Is in situ simulation in emergency medicine safe? A scoping review.

Objectives: To provide an overview of the available evidence regarding the safety of in situ simulation (ISS) in the emergency department (ED).

Design: Scoping review.

Methods: Original articles published before March 2021 were included if they investigated the use of ISS in the field of emergency medicine.

Evaluation of the feasibility and impacts of in situ simulation in emergency medicine-a mixed-method study protocol.

Introduction: In situ simulation (ISS) consists of performing a simulation in the everyday working environment with the usual team members. The feasibility of ISS in emergency medicine is an important research question, because ISS offers the possibility for repetitive, regular simulation training consistent with specific local needs. However, ISS also raises the issue of safety, since it might negatively impact the care of other patients in the emergency department (ED).

Simulation-based research in emergency medicine in Canada: Priorities and perspectives.

Objective: Simulation plays an integral role in the Canadian healthcare system with applications in quality improvement, systems development, and medical education. High-quality, simulation-based research will ensure its effective use. This study sought to summarize simulation-based research activity and its facilitators and barriers, as well as establish priorities for simulation-based research in Canadian emergency medicine (EM).

A simulated emergency department for medical students.

Background: During their training, medical students often undertake a rotation in an emergency department (ED), where they are exposed to a wide variety of patient presentations. Simulation can be an effective teaching strategy to help prepare learners for the realities of the clinical environment. Simulating an ED shift can provide students with the opportunity to perform a range of clinical activities, within their scope of practice, in a supervised and supportive learning environment.

Pre-clinical medical students' perceptions of their patient safety skills in a simulated emergency department.

Objectives: Patient safety has emerged as an important topic for inclusion in medical curricula. However, there is limited literature describing how medical students are taught, learn and self-assess patient safety skills. The present study aimed to seek pre-clinical medical students' perceptions of (i) their individual performance at a range of safety skills; and (ii) how they define patient safety in a simulated ED.

Basal cell carcinomas of the ear are more aggressive than on other head and neck locations.

Background: On pathology review, basal cell carcinomas (BCCs) on the ear more commonly present as aggressive subtypes. It is unclear if this histologic observation translates into more clinically aggressive tumors.

Objective: We sought to determine the clinical aggressiveness of ear BCCs compared with BCCs elsewhere on the head and neck.

Endocrine mucin-producing sweat gland carcinoma.

Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a rare, low-grade, cutaneous neoplasm that may be associated with invasive mucinous carcinoma. Tumors typically present as slow-growing, flesh-colored, nonspecific papules or nodules that favor the eyelids in older individuals. Histologic examination usually reveals basaloid nodules composed of cells with eosinophilic cytoplasm, with focal mucin production and occasional glandular structures.

Panfollicular carcinoma or trichoblastic carcinoma with panfollicular differentiation?

Herein, we report two cases of a follicular neoplasm with panfollicular differentiation showing architectural and cytologic findings suggestive of a malignancy. Immunohistochemical analysis of β-catenin expression in the neoplasm showed nuclear and cytoplasmic immunoreactivity, with no reactivity in the transitional and shadow cells, consistent with β-catenin expression of pilomatrical tumors. Staining for BerEp4 was positive at the periphery of both neoplasms, suggesting germinative differentiation of the neoplastic cells, whereas staining for the follicular stem-cell marker PHLDA-1 (TDAG51) showed strong focal expression in the tumor cells of both cases.

Safety of cosmetic dermatologic procedures during pregnancy.

Background: Safety of cosmetic procedures in pregnant women has not been extensively studied. Maternal and fetal health risks are important to consider in any procedure performed. With the increasing popularity of cosmetic procedures, dermatologic surgeons will be faced with scenarios necessitating knowledge regarding the safety of such procedures during pregnancy.

Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 2: Can emergency physicians safely rule in or rule out paediatric intussusception in the emergency department using bedside ultrasound?

A short cut review was carried out to establish whether emergency physicians (EPs) could confirm or refute the diagnosis of intussusception with the help of bedside ultrasonography. Two observational studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated.

Characteristics of squamous cell carcinoma in situ of the ear treated using Mohs micrographic surgery.

Background: Mohs micrographic surgery (MMS) is used to treat squamous cell carcinoma in situ (SCCIS) for tissue conservation.

Objective: To examine characteristics of patients with SCCIS of the external ear treated using MMS.

Methods: A retrospective review from 2005 to 2011.

Characteristics of basal cell carcinoma of the lip treated using Mohs micrographic surgery.

Background: There is a lack of U.S-based studies on basal cell carcinoma (BCC) of the upper lip treated using Mohs micrographic surgery (MMS).

Objective: To explore characteristics of BCC of the upper lip treated using MMS.

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 3: can pregabalin effectively diminish acute herpetic pain and reduce the incidence of post-herpetic neuralgia?

A short cut review was carried out to establish whether pregabalin can reduce acute herpetic pain and reduce post herpetic neuralgia. 48 papers were found using the reported searches, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this best paper are tabulated.

Treatment of squamous cell carcinoma in situ: a review.

Background: Squamous cell carcinoma in situ (SCCIS) is thought to be a precursor to squamous cell carcinoma. It should be treated before invasive cancer develops, especially in transplant recipients, who may develop more aggressive skin cancers. Treatment can involve surgical and nonsurgical methods.

The operative management of melanoma: where does Mohs surgery fit in?

Background: Melanoma is a life-threatening malignancy. Surgery is the primary management for melanoma, and management guidelines have evolved gradually over a century from radical surgery with lymph node dissection to conservative margin surgery. There are specific rationales and problems with Mohs micrographic (MMS) surgery for managing melanoma.

Preoperative methicillin-resistant Staphylococcus aureus screening in Mohs surgery appears to decrease postoperative infections.

Background: Colonization with methicillin-resistant Staphylococcus aureus (MRSA) places patients at risk for postoperative MRSA wound infections.

Objective: To determine the effect of a decontamination and prophylaxis protocol on postoperative MRSA wound infections in patients with nasal MRSA.

Methods & Materials: Wound cultures over a 23-month period were reviewed before and 11 months after implementation of a screening and decontamination protocol.

Multiple antithrombotic agents increase the risk of postoperative hemorrhage in dermatologic surgery.

Background: Studies show that holding single antithrombotic agents perioperatively increases the risk of acute thrombotic events and does not significantly decrease the risk of bleeding complications in dermatological surgery. Recent data suggest that selected patients may benefit from combination therapy in preventing acute thrombotic events.

Objective: We sought to evaluate postoperative bleeding complications in patients who underwent Mohs micrographic surgery while using multiple agents perioperatively compared with patients using a single agent or none at all.