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Medical Emergency (medical + emergency)
Terms modified by Medical Emergency Selected AbstractsPreparing teams for low-frequency emergencies in Norwegian hospitalsACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 10 2003T. Wisborg Background:, Medical emergencies and major trauma require optimal team function. Leadership, co-operation and communication are the most essential issues. Due to low caseloads such emergencies occur rarely in most Norwegian hospitals. Team training of personnel between real emergencies is expected to improve performance in comparable settings. Most hospitals have cardiac arrest teams, but it is known that the training of such multiprofessional teams varies widely. We wanted to know if this also was the case for trauma teams and resuscitation teams for newborns. Methods:, A telephone survey of training practices in all the Norwegian hospitals with acute cover was conducted in 2002. Information was obtained on whether trauma teams and neonatal resuscitation teams had participated in practical multiprofessional training during the previous 6 or 12 months. Results:, Information was obtained from all 50 hospitals. Of the acute care hospitals, 30% had trained their trauma teams during the previous 6 months, and an additional 18% when considering the previous year, while 38% of neonatal wards had multiprofessional training during the previous 6 months, and additionally 13% had had training during the previous year. Additionally four neonatal wards had had regular training of nurses only. More than 80% of all respondents judged regular team training to be achievable, and none considered this training impossible. Conclusion:, Only half the Norwegian acute care hospitals reported at least yearly training of trauma and neonatal resuscitation teams. Regular team training represents an underused potential to improve handling of low-frequency emergencies. [source] Medical emergencies in the dental practicePERIODONTOLOGY 2000, Issue 1 2008Mark Greenwood First page of article [source] The impact of a supervised injecting facility on ambulance call-outs in Sydney, AustraliaADDICTION, Issue 4 2010Allison M. Salmon ABSTRACT Aims Supervised injecting facilities (SIFs) are effective in reducing the harms associated with injecting drug use among their clientele, but do SIFs ease the burden on ambulance services of attending to overdoses in the community? This study addresses this question, which is yet to be answered, in the growing body of international evidence supporting SIFs efficacy. Design Ecological study of patterns in ambulance attendances at opioid-related overdoses, before and after the opening of a SIF in Sydney, Australia. Setting A SIF opened as a pilot in Sydney's ,red light' district with the aim of accommodating a high throughput of injecting drug users (IDUs) for supervised injecting episodes, recovery and the management of overdoses. Measurements A total of 20 409 ambulance attendances at opioid-related overdoses before and after the opening of the Sydney SIF. Average monthly ambulance attendances at suspected opioid-related overdoses, before (36 months) and after (60 months) the opening of the Sydney Medically Supervised Injecting Centre (MSIC), in the vicinity of the centre and in the rest of New South Wales (NSW). Results The burden on ambulance services of attending to opioid-related overdoses declined significantly in the vicinity of the Sydney SIF after it opened, compared to the rest of NSW. This effect was greatest during operating hours and in the immediate MSIC area, suggesting that SIFs may be most effective in reducing the impact of opioid-related overdose in their immediate vicinity. Conclusions By providing environments in which IDUs receive supervised injection and overdose management and education SIF can reduce the demand for ambulance services, thereby freeing them to attend other medical emergencies within the community. [source] Topics of Special Interest in an Emergency Medicine Course for Dental Practice TeamsEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 2 2004S. Weber Considering increasing life expectancy and population comorbitity, not only dentists but also nursing staff should gain knowledge and skills in treatment of patients in acute life-threatening situations. In cooperation with the State Dental Council, a 1-day course in the management of medical emergencies based on the ERC ALS guidelines was held for primary care dental practice teams. Following a short lecture series (2 hours), a systematic skills-training session (6 hours) was performed in small groups, addressing the following subjects: BLS, airway management and ventilation, intravenous techniques, manual and automated external defibrillation, ALS and resuscitation routine in a typical dental practice setting. For all skills-training sessions, life-like manikins and models were utilized and the emergency scenarios were simulated by the use of a universal patient simulator (SimMan®, MPL/Laerdal). At the end of the course, an evaluation questionnaire was completed by all candidates to find out in which emergency situations the dental practice teams now felt well trained or incompetent. In the first course with 32 participants, 13 were dentists and 19 were dental nurses. In the evaluation results, 53% of both, dentists and nurses, stated to be competent in cardiac arrest situations. 