Advocate or abdicate: the responsible choice for today's emergency medicine resident by ProQuest


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    Lancet 1994;343:386-8.                        its operating hours for such a reason.       health promotion, labour, training, and
 4. Kim RJ, Iwai S, Markowitz SM, et al.          It deserves considerable attention,          colleges and universities need to be-
    Clinical and electrophysiological spec-
    trum of idiopathic ventricular outflow        since nursing unions, academic insti-        come part of the solution. A coordi-
    tract arrhythmias. J Am Coll Cardiol          tutions and hospital administrations         nated action plan for encouraging peo-
    2007;49:2035-43.                              have been warning for many years that        ple to enter the nursing profession and
 5. Gupta AK, Shah CP, Maheshwari A,
    et al. Adenosine induced ventricular          an RN shortage is reaching critical pro-     seek out careers where they are most
    fibrillation in Wolff-Parkinson-White         portions in Ontario. As of Feb. 7,           needed, for recruiting qualified RNs
    syndrome. Pacing Clin Electrophysiol          2009, front-line health care delivery        from other locations around the world
                                                  will be visibly and directly affected by     and for making the commitment to see
 6. Exner DV, Muzyka T, Gillis AM.
    Proarrhythmia in patients with Wolff-         this crisis.                                 such a plan succeed is as necessary a
    Parkinson-White syndrome after stan-             The trends and statistics concerning      part of health care reform in Ontario as
    dard doses of intravenous adenosine.          nursing are widely available, and simi-      wait time strategies and patient safety
    Ann Intern Med 1995;122:351-2.
 7. Parham WA, Mehdirad AA, Biermann              lar to many other professions and            indicators. It’s time the public became
    KM, et al. Case report: adenosine in-         trades. They include an aging work-          aware of this threat to health care and
    duced ventricular fibrillation in a patient   force; declining enrolment in training       demand solutions from those who serve
    with stable ventricular tachycardia. J
    Interv Card Electrophysiol 2001;5:71-4.       programs, paradoxically associated           the public good.
 8. Bayes de Luna A, Coumel P, Leclercq JF.       with an increased need; and, certainly          Perhaps the overnight closure of the
    Ambulatory sudden cardiac death:              in the long-term, simple demographics.       ED at the Seaforth Community Hospi-
    mechanisms of production of fatal ar-
                                                     Small hospitals with minimal staffing     tal can serve as a sentinel event, the
    rhythmias on the basis of data from 157
    cases. Am Heart J 1989;117:151-9.             and even less potential back up face the     “canary in the coal mine” for this crisis,
 9. Rankin AC, Oldroyd KG, Chong E,               greatest challenge in RN staffing, be-       and prompt the kind of commitment to
    et al. Value and limitations of adeno-        cause a shortage of 1 or 2 nurses can        change that health care in Ontario re-
    sine in the diagnosis and treatment of
    narrow and broad complex tachycar-            mean the difference between being able       ally needs.
    dias. Br Heart J 1989;62:195-203.             to offer a high standard of care, and be-
10. Sharma AD, Klein GJ, Yee R. Intra-            ing unable to offer any care at all.         Jason Datema, MD
    venous adenosine triphosphate during
    wide QRS complex tachycardia: safety,            Hospital administrations do their best    Site Chief, Seaforth Community
    therapeutic efficacy, and diagnostic          to eliminate redundancy, maximize ef-        Hospital, Seaforth, Ont.
    utility. Am J Med 1990;88:337-43.             ficiency and optimize use of available
11. Hina K, Kusachi S, Takaishi A, et al.
    Effects of adenosine triphosphate on
                                                  human resources. But that does not ad-       Advocate or abdicate: the
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