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the viewpoint of emergency medicine. Additionally, we estimated the net yearly profits from CT use by prefecture (local governments of 47 prefectures that are considered the largest administrative districts in Japan) and discussed the profitability of introducing CT systems. 2 Methods This was an observational, correlational and cross-sectional study spanning from 2010 to 2014. We obtained data published by the Ministry of Health, Labor and Welfare of the Japanese government as described later. The data used in this study did not include detailed personal

situativity theory could be useful in understanding how contextual factors impact clinical reasoning performance and a research agenda combining these broad theories alongside more precise theories is recommended [ 3 ]. In this paper, a trans-theoretical model of situativity and systems theories is combined to examine a novel way of understanding clinical reasoning performance in the complex context of medical practice. This model is then piloted on observational data of emergency medicine residents. Situated learning in the community of practice Situativity theory emerged

1 The disembodied view in emergency medicine This introductory section discusses the communicative background and assumptions behind medical educational initiatives such as training programs, simulation training, and teaching practices. Together, those assumptions function as an underlying mechanism for deciding and judging how medical staff is being educated and evaluated in terms of their professional clinical performances. I will argue below that the mainstream assumptions behind such educational initiatives are fallibilistic and incommensurable with an

1 Introduction Pain is a common symptom in emergency medicine causing over half of the visits in emergency departments [ 1 , 2 ]. However, there are several reports showing the inadequacy of treatment of acute pain in emergency departments [ 2 , 3 , 4 , 5 , 6 ]. This can be due to non-existent pain protocols [ 2 , 3 , 5 ] clinicians’ attitudes toward opioid analgesics [ 1 , 2 ] or inappropriate concerns about the safety of opioids [ 2 ]. In pre-hospital care providing adequate pain relief is dependent on equipment and staffing of the ambulance service [ 6

Introduction The emergency department (ED) is a setting uniquely prone to substantial risk of physician error and a rich environment for the study of medical error. In the ED, a higher level of uncertainty exists with undifferentiated patients who present with vague chief complaints and where decisions need to be made with some urgency. Here, patients and their medical histories are not often known and limited resources may be available when several critically ill patients present simultaneously. Emergency medicine (EM) physicians face further challenges to

mainstay of patient-oriented laboratory testing in the ED encompasses the selection of number and type of tests according to solid criteria of appropriateness. Despite some reliable guidance about appropriate laboratory testing in the ED has been provided by the Italian Society of Clinical Biochemistry and Clinical Molecular Biology (SIBioC-Laboratory Medicine; SIBiOC) [ 8 ], both SIBioC and the Academy of Emergency Medicine and Care (AcEMC) recognized the need to reach a tentative consensus about the panel of tests that could be considered more informative, and hence

18 Department of Emergency Medicine O N J U N E 3 , 1 8 5 5 , two days before the opening of the doors of the Jews’ Hospital on West 28th Street, the Board of Directors (today’s Trustees) decreed that “the Visiting Committee be instructed not to re- ceive any patients other than Jews except in cases of accident, until fur- ther notice.”1 At the outbreak of the Civil War, the federal government asked for help, and the Hospital set up extra cots as beds to accommo- date wounded Union Army soldiers. In 1862, when the Hospital was still located on 28th Street

Introduction Diagnostic errors in medicine pose a significant burden to patients, providers, and the overall healthcare system, leading to increased morbidity and mortality and significant financial implications. Diagnostic errors are estimated to occur in at least 5% of patients in the outpatient setting [ 1 ], [ 2 ] and up to 17% of in-hospital adverse events are attributed to diagnostic error [ 2 ]. In Emergency Medicine (EM), the true diagnostic error rate is unknown. Prior studies on the topic estimate this to be anywhere from 0.6% to 35% of cases depending

S571 Critical care, Emergency medicine, Blood gases, POCT Cod: T070 USEFULNESS OF PROCALCITONIN, PRESEPSIN AND C-REACTIVE PROTEIN FOR PREDICTING BACTEREMIA IN FEBRILE URINARY TRACT INFECTION IN THE EMERGENCY DEPARTMENT L. García De Guadiana-Romualdo 1, P. Esteban-Torrella 1, E. Jiménez-Santos 1, A. Hernando-Holgado 1, M. González-Morales 1, S. Rebollo-Acebes 2, R. Jiménez-Sánchez 2, M.D. Albaladejo-Otón 1 1Biochemistry Department, Hospital Universitario Santa Lucía, Cartagena 2Intensive Care Unit, Hospital Universitario Santa Lucía, Cartagena (Spain) guadianarom

Critical care, emergency medicine, blood gases, POCT M345 THE SHARE OF CLINICAL BIOCHEMISTRY ON DIAGNOSTICS AND THERAPY OF CRITICALLY ILL PATIENTS. H. Brodská1, A. Kazda1, K. Malíčková1, T. Zima1 1Institute of Medical Biochemistry and Laboratory Diagnostics of the General University Hospital and of The First Faculty of Medicine of Charles University in Prague BACKGROUND-AIM The treatment of critically ill patients is a very complex issue. It often demands a cooperation of multidisciplinary medical team. The main role of clinical biochemists is to submit a correct