95% of the nurses, but only 69% of the dentists, thought that an automated external defibrillator should be available in the dental practice. 26% of the dentists felt unable to treat patients with anaphylactic reactions adequately, whereas 37% of the nurses felt incompetent in respiratory emergencies. [source] Interdisciplinary team interactions: a qualitative study of perceptions of team function in simulated anaesthesia crisesMEDICAL EDUCATION, Issue 4 2008Jennifer M Weller Objectives, We placed anaesthesia teams into a stressful environment in order to explore interactions between members of different professional groups and to investigate their perspectives on the impact of these interactions on team performance. Methods, Ten anaesthetists, 5 nurses and 5 trained anaesthetic assistants each participated in 2 full-immersion simulations of critical events using a high-fidelity computerised patient simulator. Their perceptions of team interactions were explored through questionnaires and semi-structured interviews. Written questionnaire data and interview transcriptions were entered into N6 qualitative software. Data were analysed by 2 investigators for emerging themes and coded to produce reports on each theme. Results, We found evidence of limited understanding of the roles and capabilities of team members across professional boundaries, different perceptions of appropriate roles and responsibilities for different members of the team, limited sharing of information between team members and limited team input into decision making. There was a perceived impact on task distribution and the optimal utilisation of resources within the team. Conclusions, Effective management of medical emergencies depends on optimal team function. We have identified important factors affecting interactions between different health professionals in the anaesthesia team, and their perceived influences on team function. This provides evidence on which to build appropriate and specific strategies for interdisciplinary team training in operating theatre staff. [source] Simulation training for medical emergencies in general practiceMEDICAL EDUCATION, Issue 11 2005Jennifer Weller No abstract is available for this article. [source] Simulation in undergraduate medical education: bridging the gap between theory and practiceMEDICAL EDUCATION, Issue 1 2004Jennifer M Weller Objective, To evaluate the use of simulation-based teaching in the medical undergraduate curriculum in the context of management of medical emergencies, using a medium fidelity simulator. Design, Small groups of medical students attended a simulation workshop on management of medical emergencies. The workshop was evaluated in a postcourse questionnaire. Subjects, All Year 4 medical students allocated to the resuscitation rotation during the first half of 2002. Main outcome measures, Student perceptions of learning outcomes, the value of the simulation in the undergraduate curriculum and their self-assessed improved mastery of workshop material. Results, A total of 33 students attended the workshop and all completed questionnaires. Students rated the workshop highly and found it a valuable learning experience. In all, 21 (64%) students identified teamwork skills as key learning points; 11 (33%) felt they had learnt how to approach a problem better, particularly in terms of using a systematic approach, and 12 (36%) felt they had learnt how to apply their theoretical knowledge in a clinical setting better. All 33 students were positive about the use of simulation in their training; 14 students wrote that simulation should be used more or should be mandatory in training; 5 students commented positively on the realism of the learning experience and a further 5 said they valued the opportunity to learn new skills in a safe environment. Conclusion, This study demonstrates that medical students value simulation-based learning highly. In particular, they value the opportunity to apply their theoretical knowledge in a safe and realistic setting, to develop teamwork skills and to develop a systematic approach to a problem. A medium fidelity simulator is a valuable educational tool in medical undergraduate education. [source] An ethical hierarchy for decision making during medical emergenciesANNALS OF NEUROLOGY, Issue 4 2010Patrick D. Lyden MD Evidence from well-designed clinical trials may guide clinicians, reduce regional variation, and lead to improved outcomes. Many physicians choose to ignore evidence-based practice