This document discusses administrative issues in emergency departments. It provides statistics on the growth and importance of emergency medicine as a specialty and the role of emergency departments in hospitals. It notes that emergency departments see a high volume of patients, often with high acuity, and generate a significant portion of hospital activity, funding, and physician full-time equivalents. The document also discusses perceptions of risk in emergency medicine and examines exam pass rates and allegations of institutional racism regarding emergency medicine certification exams.
OPD is the mirror of the hospital, which reflects the functioning of the hospital being the first point of contact between the patient and the hospital staff.
Patients visit the OPD for various purposes, like consultation, day care treatment, investigation, referral, admission and post discharge follow up. Not only for treatment but also for preventing and promotive services like, health check up, Immunisation, Physio-therapy and so on.
OPD is the mirror of the hospital, which reflects the functioning of the hospital being the first point of contact between the patient and the hospital staff.
Patients visit the OPD for various purposes, like consultation, day care treatment, investigation, referral, admission and post discharge follow up. Not only for treatment but also for preventing and promotive services like, health check up, Immunisation, Physio-therapy and so on.
Emergency is the gateway to the hospital, patients with pain and agony, relative emotionally charged enter the emergency department at any hour of the day or night, expecting immediate treatment and solace.
A compilation of those areas of IPD which are usually not covered in classrooms. A greater emphasis on the management aspect with examples from existing hospitals in INDIA
This is an overview on the organization andd function of the medical records department in a hospital. It would be of help to administrators and planners, as well as for teachers.
A medical record, health record, or medical chart is a systematic documentation of a patient\'s individual medical history and care. The term \'Medical record\' is used both for the physical folder for each individual patient and for the body of information which comprises the total of each patient\'s health history. Medical records are intensely personal documents and there are many ethical and legal issues surrounding them such as the degree of third-party access and appropriate storage and disposal. Although medical records are traditionally compiled and stored by health care providers, personal health records maintained by individual patients have become more popular in recent years.
Goods Order Inventory System Pro is an advanced and highly sophisticated software, which is being utilized as a hospital inventory management system by many leading hospitals and clinics, running at various corners of the world. This inventory software packs many brilliant features, which makes it the best online inventory software.
Laundry services in hospitals –linen handling
During any given hospital stay, patients spend most, if not all, of their time in bed.
•That means they are surrounded all day with hospital linens.
•From their gown to their sheets and blankets patients have more contact with these items than anything else in the hospital.
•Adequatesupplyofcleanlinensufficientforcomfortandsafteyofpatientandpersonalappereance&pleasant,neatlyattiredemployeesattendingpatientsinfreshcrispuniformdomuchsellthehospitaltothepublic
•Thereforeitmakessensetoensurethattheyareproperlycleaned,driedandtransportedtoavoidcrosscontamination
Planning and specification of Intensive Care UnitsAchi Kushnir PMP
This presentation has been designed to give the reader an overview in relation to the different aspects that are to be considered when planning and designing a new intensive care unit within a hospital
Closing the Loop: Strategies to Extend Care in the EDEngagingPatients
This HIMSS15 presentation discusses the challenges faced in hospital emergency departments and offers insights for implementing a process to follow up with discharged ED patients to enhance outcomes and satisfaction,while optimizing utilization and reducing risk.
Emergency is the gateway to the hospital, patients with pain and agony, relative emotionally charged enter the emergency department at any hour of the day or night, expecting immediate treatment and solace.
A compilation of those areas of IPD which are usually not covered in classrooms. A greater emphasis on the management aspect with examples from existing hospitals in INDIA
This is an overview on the organization andd function of the medical records department in a hospital. It would be of help to administrators and planners, as well as for teachers.
A medical record, health record, or medical chart is a systematic documentation of a patient\'s individual medical history and care. The term \'Medical record\' is used both for the physical folder for each individual patient and for the body of information which comprises the total of each patient\'s health history. Medical records are intensely personal documents and there are many ethical and legal issues surrounding them such as the degree of third-party access and appropriate storage and disposal. Although medical records are traditionally compiled and stored by health care providers, personal health records maintained by individual patients have become more popular in recent years.
