American Research Journal of Emergency and Intensive Critical Care

Peter S  Myla E. M Andrew W

Randomized controlled trials (RCTs) may benefit from EDs’ role as the first point of contact for many young people with mental health and suicidal issues (RCTs). Acute care facilities, on the other hand, have a difficult time filling open positions. This Teenagers aged 12 to 17 who were admitted to a mental health centre for evaluation were eligible to participate in the research. In a children’s hospital emergency department with suicidal thoughts (ED). Methods: During the earliest stages of the inquiry, recruitment barriers such as the time of day were found. Day of ED Presentations and Challenges for Acute Diabetic Diagnosis Participation inFamilies with suicidal loved ones, difficulties in enticing them to come to the ER, and environmental issuesSeveral parents and children have expressed worry about the research. We estimated the average number of new hires each month for each organisation.Using the emergency room as a recruiting ground has been studied as a method of preventing suicide among children. Check out our ability to bring in fresh employees

Thomas S. Chun, MD. Susan J. Duffry, MD.James J. Linakis, PhD.



Mark C. Knouse, MD John C. Smulian, MD, MPH2, Jeanne L. Jacoby, MD3

This research evaluated variables that affect emergency medicine (EM) patients’ choices to participate in clinical trials and if the effect of these factors varies from those of other medical specialities. Methods: While waiting for an appointment, a survey was handed out to patients in the emergency department (ED), family medicine (FM), infectious disease (ID), and OB/GYN waiting rooms. Survey participants had to be at least 18 years old and able to complete it without any help from their caregivers. Comparing participant replies using Kruskal-Wallis tests and ordinal logistic regression analysis revealed significant differences. Results: We contacted 2,893 people who were qualified, and 1,841 questionnaires were included in the final analysis. Eight of the 10 driving variables between EM and one or more of the other specializations were found to be statistically significant (p 0.001). The connection between the patient and their doctor was more motivating to patients in other specialities than to EM patients (FM [odds ratio OR:1.752, 95 percent confidence interval [CI]:1.285-2.389], ID [OR:3.281, 95 percent CI:2.293-4.695], and OB/GYN [OR:2.408, 95 percent CI:1.741-3.330]). “How effectively the study was communicated,” and “whether the information obtained will assist others,” were EM’s top two motivating criteria, and they were shared by other specialities as well. When comparing EM to the other eight disciplines, there were statistically significant differences (p0.008) in each one of the nine obstacles. “The potential of unanticipated side effects” was cited as the greatest obstacle by participants of all disciplines. No matter whether patients’ race, “time commitment” was a barrier for other specialities (FM [OR:1.613, 95% confidence interval 1.218-2.136]; ID [OR:1.340, 95% confidence interval 1.006-1.784]; or Ob/Gyn [OR:1.901, 95% confidence interval 1.431-2.526].) Patients who are considering taking part in a clinical trial may use just one of the six resources evaluated to assist them make that decision. Conclusion: There are considerable variations between EM patients and those of other disciplines in the variables that determine their involvement in clinical trials. Providing literature in the patient’s native language, explaining the study clearly, and demonstrating how their involvement can benefit others in the future may assist to enhance enrolment in EM-based clinical studies. [West J Emerg Med. 2017;18(5)846-855.

Luis Camputaro MD, MBA, MSc, FCCM, FAHA1 Ana Kovac, MD2, Lucia Scalice, MD3, Martin Steinhaus

AbStrAct The aim of this survey is to explore who provides initial care, and takes responsibility for decisions of patients suffering from acute neurological disorders in Emergency Department KEywordS: Neurocritical Patients. EmergenyDepatment

Regidor-111 Dioso1 Mohamed Janoof Amarasingam Thivyasuthan

AbstrAct Aims: This study identified general causes of work related stress among critical care nurses in the eastern province of Sri Lanka; and identified the degree of stress experienced by Sri Lankan nurses in critical care settings. Method: A descriptive quantitative cross sectional study was conducted using the self-administered questionnaire. Convenience sampling technique was used to select 105 critical care nurses working at 2 government hospitals in the eastern province of Sri Lanka. Results: Of the 105 respondents, general causes of stress was identified due to having more dependents (45%), 85% was due to extended duty shift more than 100 hours, another 35% was due to managerial issues at work place, 25% was due to inadequate partner’s contribution and 25% was due to improper workplace facilities. To specifically identify the degree of stress according to the respondents, mild stress (n=40), was identified among those who extended shift duties more than 100 hours, while moderate (n=38) for those who had poor relationship with their fellow staff or with doctors rotating in their units, the extreme stress (n=14) was due to managerial paper works documenting incident reports, and worst (n=8) was due to emergency leaves or inadequate staffing. Keywords: Nursing, stress, work-related stress, critical care nursing, and cross-sectional, Sri Lanka

 AlNofaiey YHHamam AH  AlAlayani AM

The basic skill of being able to read ECGs at a high level of proficiency and accuracy is one of the objectives of the Saudi Arabian Emergency Medicine Residency Training Program (SAEMRTP). Our objective in this study is to assess the ECG reading knowledge and skill proficiency of the residents enrolled in the SAEMRTP in the three major regions of the Kingdom of Saudi Arabia for a variety of clinically important, and in some cases, fatal diagnoses. Methods: This is a prospective cross sectional observational study of Emergency Medicine residents enrolled in the SAEMRTP, with a questionnaire based assessment of the participating subject demographics, and their interpretation of ten 12-lead ECG tracings. The ECGs were selected from a well-known published book reference made for emergency physicians. All ECGs were representatives of deadly conditions that the residents are being taught about, and/or have seen in the clinical setting during their training. The residents were required to indicate the abnormalities in the traces, and their differential diagnosis, under timed conditions. All data was then collected, processed and analyzed to assess proportions, frequencies, and reading skill competency identified from a score of 2 for each ECG (2= correct, 1= partially correct, 0=incorrect). The reference for the findings was the ECG book. Statistical significance was ascertained by use of the Mann-Whitney U test for ordinal data and the Chi-squared test for nominal data. Results: Over the three regions, 132 residents were included in this study. We found that the average overall ECGs read correctly were 16.14% [95% CI 22.71- 9.56%]. There was an observed trend of improving reading competency between the junior residents 10.89% [95% CI 17.72-4.05%] and the senior residents 23.96% [95% CI 29.25-18.67%] p-value < 0.0001. The Competency score mean ranged from: 18.18% for WPW syndrome, to 0.76% for Suspected Digoxin Toxicity. Conclusion: Despite improvement in the interpretation competency with clinical experience, the overall performance of the residents remains alarmingly low. The proficiency of ECG reading skills fall well below the observed international levels of other international programs. Further research into methods for improving the resident proficiency at ECG reading, should be to done in order to improve the current standards