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Dis Colon Rectum 2003,46(5) 649–52.PubMedCrossRef 10. Santry H, Pringle PL, Emhoff TA, Velmahos GC: Acute care surgery patterns in the current Era: results of a qualitative study. http://​escholarship.​umassmed.​edu/​cgi/​viewcontent.​cgi?​article 11. Initial assessment and management , chapter 1: Advanced trauma life support, student course manual. 8th edition.

Chicago, IL: American college of surgeons; 2008:1–19. 12. Kahn CA, Schultz CH, Miller KT, Anderson CL: Does START triage work? An outcomes assessment after a disaster. Ann Emerg Med 2009,54(3) 424–30.PubMedCrossRef Protein Tyrosine Kinase inhibitor 13. Kluger Y, Mayo A, Aladgem D, Halperin P: Functions and principles in the management of bombing mass casualty incidents – lessons learned at the Tel-Aviv Sourasky medical center. Eur J Emerg Med 2004, 11:329–34.PubMedCrossRef 14. National confidential enquiry into patient outcome and death. London: The NCEPOD classification of interventions [Online]; 2004. http://​www.​ncepod.​org.​uk/​pdf/​NCEPODClassifica​tion.​pdf Competing interests The authors declare that

they have no competing interests.”
“Introduction selleck products Acute pelvic pain accounts for up to 40% of visits to gynecologic emergency departments (EDs) [1] and may indicate a life-threatening emergency. A prompt diagnosis is crucial to prevent severe morbidity or death [2]. The physical examination is not fully reliable [2–5]. Extensive use of diagnostic laparoscopy has been suggested to avoid missing gynecologic or non gynecologic disorders requiring emergency surgical treatment [1, 6]. However, laparoscopy is an invasive procedure associated with a number of complications [7], and its use as a diagnostic tool should therefore be avoided whenever possible [8]. Since the 1990s, transvaginal

BAY 80-6946 order ultrasonography (TVUS) has become an essential diagnostic tool for gynecologic emergencies [9]. Nonetheless, the impact of around-the-clock access to TVUS in gynecologic EDs remains unclear. In most of the studies establishing the diagnostic accuracy of TVUS in detecting gynecological emergencies, the examination was performed by board-certified radiologists or obstetricians/gynecologists. These specialized physicians are not available around-the-clock when resources are limited, as is increasingly the case in this era of patient care in Megestrol Acetate the case of cost containment. It has been suggested that obstetrics/gynecology residents can perform reliable ultrasound scans in the ED to increase the rapidity and improve the quality of patient care in case of gynecologic emergencies [10]. In France, obstetrics/gynecology residents perform the initial evaluation of patients seen in gynecologic EDs, including bedside TVUS. In a previous study, we demonstrated that standardizing the gynecologic emergency ultrasonogram allowed scoring and quality control and also significantly improved the quality of ultrasonography in the gynecologic EDs [11].

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