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Core Content for Wilderness Medicine Fellowship Training of Emergency Medicine Graduates 总被引:2,自引:0,他引:2
Grant S. Lipman MD Lori Weichenthal MD N. Stuart Harris MD Scott E. McIntosh MD Tracy Cushing MD Michael J. Caudell MD Darryl J. Macias MD Eric A. Weiss MD Jay Lemery MD Mark A. Ellis MD Susanne Spano MD Marion McDevitt DO Christopher Tedeschi MD Jennifer Dow MD Vicki Mazzorana MD Henderson McGinnis MD Angela F. Gardner MD Paul S. Auerbach MD 《Academic emergency medicine》2014,21(2):204-207
Wilderness medicine is the practice of resource‐limited medicine under austere conditions. In 2003, the first wilderness medicine fellowship was established, and as of March 2013, a total of 12 wilderness medicine fellowships exist. In 2009 the American College of Emergency Physicians Wilderness Medicine Section created a Fellowship Subcommittee and Taskforce to bring together fellowship directors, associate directors, and other interested stakeholders to research and develop a standardized curriculum and core content for emergency medicine (EM)‐based wilderness medicine fellowships. This paper describes the process and results of what became a 4‐year project to articulate a standardized curriculum for wilderness medicine fellowships. The final product specifies the minimum core content that should be covered during a 1‐year wilderness medicine fellowship. It also describes the structure, length, site, and program requirements for a wilderness medicine fellowship. 相似文献
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Spinal Cord Stimulator Implant Infection Rates and Risk Factors: A Multicenter Retrospective Study
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Bryan C. Hoelzer MD Mark A. Bendel MD Timothy R. Deer MD Jason S. Eldrige MD David R. Walega MD Zhen Wang PhD Shrif Costandi MD Gerges Azer MD Wenchun Qu MD PhD Steven M. Falowski MD Stephanie A. Neuman MD Susan M. Moeschler MD Catherine Wassef BS Christopher Kim MD Tariq Niazi MD Taher Saifullah MD Brian Yee DO Chong Kim MD Christine L. Oryhan MD Joshua M. Rosenow MD Daniel T. Warren MD Imanuel Lerman MD MS Ruben Mora MD Salim M. Hayek MD PhD Michael Hanes MD Thomas Simopoulos MD Sanjiv Sharma MBBS FRCA Chris Gilligan MD Warren Grace MD Timothy Ade MD Nagy A. Mekhail MD PhD John P. Hunter MD Daniel Choi MD Deborah Y. Choi PhD 《Neuromodulation》2017,20(6):558-562
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History,Physical Examination,Laboratory Testing,and Emergency Department Ultrasonography for the Diagnosis of Acute Cholecystitis
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Patients and cosmetic surgeons continue to develop innovative devices and techniques in search of the elusive fountain of youth. Our efforts in the past decade can be distilled to three primary approaches: refinement of existing technologies (ablative lasers); refinement of tried-and-true techniques (chemical peeling); and innovative use of new technologies (photorejuvenation). In this contribution, the authors discuss how these three approaches are used to achieve facial skin rejuvenation. Specifically, the authors compare and contrast the clinical benefits and disadvantages of the ablative fractionated and unfractionated carbon dioxide resurfacing lasers, medium-depth and deep chemical peeling, and the combination of photodynamic therapy with intense-pulsed light. 相似文献
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Michael C. Wadman MD Carol S. Lomneth PhD Lance H. Hoffman MD Wesley G. Zeger DO Lina Lander ScD Richard A. Walker MD 《Academic emergency medicine》2010,17(1):88-92
Objectives: Repetitive practice with feedback in residency training is essential in the development of procedural competency. Lightly embalmed cadaver laboratories provide excellent simulation models for a variety of procedures, but to the best of our knowledge, none describe a central venous access model that includes the key psychomotor feedback elements for the procedure, namely intravascular contents that allow for determination of correct needle position by either ultrasonographic imaging and/or aspiration or vascular contents. Methods: A cadaver was lightly embalmed using a technique that preserves tissue texture and elasticity. We then performed popliteal fossa dissections exposing the popliteal artery and vein. Vessels were ligated distally, and 14‐gauge catheters were introduced into the lumen of each artery and vein. The popliteal artery and vein were then infused with 200 mL of icterine/gel and 200 mL of methylene blue/gel, respectively. Physician evaluators then performed ultrasound (US)‐guided femoral central venous line placements and rated the key psychomotor elements on a five‐point Likert scale. Results: The physician evaluators reported a median of 10.5 years of clinical emergency medicine (EM) experience with an interquartile range (IQR) of 16 and a median of 10 central lines placed annually (IQR = 10). Physician evaluators rated the key psychomotor elements of the simulated procedure as follows: ultrasonographic image of vascular elements, 4 (IQR = 0); needle penetration of skin, 4.5 (IQR = 1); needle penetration of vein, 5 (IQR = 1); US image of needle penetrating vein, 4 (IQR = 2); aspiration of vein contents, 3 (IQR = 2); passage of dilator into vein, 4 (IQR = 2); insertion of central venous catheter, 5 (IQR = 1); US image of catheter insertion into vein, 5 (IQR = 1); and overall psychomotor feedback of the simulated procedure compared to the evaluators’ actual patient experience, 4 (IQR = 1). Conclusions: For the key psychomotor elements of central venous access, the lightly embalmed cadaver with intravascular water‐soluble gel infusion provided a procedural model that closely simulated clinicians’ experience with patients. ACADEMIC EMERGENCY MEDICINE 2010; 17:88–92 © 2009 by the Society for Academic Emergency Medicine 相似文献
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