- Email: [email protected]
A breast screening behavior survey in an urban emergency department
RESEARCH FORUM A B S T R A C T S
reviewed to identify eligible patients presenting consecutively from November 23 to November 30, 1996. All acutely injured patients not involved in a motorized vehicle crash were included. Results: Sixty-one patients were identified as intentional assault victims; we were able to locate both physician and nurse charts for 59 (97%). Fewer than half of the charts indicated the identity of the assailant or the date of the assault. Physicians were significantly more likely than nurses to document the identity of the assailant (29% versus 10%; P=.011), as well as the date of assault (46% versus 17%; P=.001). There was no difference between physician and nurse documentation of place of assault (14% versus 10%; P=.569). All charts had documentation of object use; however, 11 charts (9%) had a discrepancy in the type of object documented. Conclusion: Although the ED commonly treats assaulted patients, basic surveillance data are often omitted from the chart. Physicians document more than nurses, but both physicians and nurses are poor overall at documennng information regarding assaults. Structured charting may provide more complete data collection.
426
Conclusion: BSE and mammography to detect early breast changes was higher than expected in this ED population of women. Lower-income and younger women performed less BSE than higher-income women and lower-income women received less mammography. The ED may be an important site to educate young and lower-income women about BSE and mammography.
Advanced Cardiac Life Support Training: Comparison of Brazilian Versus North American Student Responses
Kern KB, Timerman S, Paiva E/NCR Brazil, San Pauio, Brazil; University of Arizona, Tucson, AZ A nationally coordinated effort has recently begun to teach advanced cardiac life support (ACLS) to health care professionals throughout Brazil. Under the direction of FUNCOR of the Brazilian Heart Foundation Society of Cardiology, these courses have carefully followed the American Heart Association's ACLS guidelines. ACtS materials (English) were available before the course for each student. Data on student preparation and end of course evaluations have been prospectively gathered and comparisons made between the first 122 Brazilian students and a similar 1997 student cohort from the University of Arizona (n=31). Students evaluated the different course aspects as unsatisfactory, satisfactory, or superior. No differences in raungs concerning course schedule, course dynamics, or content were detected with both groups giving each of these categories approximately a 45% "superior" rating. Significantly more Brazilian students rated "superior" course organization (62% versus 42%; P<.02) and duration (10% versus 27%; P<.05) than did the Arizona students. Instructors were rated similarly high and "superior" by both student groups (57% versus 48%; P<.5). Likewise, no differences were found in course materials (56% versus 45%; P<.3) or knowledge gained (50% versus 50%; P<.9). Brazilian students did rank facilities (54% versus 26%; P<.01) and mannequin use (44% versus 20%; P<.O2) higher than the Arizona students. Both groups of students appear to prepare equally well, with 33% versus 50% reading a majority of the ACLS text before the course (P<.3). The vast majority claimed their treatment of cardiac arrest victims would be drastically altered from having attended the ALCS course (95% versus 90%; P<.4). Finally, in both countries there was unanimous agreement that the course was worthwhile and should be recommended for all health care professionals.
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A Breast Screening Behavior Survey in an Urban Emergency Department
Takakuwa KM, ErnstAA, Weiss SJ/University of California-Davis Medical Center,Sacramento,CA Study objective: It is well known that screening mammography is the best way to detect early breast disease. Women themselves detect 90% of their own breast cancers. In this study, we wanted to determine whether women presenting to our emergency department practiced behaviors that might increase their rate of detecting early breast disease. Our null hypothesis is that behavior will be the same across age, race, income, and insurance type. Methods: Between February and April 1999, we administered a 1-page convenience sampling of women in the ED treatment and waiting areas at the University of California-Davis Medical Center aged 18 and older. Participation was strictly voluntary. During this time, 200 completed surveys were collected. We studied whether women performed breast self-examination (BSE) and if they had received a mammogram by age, race, income, and insurance type. Results: A total of 68.5% of the women performed BSE. Women who were older (>40 years old) were significantly more likely to perform BSE than younger women (P<.001). Higher-income (>$20,000 per year) women were sigmficantly more likely to perform BSE than lower-income (<$20,000) women (P<.01). There were no differences between races and by type of insurance. Of the women older than 40 years, 87.8% had received a mammogram. Higherincome women were significantly more likely to receive a mammogramthan lower income women (P<.01). There were no differences between race or by type of insurance.