guidelines. Using unproven therapies outside of a randomized trial slows recruitment in clinical trials that could yield information on clinical and economic efficacy. Using acute stroke therapy as an illustration, we present an ethical hierarchy for therapeutic decision making during medical emergencies. First, physicians should offer standard care. If no standard care option exists, the physician should consider enrollment in a randomized clinical trial. If no trial is appropriate, the physician should consider a nonrandomized registry, or consensus-based guidelines. Finally, only after considering the first 3 options, the physician should use best judgment based on previous personal experience and any published case series or anecdotes. Given the paucity of quality randomized clinical trial data for most medical decisions, the "best judgment" option will be used most frequently. Nevertheless, such a hierarchy is needed because of the limited time during medical emergencies for consideration of general principles of clinical decision making. There should be general agreement in advance as to the hierarchy to follow in selecting treatment for critically ill patients. Were more clinicians to follow this hierarchy, and choose to participate in clinical trials, the generation of new knowledge would accelerate, yielding rigorous data supporting or refuting the efficacy and safety of new interventions more quickly, thus benefiting far more patients over time. ANN NEUROL 2010;67:434-440 [source] Five years later: children's memory for medical emergenciesAPPLIED COGNITIVE PSYCHOLOGY, Issue 7 2001Carole Peterson Children who had been 2,13 years of age at the time of a medical emergency (an injury serious enough to require hospital ER treatment) were re-interviewed about their injury and treatment five years after injury, and three years after a previous interview. The children showed excellent recall of the central components of their injury experience, although their recall of hospital treatment was more incomplete. Thus, both the nature of the event being recalled (the injury versus the hospital treatment) and the centrality of information (central versus peripheral) were important. The recall of 2-year-olds, although not as good as that of children just a year older, did not fit with predictions of infantile amnesia since they recalled a considerable amount about their injury. High stress levels at the time of the target experiences had little effect on the highly memorable injury event, but seemed to facilitate children's recall of central components of the hospital event,the event that they had a harder time remembering. Implications for eyewitness testimony are discussed. Copyright © 2001 John Wiley & Sons, Ltd. [source] Time Trends in Incidence, Mortality, and Case-Fatality after First Episode of Status EpilepticusEPILEPSIA, Issue 8 2001Giancarlo Logroscino Summary: ,Purpose: Status epilepticus (SE) is a medical emergency associated with a high mortality. Clinical series have suggested that mortality after SE has decreased. No studies have systematically examined trends in incidence, mortality, and case fatality after SE in a well-defined population. Methods: All first episodes of SE receiving medical attention between January 1, 1935, and December 31, 1984, were ascertained through the Rochester Epidemiology Project Records-Linkage System and followed up until death or study termination (February 1, 1996). We calculated incidence rates in the 50-year period (1935,1984), while we considered mortality and case-fatality in the last 30-year period (1955,1984). Results: Incidence of SE increased over time to 18.1/100,000 (1975 through 1984). The increase was related to an increased incidence in the elderly and to the advent of myoclonic SE after cardiac arrest, a condition not seen in the early decades. In the last decade, ,16% of the incidence was due to myoclonic SE. The mortality rates increased from 3.6 per year in the decade 1955,1965 to 4.0/100,000 per year between 1975 and 1984. The 30-day case-fatality (CF) was unchanged, although a trend toward improvement was shown after excluding myoclonic SE. Conclusions: Incidence and mortality rates of SE have increased in the last 30 years. Case fatality remained the same. The increased incidence and mortality are due to the occurrence in the last decade of myoclonic SE after cardiac arrest. The mortality in the elderly was twice that of the youngest age group, across all study periods. Changes in the age and cause distribution of SE over time are responsible for the stable survivorship. There is improvement in survivorship in the last decade when myoclonic SE is excluded. [source] Evaluation of PG-M3 antibody in the diagnosis of acute promyelocytic leukaemiaEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 10 2010Sanjeev Kumar Gupta Eur J Clin Invest 2010; 40 (10): 960,962 Abstract Background & objectives, Acute promyelocytic leukaemia (APL) is a distinct subtype