Goods Order Inventory System Pro is an advanced and highly sophisticated software, which is being utilized as a hospital inventory management system by many leading hospitals and clinics, running at various corners of the world. This inventory software packs many brilliant features, which makes it the best online inventory software.
Laundry services in hospitals –linen handling
During any given hospital stay, patients spend most, if not all, of their time in bed.
•That means they are surrounded all day with hospital linens.
•From their gown to their sheets and blankets patients have more contact with these items than anything else in the hospital.
•Adequatesupplyofcleanlinensufficientforcomfortandsafteyofpatientandpersonalappereance&pleasant,neatlyattiredemployeesattendingpatientsinfreshcrispuniformdomuchsellthehospitaltothepublic
•Thereforeitmakessensetoensurethattheyareproperlycleaned,driedandtransportedtoavoidcrosscontamination
Planning and specification of Intensive Care UnitsAchi Kushnir PMP
This presentation has been designed to give the reader an overview in relation to the different aspects that are to be considered when planning and designing a new intensive care unit within a hospital
Closing the Loop: Strategies to Extend Care in the EDEngagingPatients
This HIMSS15 presentation discusses the challenges faced in hospital emergency departments and offers insights for implementing a process to follow up with discharged ED patients to enhance outcomes and satisfaction,while optimizing utilization and reducing risk.
Audit of Inclusion Health in the Emergency Department.
Audit of the emergency care for the homeless population at City and Sandwell Hospitals, Birmingham.
Objective
Safer Healthcare Now!, a program of the Canadian Patient Safety Institute, invites you to participate in the Canadian VTE Audit, designed to establish a national perspective of VTE thromboprophylaxis rates and raise awareness of appropriate VTE prophylaxis.
VTE is one of the most common and preventable complications of hospitalization and is a Required Organizational Practice (ROP) of Accreditation Canada.
By participating in the national audit day you will be a part of a movement aimed at preventing deep vein thrombosis (DVT) and pulmonary embolism (PE) in hospital patients.
Watch the recording: http://bit.ly/1wfinCE
Clinician Satisfaction Before and After Transition from a Basic to a Comprehe...Allison McCoy
Healthcare organizations are transitioning from basic to comprehensive electronic health records (EHRs) to meet Meaningful Use requirements and improve patient safety. Yet, full adoption of EHRs is lagging and may be linked to clinician dissatisfaction. In depth assessment of satisfaction before, during, and after EHR transition is rarely done. Using an adapted published tool to assess adoption and satisfaction with EHRs, we surveyed clinicians at a large, non-profit academic medical center before (baseline) and 6-12 months (short-term follow-up) and 12-24 months (long-term follow-up) after transition from a basic, locally-developed to a comprehensive, commercial EHR. Satisfaction with the EHR (overall and by component) was captured at each interval. Overall satisfaction was highest at baseline (85%), lowest at short-term follow-up (66%), and increasing at long-term follow-up (79%). This trend was similar for satisfaction with EHR components designed to improve patient safety including clinical decision support, patient communication, health information exchange, and system reliability. Conversely, at baseline, short-term and long-term follow-up, perceptions of productivity, ability to provide better care with the EHR, and satisfaction with available resources, were lower at both short- and long-term follow-up compared to baseline. Persistent dissatisfaction with productivity and resources was identified. Addressing determinants of dissatisfaction may increase full adoption of EHRs. Further investigation in larger populations is warranted.
Our presentation at AMIA about our regional MRSA collaborative and use of health information technology to share MRSA colonization and infection data electronically.
• Implementing ACE in 100 aged care facilities
• Building relationships with aged care staff for improved patient outcomes
• Examining savings and delivering results
Speaker: Jacqueline Hewitt Clinical Nurse Consultant John Hunter Hospital, NSW
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
2. Overview
• ED – by the numbers
• Our perception ’s of risk/ risk avoidance
• WEAT- why?