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ANNALS OF EMERGENCY MEDICINE 34:4 OCTOBER 1999, PART 2
reviewed to identify eligible patients presenting consecutively from November 23 to November 30, 1996. All acutely injured patients not involved in a motorized vehicle crash were included. Results: Sixty-one patients were identified as intentional assault victims; we were able to locate both physician and nurse charts for 59 (97%). Fewer than half of the charts indicated the identity of the assailant or the date of the assault. Physicians were significantly more likely than nurses to document the identity of the assailant (29% versus 10%; P=.011), as well as the date of assault (46% versus 17%; P=.001). There was no difference between physician and nurse documentation of place of assault (14% versus 10%; P=.569). All charts had documentation of object use; however, 11 charts (9%) had a discrepancy in the type of object documented. Conclusion: Although the ED commonly treats assaulted patients, basic surveillance data are often omitted from the chart. Physicians document more than nurses, but both physicians and nurses are poor overall at documennng information regarding assaults. Structured charting may provide more complete data collection.
426
Conclusion: BSE and mammography to detect early breast changes was higher than expected in this ED population of women. Lower-income and younger women performed less BSE than higher-income women and lower-income women received less mammography. The ED may be an important site to educate young and lower-income women about BSE and mammography.
Advanced Cardiac Life Support Training: Comparison of Brazilian Versus North American Student Responses
Kern KB, Timerman S, Paiva E/NCR Brazil, San Pauio, Brazil; University of Arizona, Tucson, AZ A nationally coordinated effort has recently begun to teach advanced cardiac life support (ACLS) to health care professionals throughout Brazil. Under the direction of FUNCOR of the Brazilian Heart Foundation Society of Cardiology, these courses have carefully followed the American Heart Association's ACLS guidelines. ACtS materials (English) were available before the course for each student. Data on student preparation and end of course evaluations have been prospectively gathered and comparisons made between the first 122 Brazilian students and a similar 1997 student cohort from the University of Arizona (n=31). Students evaluated the different course aspects as unsatisfactory, satisfactory, or superior. No differences in raungs concerning course schedule, course dynamics, or content were detected with both groups giving each of these categories approximately a 45% "superior" rating. Significantly more Brazilian students rated "superior" course organization (62% versus 42%; P<.02) and duration (10% versus 27%; P<.05) than did the Arizona students. Instructors were rated similarly high and "superior" by both student groups (57% versus 48%; P<.5). Likewise, no differences were found in course materials (56% versus 45%; P<.3) or knowledge gained (50% versus 50%; P<.9). Brazilian students did rank facilities (54% versus 26%; P<.01) and mannequin use (44% versus 20%; P<.O2) higher than the Arizona students. Both groups of students appear to prepare equally well, with 33% versus 50% reading a majority of the ACLS text before the course (P<.3). The vast majority claimed their treatment of cardiac arrest victims would be drastically altered from having attended the ALCS course (95% versus 90%; P<.4). Finally, in both countries there was unanimous agreement that the course was worthwhile and should be recommended for all health care professionals.
Am)'7
"~L/
A Breast Screening Behavior Survey in an Urban Emergency Department
Takakuwa KM, ErnstAA, Weiss SJ/University of California-Davis Medical Center,Sacramento,CA Study objective: It is well known that screening mammography is the best way to detect early breast disease. Women themselves detect 90% of their own breast cancers. In this study, we wanted to determine whether women presenting to our emergency department practiced behaviors that might increase their rate of detecting early breast disease. Our null hypothesis is that behavior will be the same across age, race, income, and insurance type. Methods: Between February and April 1999, we administered a 1-page convenience sampling of women in the ED treatment and waiting areas at the University of California-Davis Medical Center aged 18 and older. Participation was strictly voluntary. During this time, 200 completed surveys were collected. We studied whether women performed breast self-examination (BSE) and if they had received a mammogram by age, race, income, and insurance type. Results: A total of 68.5% of the women performed BSE. Women who were older (>40 years old) were significantly more likely to perform BSE than younger women (P<.001). Higher-income (>$20,000 per year) women were sigmficantly more likely to perform BSE than lower-income (<$20,000) women (P<.01). There were no differences between races and by type of insurance. Of the women older than 40 years, 87.8% had received a mammogram. Higherincome women were significantly more likely to receive a mammogramthan lower income women (P<.01). There were no differences between race or by type of insurance.
S 1 08
ANNALS OF EMERGENCY MEDICINE 34:4 OCTOBER 1999, PART 2