Assessing the inter-rater reliability and agreement of a hybrid assessment framework in the Emergency Department.

Objective: There is often little consensus on the levels of trainees' performances, given the varied expertise and experience of the assessors, different tasks to be assessed and dynamic circumstances. Consequently, assessors are considered to be a major source of measurement error in workplace assessment. The aim of this pilot study is to assess the inter-rater reliability and agreement of a hybrid framework for assessment of nonspecialist doctors in our Emergency Department.

Ultrasound-guided reduction of distal radius fractures.

Introduction: In our local emergency departments (EDs), manipulation and reduction (M&R) of distal radius fractures are performed by emergency doctors, with blind manual palpation, using postreduction x-rays to assess adequacy. We sought to study the effectiveness of ultrasound guidance in the reduction of distal radius fractures in adult patients presenting to a regional ED.

Methods: This was a before-and-after study.

Clinical predictors of bleeding esophageal varices in the ED.

Objectives: Some authors have found that thrombocytopenia (<118,000/mm3), splenomegaly, and ascites are useful predictors of large esophageal varices in cirrhotic patients. We decide to see whether these factors could also be used to predict bleeding esophageal varices in patients known to have chronic liver disease in the ED.

Methods: A case record review was done of all patients admitted to the ED of Changi General Hospital with upper gastrointestinal bleeding from esophageal varices from October 1999 to April 2004.