INTRODUCTION: Increasing attention has been focused on parental leave, but little is known about early leave and parental experiences for male and female attending physicians. Our goal was to describe and quantify the parental leave experiences of a nationally representative sample of emergency physicians (EP). METHODS: We conducted a web-based survey, distributed via emergency medicine professional organizations, discussion boards, and listservs, to address study objectives. RESULTS: We analyzed data from 464 respondents; 56% were women. Most experienced childbirth while employed as an EP. Fifty-three percent of women and 60% of men reported working in a setting with a formal maternity leave policy; however, 36% of women and 18% of men reported dissatisfaction with these policies. Most reported that other group members cover maternity-related shift vacancies; a minority reported that pregnant partners work extra shifts prior to leave. Leave duration and compensation varied widely, ranging from no compensated leave (18%) to 12 or more weeks at 100% salary (7%). Supportive attitudes were reported during pregnancy (53%) and, to a lesser degree (43%), during leave. Policy improvement suggestions included the development of clear, formal policies; improving leave duration and compensation; adding paternity and adoption leave; providing support for physicians working extra to cover colleagues' leave; and addressing breastfeeding issues. CONCLUSION: In this national sample of EPs, maternity leave policies varied widely. The duration and compensation during leave also had significant variation. Participants suggested formalizing policies, increasing leave duration and compensation, adding paternity leave, and changing the coverage for vacancies to relieve burden on physician colleagues.


Assuntos
Atitude do Pessoal de Saúde , Medicina de Emergência/organização & administração , Cultura Organizacional , Licença Parental , Médicos/psicologia , Jornada de Trabalho em Turnos/psicologia , Adulto , Idoso , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Política Organizacional , Gravidez , Jornada de Trabalho em Turnos/estatística & dados numéricos , Inquéritos e Questionários , Recursos Humanos , Adulto Jovem
14.
J Emerg Med ; 43(1): 124-8, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22244288

RESUMO

BACKGROUND: Emergency physicians are increasingly performing transvaginal ultrasound (TVUS) to rule out ectopic pregnancy. However, little is known about appropriate educational pathways to train emergency medicine residents in TVUS. STUDY OBJECTIVES: To evaluate the ability of Emergency Medicine (EM) residents who underwent a training program in TVUS to detect the presence or absence of an intrauterine pregnancy (IUP) in patients of < 13 weeks gestation with vaginal bleeding or abdominal pain, as compared to the final interpretation of each study as determined by the Emergency Department (ED) Director of Ultrasound. METHODS: This was a prospective, observational study in a single residency program. Training included a lecture, competency examination, and 10 supervised TVUSs. The EM residents then performed TVUSs with the goal of determining the presence or absence of an IUP without input from an attending physician. Correlation with the ED Director of Ultrasound was assessed for the cohort, and stratified by year of training. RESULTS: There were 22 residents who performed 75 TVUSs over 17 months. Correlation with the ED Director of Ultrasound was 93.3%. Differences in correlation with the ED Director of Ultrasound were noted when compared by year of training: post-graduate year (PGY)-3 (93.3%), PGY-2 (92.1%), and PGY-1 (100%); p < 0.001. CONCLUSION: Residents were able to perform TVUSs to determine the presence or absence of an IUP in patients in whom the diagnosis of ectopic pregnancy was being considered with a high degree of correlation with the ED Director of Ultrasound after a brief training program. Correlation with the ED director of ultrasound was influenced by year of training.


Assuntos
Medicina de Emergência/educação , Endossonografia , Internato e Residência/métodos , Gravidez Ectópica/diagnóstico por imagem , Competência Clínica , Diagnóstico Diferencial , Feminino , Humanos , Gravidez , Estudos Prospectivos , Hemorragia Uterina/etiologia , Vagina
16.
Pediatr Emerg Care ; 25(7): 460-2, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19606003

RESUMO

Unintentional ingestions are a common presentation to the emergency department in the pediatric population. However, very few ingestions of an atypical antipsychotic, such as ziprasidone, have been described in the emergency medicine literature. While the prevalence of these newer antipsychotics increases in the general population, emergency physicians can expect to see more patients with accidental or intentional overdoses. Many emergency physicians may be unfamiliar with the presentation, initial workup, and expected clinical course of such an overdose. We describe a case of an unintentional ingestion of ziprasidone tablets in a 22-month-old girl who presented to the emergency department with somnolence, drooling, and poor tone.


Assuntos
Antipsicóticos/envenenamento , Overdose de Drogas/etiologia , Piperazinas/envenenamento , Tiazóis/envenenamento , Diagnóstico Diferencial , Overdose de Drogas/diagnóstico , Eletrocardiografia , Feminino , Humanos , Lactente
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...