• Are the College/exam/examiners racist
3. ED – the specialty: by the numbers
• 35 years since College founded: Tom Hamilton (WA) 1st Pres
• 30 years since 1st trainee passed (WA)
• 25 years since recognised as specialty next year
• 20 years since 1st Professor (SCGH /UWA)
• 67 initial fellows- > 2000 now
• 6th largest specialty by numbers (GP, Phys, Anaes, Surg, Psych)
4. What % of your hospitals Dr. FTE are
employed by/in the ED.
• 1%
• 2%
• 4%
• 7%
• 10%
• 15%
• 20%
• 25%
5. What % of patient bed-days are used by
patients admitted via ED
• 15%
• 25%
• 35%
• 45%
• 55%
• 65%
• 75%
6. What % of hospital activity/funding is directly
ED generated.
• 1%
• 2%
• 3%
• 5%
• 8%
• 10%
• 15%
• 20%
7. ED- ? important in your hospital
• 55% of patient bed days via ED
• 20-25% of “non 24hr/day beds’ = ED cubicles (20?/100)
• 10% of all hospital WAU( weighted activity is ED)
• 10%~ of medical FTE in ED (75-85/780 FTE)
• 8% of nursing FTE in ED (10% of hospital nursing costs)
• 8% of hospital funding (ED generates $65M / $780)
• 5% of hospital budget directly allocated to ED: $42M
• 4-5% of inpatient beds are Obs (16) / virtual (5-10 IP; boarded)
8. Annual activity
• 70-71000 p.a. attendances; 150-240/day
• Attendances > by 40% in last 10 years
• <2.5% attendances this year, 5-6% < than hx activity
• 45-80 ambulances
• 30% (45-65 per day) admitted to IP (3% tfer)
• 20-25% fast track
• 10-15% Obs ward (15-25% then admitted)
Tests
• $1-1.5 M of pathology ordered
• 150-180 Radiology requests a day (40-60 CT)-
• $15-20000 per day; $6-7M p.a
9. ED- a risky environment?
• High volume
• High acuity
• High disability risk
• High expectations
• Low information
• Low certainty
• Low patient understanding
14. Who has the biggest claims against them
Proportion of high to low
claims
• Emerg Med 3:1 x > %
• O and G/ ortho 2:1
• Gen Surg 2:1
• Others: 1:1
• GP 1:2
15. Private practice Florida- spend more get sued less!
Jena AB, Schoemaker L, Bhattacharya J, Seabury SA. Physician spending and subsequent risk of malpractice claims: observational study. BMJ. 2015 Nov 4;351:h5516.
0
0.1
0.2
0.3
0.4
0.5
0.6
0 1 2 3 4 5 6
Malpractice claim rate GP(%, 95%
CI)
18. Evidence for 4HR; when 1st applied
• Overcrowding associated with many poor outcomes(not proof of effect)
• > mortality, morbidity, MRSA >, > ramping, complaints, DNW, slow/ poor care, >LOS
• UK- none (patient surveys?);
• WA – pollies-admin visited UK; agreed a great thing- times improved-media
better; just before mid-Stafford
• Timely care/ targets- advocated for by ACEM
• NEAT-national, still no real data re patient outcomes
19. Monthly WA 4 hr performance tertiary acute -7/8
to 10-11
20. More recent data suggests > flow, better
outcomes
• WA data: 2007-2011; - as access block decreased at
tertiaries, reduced mortality seen in 2011(but not
2010) vs 2007-09 (1.12% to 0.98%- 13% <)
• Emergency department overcrowding, mortality and the 4-hour rule in Western Australia Gary C Geelhoed and Nicholas H de
Klerk Med J Aust 2012; 196 (2): 122-126. || doi: 10.5694/mja11.11159
• National data comparing hospital mort data (HSMR) vs
4HR performance
• The National Emergency Access Target (NEAT) and the 4-hour rule: time to review the target Clair Sullivan, Andrew Staib,
Sankalp Khanna, Norm M Good, Justin Boyle, Rohan Cattell, Liam Heiniger, Bronwyn R Griffin, Anthony Jr Bell, James Lind and Ian
A Scott Med J Aust 2016; 204 (9): 354. || doi: 10.5694/mja15.01177
21. NZ and WA data
• NZ 6 Hour rule data (95%)- national data
set; less deaths in ED and elective; but not
admits
• Impact of a national time target for ED length of stay on patient outcomes; Jones P et al NZMJ 2017
