ABSTRACT
Experience and the significance of cardiopulmonary arrest on arrival (CPAOA) for residents were examined through an investigation of 47 cases of CPAOA at the department of emergency medicine of Saga Medical School Hospital from December 1, 1996, through November 30, 1997. Causes of CPAOA, outcomes, issuance of death certificates or inspection certificates, and whether a judicial inspection was performed were analyzed in each case. The cause of CPAOA was intrinsic in 31 cases and extrinsic in 16 cases. Eleven patients were admitted, one of whom recovered completely. Death certificates were issued in 25 cases, of which 7 underwent judicial inspection. Inspection certificates were issued in 21 cases, all of which underwent judicial inspection. Twenty-nine residents received 3 months of clinical training in the emergency department. The percentages of residents who encountered cases of CPAOA, CPAOA caused by extrinsic factors, cases in which inspection certificates were issued, and cases in which judicial inspection was done were 51.7%, 79.3%, 82.8%, and 89.7%, respectively. These findings show that residents receive practical experience in our department of emergency medicine.
ABSTRACT
A university hospital plays roles as a specific functional hospital and as a teaching hospital in primary care because most medical school graduates receive basic clinical training in this area. An important objective of primary care education for all residents is the initial treatment of patients with first-to third-level emergencies. We examined the number of patients, the level of emergency (first, second, and third level) and the diagnoses that each resident encountered. Subjects included 29 residents (3 in the first year, 4 in the second year, and 2 in the third year) who had undergone clinical training for 3 months in the department of emergency medicine at the Saga Medical School Hospital which treats 7, 000 to 8, 000 patients per year with first-to third-level emergencies. Residents were involved with 214.6 emergency cases, which included approximately 59 types of first-level emergency, 31 types of second-level emergency, and 15 types of third-level emergencies. These results were largely compatible with the Objectives of Postgraduate Basic Clinical Training proposed by the Japan Society for Medical Education. These results show that university hospitals as specific functional hospitals should accept numerous emergency patients and that residents must receive clinical training in emergency medicine to achieve the objectives of primary care education.
ABSTRACT
When serious emergency patients come to a 3rd-level emergency hospital, they are able to obtain optimal medical treatment for their condition. However, the emergency room of general hospitals are extremely crowded with many kinds of patients, ranging from 1st-to 3rd-level emergencies. Thus, a good training program in triage is necessary for emergency medicine doctors because of the risk of inappropriate management of patients.<BR>In this study, we examined the number of 2nd-and 3rd-level emergency patients who came to our emergency room initially as walk-in 1st-level emergency patients in 1991 and 1992. Our results indicate that the education for emergency medicine doctors needs to cover a wide range of medical fields dealing with 1st-to 3rd-level emergency patients, and that ideal training in emergency medicine must be organized in hospitals that accept 1st-to 3rd-level emergency patients.