of acute myeloid leukaemia (AML) characterized by a reciprocal translocation, t(15;17) and a high incidence of life-threatening coagulopathy. APL diagnosis is considered a medical emergency. As reverse transcription-polymerase chain reaction (RT-PCR) for PML-RAR, fusion oncoprotein is time consuming, there is a need for a rapid and accurate diagnostic test for APL. This study evaluates the role of PG-M3 monoclonal antibody using immunofluorescence (IF) in the early diagnosis of APL. Materials and Methods, Thirty-six new untreated APL cases diagnosed with RT-PCR for PML-RAR, as the gold standard and 38 non-APL controls (28 non-APL AMLs and 10 non-leukaemic samples) were evaluated by routine morphology and cytochemistry, RT-PCR and IF using PG-M3 monoclonal antibody. Results, Using IF, 34 of 36 (94·4%) APL cases showed a microgranular pattern suggestive of APL and two cases (5·6%) showed a speckled pattern typical of wild-type PML protein (False negative). By comparison, two of 28 (7·1%) non-APL AMLs showed microgranular pattern (false positive). Hence, IF as a diagnostic test for APL resulted in a sensitivity of 94·4%, specificity of 92·9% and positive and negative predictive values of 94·4% and 92·9% respectively. All 10 non-leukaemic samples showed a speckled pattern. Conclusions, IF using PG-M3 antibodies can be used as a rapid (takes 2 h), cheap, sensitive and specific method to identify APL. It can be a useful adjunct for diagnosis of APL especially if facilities for RT-PCR are not available, particularly in resource-limited settings. [source] Viral meningoencephalitis: a review of diagnostic methods and guidelines for managementEUROPEAN JOURNAL OF NEUROLOGY, Issue 8 2010I. Steiner Background:, Viral encephalitis is a medical emergency. The prognosis depends mainly on the pathogen and host immunologic state. Correct immediate diagnosis and introduction of symptomatic and specific therapy has a dramatic influence upon survival and reduces the extent of permanent brain injury. Methods:, We searched the literature from 1966 to 2009. Recommendations were reached by consensus. Where there was lack of evidence but consensus was clear, we have stated our opinion as good practice points. Recommendations:, Diagnosis should be based on medical history and examination followed by CSF analysis for protein and glucose levels, cellular analysis, and identification of the pathogen by polymerase chain reaction amplification (recommendation level A) and serology (level B). Neuroimaging, preferably by MRI, is essential (level B). Lumbar puncture can follow neuroimaging when immediately available, but if this cannot be performed immediately, LP should be delayed only under unusual circumstances. Brain biopsy should be reserved only for unusual and diagnostically difficult cases. Patients must be hospitalized with easy access to intensive care units. Specific, evidence-based, antiviral therapy, acyclovir, is available for herpes encephalitis (level A) and may also be effective for varicella-zoster virus encephalitis. Ganciclovir and foscarnet can be given to treat cytomegalovirus encephalitis, and pleconaril for enterovirus encephalitis (IV class evidence). Corticosteroids as an adjunct treatment for acute viral encephalitis are not generally considered to be effective, and their use is controversial, but this important issue is currently being evaluated in a large clinical trial. Surgical decompression is indicated for impending uncal herniation or increased intracranial pressure refractory to medical management. [source] Viral encephalitis: a review of diagnostic methods and guidelines for managementEUROPEAN JOURNAL OF NEUROLOGY, Issue 5 2005I. Steiner Viral encephalitis is a medical emergency. The spectrum of brain involvement and the prognosis are dependent mainly on the specific pathogen and the immunological state of the host. Although specific therapy is limited to only several viral agents, correct immediate diagnosis and introduction of symptomatic and specific therapy has a dramatic influence upon survival and reduces the extent of permanent brain injury in survivors. We searched MEDLINE (National Library of Medicine) for relevant literature from 1966 to May 2004. Review articles and book chapters were also included. Recommendations are based on this literature based on our judgment of the relevance of the references to the subject. Recommendations were reached by consensus. Where there was lack of evidence but consensus was clear we have stated our opinion as good practice points. Diagnosis should be based on medical history, examination followed by analysis of cerebrospinal fluid for protein and glucose contents, cellular analysis and identification of the pathogen by polymerase chain reaction (PCR) amplification (recommendation level A) and serology (recommendation level B). Neuroimaging, preferably by magnetic resonance imaging, is an essential aspect of evaluation (recommendation level B). Lumbar puncture