Delving into the Latest Updates on The University of Arizona Health Network with Synapse

作者: Abd Ellah, Mohamed M H ; Tagliafico, Alberto ; Taljanovic, Mihra S ; Halpern, Ethan J ; Martinoli, Carlo ; Klauser, Andrea S ; Jaschke, Werner R ; Sojer, Martin ; Sporer, Isabella

OBJECTIVESTo evaluate the efficacy of ultrasound (US)-guided injections around the lateral femoral cutaneous nerve (LFCN) at different levels in meralgia paraesthetica (MP) patients.METHODSThe study was approved by the university ethics committee and informed oral and written consent were obtained from all patients. Between June 2008 and August 2013, 20 patients with symptoms of MP, including nine men (mean age, 61.33 years) and 11 women (mean age 61.18 years), were treated with US-guided injection of steroids along the LFCN at three different levels in a mean of 2.25 sessions. A visual analogue scale (VAS) was used to measure symptoms before, immediately after and 12 months after treatment.RESULTSComplete resolution of symptoms was documented in 15/20 patients (mean VAS decreased from 82 to 0), and partial resolution in the remaining five (mean VAS decreased from 92 to 42), which was confirmed at 12-month follow-up. By using the different levels of injection approach overall significantly better symptom relief was obtained (p < 0.05).CONCLUSIONThe outcome of US-guided injection along the LFCN can be further improved by injections at different levels (p < 0.05), which was confirmed at 12-month long-term follow-up.KEY POINTSMeralgia paraesthetica is an entrapment neuropathy of the lateral femoral cutaneous nerve. Ultrasound proved effective in diagnosis and in guiding injection therapy. Injection at the anterior superior iliac spine has been used previously. Multiple injections along the nerve course were used in this study. Long-term follow-up (12 months) confirmed the results.

2015-06-01·The Journal of Emergency Medicine4区 · 医学

Implementing a Third-Year Emergency Medicine Medical Student Curriculum

4区 · 医学

Article

作者: Wald, David A ; Coltman, Marion ; Hiller, Kathy ; An, Charlene ; Tews, Matthew C ; Khandelwal, Sorabh ; Jung, Julianna ; Ander, Douglas S ; Zun, Leslie S ; Zinzuwadia, Shreni ; Oyama, Leslie C ; Jubanyik, Karen ; Pandit, Kiran ; Ditz Wyte, Collette Marie ; Goldenberg, William

BACKGROUNDEmergency medicine (EM) is commonly introduced in the fourth year of medical school because of a perceived need to have more experienced students in the complex and dynamic environment of the emergency department. However, there is no evidence supporting the optimal time or duration for an EM rotation, and a number of institutions offer third-year rotations.OBJECTIVEA recently published syllabus provides areas of knowledge, skills, and attitudes that third-year EM rotation directors can use to develop curricula. This article expands on that syllabus by providing a comprehensive curricular guide for the third-year medical student rotation with a focus on implementation.DISCUSSIONIncluded are consensus-derived learning objectives, discussion of educational methods, considerations for implementation, and information on feedback and evaluation as proposed by the Clerkship Directors in Emergency Medicine Third-Year Curriculum Work Group. External validation results, derived from a survey of third-year rotation directors, are provided in the form of a content validity index for each content area.CONCLUSIONSThis consensus-derived curricular guide can be used by faculty who are developing or revising a third-year EM medical student rotation and provide guidance for implementing this curriculum at their institution.

2014-11-25·Circulation

Abstract 260: Impact of Viewing an Ultrabrief Chest Compression--Only Video or Teaching a Chest Compression--Only Class on Lay Bystander CPR Performance in a High School

作者: Brown, Jeffrey ; Ludgate, Melissa ; McMorrow, Devin ; Beskind, Daniel ; Tiutan, Tim ; Smith, Mike ; Smith, Ann ; Thiede, Rebecca ; Burns, Whitney E ; Shane, Romy ; Panchal, Ashish ; Pleasants, Michael ; Hoyer, Riley ; Stoltz, Uwe

Introduction: Cardiac arrest is responsible for 300,000 deaths in the United States. Bystander CPR has been shown to improve survival, but is only performed 30-50% of the time. Objectives: To determine if a chest compression-only (CCO) ultra-brief video (UBV) and a CCO-CPR class are effective at teaching CCO-CPR to high school students. Methods: This was a prospective cluster-randomized controlled trial with three arms: 1) CCO- UBV, 2) CCO-Class, 3) a control group (college recruiting video). High school students enrolled in a health course were randomized by class into of the 3 study arms. CPR performance was assessed with Laerdal Skillreporter mannequins after presentation of a scenario (sudden witnessed collapse) before (Pre), after (Post), and at 2 months following each intervention. CPR performance measures included the following: calling 911/starting compressions within 2 minutes, mean rate and depth of compressions. Results: 168/206 students 14-18 years of age, representing 5 classes, participated in this study. Results are shown in the Table. The proportion of participants that called 911 and/or started compressions within 2 minutes, as well as chest compression rate, significantly improved following the UBV and CCO-Class Post and at 2 months. Chest compression depth significantly improved following the CCO-Class both Post and at 2 months. No performance measure improved Pre to Post for the control arm. Limitations: More than one model of mannequin was used, observers and participants were not blinded to the intervention, and the study population represented a single public high school. Conclusions: A CCO-UBV and a brief CCO-CPR Class were effective at increasing the likelihood of calling 911, initiating CCO-CPR within 2 minutes and improving chest compression rate up to 2 months after the video or class in a population of high school students. The CCO-CPR class also significantly improved chest compression depth up to 2 months after the class.

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