• Unpublished WA data- NHMRC funded study
• NB other 3 states did not show sig. change
• Forero Mountain Ngo Fatovich Man et al
22. Important to stay on track?
• Improved flow clearly improves LOS/ reduces access
block etc.
• No proven benefits of overcrowding
• Strong associations with poor outcomes when ED OC
• 4 current Australasian studies (1 weak UK study as
well) –suggest reversibility
• Which target?
• 4hr:, 80,90,95
• 6hr ; 95
24. ACEM- institutional racism?
• Issues raised in press
• V low pass rates for non-A/Saxon bckgd
• Basis was “non-white” pass rate 6.8% vs 85% for “cauc”
• Claimed “clearly not due to English skills”
• Claims that exam was overtly racist- “the only explanation”
• A follow up story in the Australian added fuel to fire with comments
leaked from an examiners blog:
“This may be a language issue such as failing to recognise subtle differences in meaning ... or may
be due to the methods used in their basic medical training,” Dr Dunn writes.
“a key problem facing graduates of overseas medical schools was a lack of “specialist level
knowledge”,
“Particularly troublesome were specialist trainees who had inadequate skills but did not realise it,
who “barrel on confidently with the wrong diagnosis, treatment and make errors that will harm
patients”. “They need to be brought back to earth very clearly,”
25. Exam pass rates in context?
• What is the history of the ACEM exam?
• Low overall pass rates 45-70%
• Problems considered for:
• Objectivity/ reproducibility/ writing/
• Examiners interaction- influence; too subjective ? standard
• Major format changes 2015/1 ? AMC driven:
• MCQ/SAQ only- written; std setting
• No short/longs-SCE’s only (12 ; mainly communication)
• Minimal examiner interactions- with candidates/ can’t intervene
• 2015/1 had a v high pass rate (80% +)- 2015/2 <50%
26. Exam pass rates:
written /clinical
• Written- always different pass
• Difficult to discriminate
• No candidate details-info
• No change in proportions after
• Clinical:
• Increasing non-anglo pass
• Greater pass rate since 2011
• Massive drop on 2015 onwards
• What changed
• Not examiners/ make up
• Written ? a bit easier
• Candidates –v unlikely
• EXAM +++
27. Other Colleges/ high stake exams have seen
similar (but not as severe differences)
28. What % of hospital activity/funding is ED
generated
• 1%
• 2%
• 3%
• 5%
• 8%
• 10%
• 15%
• 20%
29. What % of public hospital Dr. FTE are
employed by/in the ED.
• 1%
• 2%
• 4%
• 6%
• 10%
• 15%
• 20%
• 25%
30. What % of patient beds are patients admitted
via ED
• 15
• 25
• 35
• 45
• 55
• 65
• 75
37. CVA thrombolysis; 2017 updatehttps://acem.org.au/getattachment/8321986e-bb5a-470b-b947-c646573f2b08/Systematic-Review-of-Intravenous-Thrombolysis-in-A.aspx
• 2016 ACEM review with independent meta-analysis
• Agreed that there was level 1A evidence of benefit for Tlysis
• NNT- 7-18 depending for improved functional outcome 0-1 (mRS)
• By 90 days no more deaths, > early deaths / more late deaths
• Equal numbers of severe dependence
• Quality of evidence was moderate (heterogeneity/ risk of bias)
• 2017 ACEM will not be endorsing current Stroke guidelines
• Concerns with agressive