can follow neuroimaging when immediately available, but if this cannot be obtained at the shortest span of time it should be delayed only in the presence of strict contraindications. Brain biopsy should be reserved only for unusual and diagnostically difficult cases. All encephalitis cases must be hospitalized with an access to intensive care units. Supportive therapy is an important basis of management. Specific, evidence-based, anti-viral therapy, acyclovir, is available for herpes encephalitis (recommendation level A). Acyclovir might also be effective for varicella-zoster virus encephalitis, gancyclovir and foscarnet for cytomegalovirus encephalitis and pleconaril for enterovirus encephalitis (IV class of evidence). Corticosteroids as an adjunct treatment for acute viral encephalitis are not generally considered to be effective and their use is controversial. Surgical decompression is indicated for impending uncal herniation or increased intracranial pressure refractory to medical management. [source] Adding a caveat to the urgent clinical notification of anaemia does not reduce inappropriate emergency room referral ratesINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 3 2003P. Froom Summary Background: Urgent clinician notification of low haemoglobin values might influence the clinicians' decision to refer patients to the emergency room (ER). Methods: We compared the effects of urgent clinician notification for low haemoglobin values with and without an added statement, that an urgent visit to the ER is not required if the patient has a haemoglobin value of 50 g/l or more and is clinically stable. We compared the referral rates and outcomes of 100 consecutive cases reported previously to that of 99 consecutive new cases with the added caveat. Results: Overall 47 (47%) of the historical control patients were referred to the ER compared with 45 (45.5%) in the study group (relative risk, 0.97, 95% CI, 0.72,1.3). Five patients were inappropriately transfused and almost none of the ER visits were an emergency. Conclusions: Adding a caveat to the urgent clinician notification that anaemia in clinically stable patients is not a medical emergency does not decrease the rate of ER referrals. Further studies are needed in order to find ways to decrease the number of inappropriate ER referrals. [source] Early recognition of delirium: review of the literatureJOURNAL OF CLINICAL NURSING, Issue 6 2001Marieke J. Schuurmans PhD ,,This review focuses on delirium and early recognition of symptoms by nurses. ,,Delirium is a transient organic mental syndrome characterized by disturbances in consciousness, thinking and memory. The incidence in older hospitalized patients is about 25%. ,,The causes of delirium are multi-factorial; risk factors include high age, cognitive impairment and severity of illness. ,,The consequences of delirium include high morbidity and mortality, lengthened hospital stay and nursing home placement. ,,Delirium develops in a short period and symptoms fluctuate, therefore nurses are in a key position to recognize symptoms. ,,Delirium is often overlooked or misdiagnosed due to lack of knowledge and awareness in nurses and doctors. To improve early recognition of delirium, emphasis should be given to terminology, vision and knowledge regarding health in ageing and delirium as a potential medical emergency, and to instruments for systematic screening of symptoms. [source] Review article: the clinical management of congenital chloride diarrhoeaALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2010S. WEDENOJA Aliment Pharmacol Ther,31, 477,485 Summary Background, Congenital chloride diarrhoea in a newborn is a medical emergency, requiring early diagnostics and treatment to prevent severe dehydration and infant mortality. While most of the 250 cases reported arise from Finland, Poland and Arab countries, single cases with this autosomal recessive disorder appear worldwide. Such congenital chloride diarrhoea rarity makes diagnosis difficult. Life-long salt substitution with NaCl and KCl stabilizes fluid, electrolyte and acid-base balance diagnosis. When properly treated, the long-term outcome is favourable. Aim To summarize data on congenital chloride diarrhoea diagnosis, pathophysiology and treatment, and to provide guidelines for both acute and long-term management of congenital chloride diarrhoea. Methods, Data are based on MEDLINE search for ,chloride diarrhoea', in addition to clinical experience in the treatment of the largest known series of patients. Results, Treatment of congenital chloride diarrhoea involves (i) life-long salt substitution; (ii) management of acute dehydration and hypokalaemia during gastroenteritis or other infections; and (iii) recognition and treatment of other manifestations of the disease, such as intestinal inflammation, renal impairment and male subfertility. Conclusions, This review summarizes data on congenital chloride diarrhoea and provides guidelines for