Acute encephalopathy with concurrent respiratory and metabolic disturbances in first known parenteral human administration of flunixin meglumine and acepromazine maleate.

Background: Flunexin is a nonsteroidal anti-inflammatory drug approved for veterinary use in horses and cattle. Acepromazine is a phenothiazine derivative used in horses, dogs, and cats. Human exposure to these substances is rare.

Partnering in interprofessional education to design simulation programs to promote collaboration and patient safety.

Interprofessional education (IPE) using simulation strategies is a rewarding way to promote teamwork and interprofessional collaboration. The benefits of collaboration far outweigh the challenges that arise from differences in educational culture and scheduling logistics.

Rhabdomyolysis associated with kava ingestion.

We report a case of rhabdomyolysis temporally related to the ingestion of a large amount of kava. Kava is a naturally occurring plant used in the United States and elsewhere in the world for its sedative properties. A previous case report also related rhabdomyolysis to the ingestion of kava.

The assessment of individual cognitive expertise and clinical competency: a research agenda.

There is a large push to utilize evidence-based practices in medical education. At the same time, credentialing bodies are evaluating the use of simulation technologies to assess the competency and safety of its practitioners. At the 2008 Academic Emergency Medicine Consensus Conference on "The Science of Simulation in Healthcare," our breakout session critically evaluated several issues important to the use of simulation in emergency physician (EP) assessment.

National growth in simulation training within emergency medicine residency programs, 2003-2008.

Objectives: The use of medical simulation has grown dramatically over the past decade, yet national data on the prevalence and growth of use among individual specialty training programs are lacking. The objectives of this study were to describe the current role of simulation training in emergency medicine (EM) residency programs and to quantify growth in use of the technology over the past 5 years.

Methods: In follow-up of a 2006 study (2003 data), the authors distributed an updated survey to program directors (PDs) of all 179 EM residency programs operating in early 2008 (140 Accreditation Council on Graduate Medical Education [ACGME]-approved allopathic programs and 39 American Osteopathic Association [AOA]-accredited osteopathic programs).

Using patient care quality measures to assess educational outcomes.

Objectives: To report the results of a project designed to develop and implement a prototype methodology for identifying candidate patient care quality measures for potential use in assessing the outcomes and effectiveness of graduate medical education in emergency medicine.

Methods: A workgroup composed of experts in emergency medicine residency education and patient care quality measurement was convened. Workgroup members performed a modified Delphi process that included iterative review of potential measures; individual expert rating of the measures on four dimensions, including measures quality of care and educational effectiveness; development of consensus on measures to be retained; external stakeholder rating of measures followed by a final workgroup review; and a post hoc stratification of measures.

The use of simulation in emergency medicine: a research agenda.

Medical simulation is a rapidly expanding area within medical education. In 2005, the Society for Academic Emergency Medicine Simulation Task Force was created to ensure that the Society and its members had adequate access to information and resources regarding this new and important topic. One of the objectives of the task force was to create a research agenda for the use of simulation in emergency medical education.

The status of human simulation training in emergency medicine residency programs.

Introduction: : The objective of this study was to describe the availability and current use of high-fidelity mannequin-based simulation (HFMB) in emergency medicine (EM) training programs.

Methods: : A 12-item survey instrument was used to collect data on the status of human simulation training at the 126 approved EM residencies and the 30 accredited osteopathic EM residencies.

Results: : In all, 114 out of 156 programs completed the survey for a response rate of 73%.

Refractory hypoglycemia from ciprofloxacin and glyburide interaction.

Patients taking multiple medications may suffer from unpredictable and complex drug-drug interactions resulting in significant morbidity and mortality. There are few reports in the literature of hypoglycemia with concurrent administration of an oral hyperglycemic agent and a fluoroquinolone antibiotic. We present a case of a diabetic patient taking glyburide who was prescribed ciprofloxacin and developed prolonged hypoglycemia, which persisted for over 24 hours.

The use of simulation for emergency medicine resident assessment.

Simulations are exercises designed to mimic real-life situations in which learners are given the opportunity to reason through a clinical problem and make critical decisions without the potential of harming actual patients. Simulation, using a variety of formats, is useful for assessing the core competencies-particularly patient care (decision making, prioritizing, procedural skills), interpersonal skills (team leadership, communication), and systems-based practice (team structure and utilization, resource use). High-fidelity computerized human simulators are a relatively new tool for use in medical simulation.