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A B Sanders

Publications and source records attributed to A B Sanders.

113 records · Page 7Linked to original sources
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Current status of academic emergency medicine within academic medicine in the United States.

OBJECTIVE: To characterize the status of emergency medicine within U.S. academic medical centers. METHODS: All accredited emergency medicine residency programs and all four-year allopathic medical schools in the United States were identified. Institutions were defined as academic medical centers based upon NIH research grant funding. These institutions were ranked using five measures of academic stature: a survey of medical school deans, a survey of internal medicine residency directors, level of research funding, characteristics of the student body, and an unweighted composite variable reflecting overall academic stature. The relationship between institutional academic stature and an empiric scale of institutional affiliation with emergency medicine was assessed. RESULTS: Sixty-two institutions were designated academic medical centers. These medical schools captured 90% of all NIH grant monies awarded in fiscal year 1990. Twenty-six of 87 emergency medicine residency programs (30%) were closely affiliated with one of these medical schools. Within academic medical centers, the presence of a residency or an academic department of emergency medicine was inversely associated with the medical school deans' ranking (p < 0.005), research rank (p < 0.001), and composite academic rank (p < 0.001). CONCLUSION: The majority of emergency medicine residency programs (70%) are not closely affiliated with institutions receiving the bulk (90%) of NIH resources for research. Within the institutions receiving the majority of NIH funding, there is a quantitatively and statistically significant inverse association of institutional emergency medicine affiliation and institutional academic rank.

Academic Medical Centers↗
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Substance use and alcohol abuse in emergency medicine training programs, by resident report. SAEM Residency Survey Task Force.

OBJECTIVE: To determine the prevalence of substance use and alcohol abuse among emergency medicine residents. METHOD: The study instrument was an anonymous, self-report survey that assessed the use of 13 substances and included the CAGE questions for measuring alcohol abuse. The survey was administered to emergency medicine residents at the time of the American Board of Emergency Medicine's annual In-Service Examination. RESULTS: Alcohol was the substance most commonly used by emergency medicine residents for nonmedical reasons. Using the CAGE score, 4.9% of residents were classified as alcoholic and another 7.6% as suspect for alcoholism, rates similar to those for housestaff of all specialties as reported in earlier studies. Instruction related to physician impairment during training in their emergency medicine residency was reported by only 36% of the respondents. CONCLUSIONS: Emergency medicine residents report a low rate of illicit substance use and do not appear to misuse alcohol differently than other housestaff. Interpretation of these results must be tempered with the potential for underreporting that may occur with a voluntary self-report survey of a sensitive nature.

Adult↗
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Efficacy of audio-prompted rate guidance in improving resuscitator performance of cardiopulmonary resuscitation on children.

OBJECTIVE: To evaluate the effect of audio-prompted rate guidance during chest compressions on the performance of cardiopulmonary resuscitation (CPR) on children. METHODS: This 24-month prospective study occurred in the pediatric intensive care units of a university hospital and a children's hospital. Intubated children with nontraumatic cardiac arrest were eligible. After placement of an infrared capnometer between the endotracheal tube and resuscitation bag, an audiotape instructed the resuscitator to perform chest compressions at 100 per minute or 140 per minute for one minute, followed by another minute at the other rate. End-tidal carbon dioxide partial pressure (PETCO2) was recorded prior to audiotape instruction and after one minute of CPR at each rate. RESULTS: Six patients, two boys and four girls, with a mean age of 15 +/- 13 months (range 2-36 months) were studied. All had asystole or pulseless electrical activity. CPR was provided for 14 +/- 9 minutes prior to institution of the study protocol. PETCO2 at 140/min was higher than at baseline (12 +/- 7 torr verus 4 +/- 3 torr, p < 0.05). There was a trend towards higher PETCO2s at 100/min compared with baseline (11 +/- 12 torr versus 4 +/- 3 torr, p = 0.08). PETCO2s did not differ at 100/min compared with 140/min. CONCLUSIONS: In support of prior adult and animal investigations suggesting that basic CPRR is often performed poorly and at inappropriately slow rates, audio- prompted rate guidance during CPR in children resulted in higher PETCO2, suggesting improved CPR performance.

Carbon Dioxide↗