treatment. After being a mostly paediatric problem, adult patients constitute a rare challenge for gastroenterologists worldwide. [source] Clinic in the Air?JOURNAL OF TRAVEL MEDICINE, Issue 6 2008A Retrospective Study of Medical Emergency Calls From A Major International Airline Background There is a high likelihood of a medical professional being onboard the aircraft at the time of emergency. Therefore, a health-care professional should be familiar with in-flight medical events and how to deal with them. Methods I present a 12-month retrospective study of medical distress calls from a major Asian international airline for which International SOS provided in-flight telemedical assistance. All the calls from the airplane to our center were analyzed from January 1, 2006, to January 1, 2007. The number of recommended diversions, availability of a medical professional, the range of medical problems, and used medications were considered. Results Overall, there were 191 in-flight air-to-ground consultations. Twenty-three (12.04%) calls were made for pediatric problems, with the youngest patient being 9 months old. Gastrointestinal complaints and simple faints comprised 50.2% of all calls. Most of the in-flight problems were successfully treated symptomatically with the initial recommendation to lie the patient down and administer oxygen. Metoclopramide, stemetil, loperamide, and buscopan were the most often administered drugs. A doctor was onboard in 45.5% of all calls. A recommendation to divert the aircraft was made in six (3.1%) cases. Conclusions Although developments in telemedical assistance and the content of a medical kit make the management of potential in-flight medical emergency much easier, they will never turn a commercial aircraft into a flying clinic. Preflight check-in screening by airlines and encouraging future air travelers with health concerns to seek medical help before flying should be recommended. [source] The Treatment of Acute Adrenocortical Insufficiency in the DogJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 1 2001DACVECC, DACVIM, Michael Schaer DVM Summary Acute hypoadrenocorticism in the dog is a true medical emergency that requires a prompt and accurate diagnosis and appropriate treatment in order to provide for the most optimal outcome. Because the signs of adrenal insufficiency mimic those caused by other more common clinical conditions such as renal failure, intoxications, and various gastrointestinal disorders, it behooves the emergency clinician to always include this condition in the list of differential diagnoses. This paper will review the main elements of this hypoendocrinopathy in order to provide the emergency clinician with the essentials that will be required for appropriate diagnosis and treatment. J Vet emerg Crit Care 2001; 11(1):7,14 [source] Risk factors of status epilepticus in childrenPEDIATRICS INTERNATIONAL, Issue 4 2003Serap Karasal AbstractBackground:,Although there is abundant literature about the morbidity and mortality rates of status epilepticus (SE), little is known about the risk factors of this medical emergency. The aim of the present study is to assess the risk factors of SE in children. Methods:,The authors reviewed the medical records of 83 patients admitted to the Pediatric Neurology Unit of Trakya University Hospital, Edirne, Turkey from January 1994 to December 2001 with the diagnosis of SE. Eighty-three patients were compared with 166 controls who were admitted to the same unit due to non-status epilepticus (non-SE) seizure. Results:,The univariate analysis demonstrated that SE episodes were significantly associated with a history of birth asphyxia, neonatal seizure, discontinuation of antiepileptic medication, epilepsy, partial seizure evolving to secondary generalized seizures, myoclonic seizure, generalized abnormalities in the neurological examination, neuromotor retardation, generalized background abnormalities on electroencephalogram (EEG), generalized abnormalities on neuroimaging and polypharmacy than non-SE episodes. Logistic regression was used to test the independence of these parameters as predictors of SE risk. Four parameters emerged as significant independent predictors of SE in children in multiple logistic regression: polypharmacy (Odds ratio (OR) 5.17, P = 0.0004), discontinuation of antiepileptic medication (OR 4.04, P = 0.0095), neuromotor retardation (OR 4.03, P = 0.0016) and generalized background abnormalities on EEG (OR 2.48, P = 0.0419). Conclusion:,Polypharmacy, discontinuation of antiepileptic medication, neuromotor retardation and generalized background abnormalities on EEG are indicators in children of a higher risk of SE. [source] Status epilepticus: features and appropriate managementPRESCRIBER, Issue 6 2009Nicholas Silver MRCP Status epilepticus represents a medical emergency and is associated with significant morbidity and mortality. The authors describe the clinical features and recommended