Author Interviews, Emergency Care / 30.07.2018 Interview with: Benjamin H. Schnapp, MD BerBee Walsh Department of Emergency Medicine Assistant Professor (CHS) Assistant Emergency Medicine Residency Program Director University of Wisconsin What is the background for this study? What are the main findings? Response: Medical errors harm thousands of patients per year.  There’s already a lot we know about systems errors - the ways that care delivery can go wrong.  We know less about cognitive errors, or the ways in which doctors think that can lead to bad outcomes.  An Emergency Department can feel particularly vulnerable to this type of errors - it’s a chaotic environment with patients in various states of illness, many unaccompanied, without records, or too ill to communicate well. An Emergency Department with trainee physicians can feel even more chaotic - even though they are supervised by staff physicians, resident physicians in their first few months to years of training have not yet accumulated the same level of knowledge and experience as longer-tenured doctors.  Errors that get made on the hospital floor are errors of information processing - physicians have the right information, they just don’t always do the right thing with it.  We wanted to know what kinds of errors get made in an Emergency Department with trainees.  Are the errors related to the chaos and an inability to obtain reliable information from patients?  Are they related to the trainees not having enough knowledge and experience?  Or are they like the errors that get made on an inpatient floor? Our study found that the most frequent type of errors were errors of information processing - just like on the hospital floors.  The most common types of errors we saw were physicians settling on a diagnosis prematurely and weighing the importance of findings incorrectly. Patients with abdominal problems had the highest number of errors in our study.  Patients with certain risk factors, such as psychiatric disease or substance abuse, seemed to be particularly prone to errors. (more…)
Author Interviews, Emergency Care, NEJM / 30.05.2013 eInterview with: Adam Z. Tobias, MD, MPH Assistant Professor of Emergency Medicine University of Pittsburgh School of Medicine Pittsburgh, PA  15261Adam Z. Tobias, MD, MPH Assistant Professor of Emergency Medicine University of Pittsburgh School of Medicine Pittsburgh, PA  15261 What are the main findings of the study? Answer: We reviewed records of 11,920 in-flight medical emergency calls from five domestic and international commercial airlines to a physician-staffed medical communications center at the University of Pittsburgh.  We found that during the study period, there was one medical emergency per 604 flights (16 per 1 million passengers).  The most common problems were syncope or pre-syncope, respiratory symptoms, and nausea and vomiting.  Aircraft diversion to an alternative landing site occurred just over 7% of the time. About one quarter of patients were transported to a hospital and only 8.6% were admitted. (more…)