treatment. Copyright © 2009 Wiley Interface Ltd [source] Five years later: children's memory for medical emergenciesAPPLIED COGNITIVE PSYCHOLOGY, Issue 7 2001Carole Peterson Children who had been 2,13 years of age at the time of a medical emergency (an injury serious enough to require hospital ER treatment) were re-interviewed about their injury and treatment five years after injury, and three years after a previous interview. The children showed excellent recall of the central components of their injury experience, although their recall of hospital treatment was more incomplete. Thus, both the nature of the event being recalled (the injury versus the hospital treatment) and the centrality of information (central versus peripheral) were important. The recall of 2-year-olds, although not as good as that of children just a year older, did not fit with predictions of infantile amnesia since they recalled a considerable amount about their injury. High stress levels at the time of the target experiences had little effect on the highly memorable injury event, but seemed to facilitate children's recall of central components of the hospital event,the event that they had a harder time remembering. Implications for eyewitness testimony are discussed. Copyright © 2001 John Wiley & Sons, Ltd. [source] Basic Emergency Medicine Skills Workshop as the Introduction to the Medical School Clinical Skills CurriculumACADEMIC EMERGENCY MEDICINE, Issue 2009Wallace Carter Introduction:,Most medical school curricula lack training in basic skills needed in a medical emergency. After the September 11th, 2001 terrorist attacks, junior level medical students at our institution volunteered their time in the emergency department[ or at Ground Zero. They quickly realized they had little or no practical training for an emergency situation. Objectives:,To correct this curriculum deficit, a five hour basic emergency medicine skills / first responder course for students in their first few weeks of medical school was designed. Methods:,The course consists of lectures followed by related skills stations. Lectures include an introduction to the first responder concept, basic airway, breathing, and circulation management, and a rapid, systematic approach to common emergencies. Skills stations teach basic airway management, bag valve mask ventilation, splinting and immobilizing, and moving patients in the field, stressing improvisation. Multiple skills are practiced in a final simulation station using actors with wound moulage and scripted scenarios. Results:,This course, instituted at Weill Cornell Medical School in 2002, has become a mainstay of the first year curriculum. Student evaluations have been uniformly superlative. There is strong student sentiment that this is the most practical course of the first year. Conclusion:,After six years of experience, we have shown it is possible to present a truncated first responder course as part of the first year curriculum. The course generates tremendous interest and awareness regarding emergency medicine. Future research will examine whether skills taught in this course are retained and can be correctly applied later in medical school. [source] When did Louis Pasteur present his memoir on the discovery of molecular chirality to the Académie des sciences?CHIRALITY, Issue 10 2008Analysis of a discrepancy Abstract Louis Pasteur presented his historic memoir on the discovery of molecular chirality to the Académie des sciences in Paris on May 22nd, 1848. The literature, however, nearly completely ignores this date, widely claiming instead May 15th, 1848, which first surfaced in 1922 in Pasteur's collected works edited by his grandson Louis Pasteur Vallery-Radot. On May 21st, 1848, i.e., one day before Pasteur's presentation in Paris, his mother died in Arbois, eastern France. Informed at an unknown point in time that she was "very ill," Pasteur left for Arbois only after his presentation. Biographies of Pasteur by his son-in-law René Vallery-Radot or the grandson, and Pasteur's collected correspondence edited by the grandson are incomprehensibly laconic or silent about the historic presentation. While no definite conclusions are possible, the evidence strongly suggests a deliberate alteration of the record by the biographer relatives, presumably for fear of adverse public judgment of Pasteur for a real or perceived insensitivity to a grave family medical emergency. Such fear would have been in accord with their hagiographic portrayal of Pasteur, and the findings raise questions concerning the extent of their zeal in protecting his "demigod" image. Universal recognition of the true date of Pasteur's announcement of molecular chirality is long overdue. Chirality, 2008. © 2008 Wiley-Liss, Inc. [source] Giant cell arteritis: managing the ophthalmic medical emergencyCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 3 2003Helen Danesh-Meyer FRANZCO No abstract is available for this article. [source] | ||||||||||