Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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The reality of emergency health care in the United States today requires new approaches to mental health in the emergency department (ED). Major depression is a disabling condition that disproportionately affects women. ⋯ ED providers rarely addressed depression. Qualitative analysis of significant patient-provider interactions regarding depression found that screening for depression in the ED can be accomplished with minimal expenditure of provider time and effort. Attention to psychosocial risk factors has the potential to improve the quality of ED care and patient satisfaction.
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To identify the perceptions of emergency physicians (EPs) and hospitalists regarding interservice handoff communication as patients are transferred from the emergency department to the inpatient setting. ⋯ Handoffs between EPs and hospitalists both reflect and contribute to the ambiguity inherent in emergency medicine. Poor handoffs, consisting of faulty communication behaviors and conflicting expectations for information, contribute to patient boarding conditions that can pose safety threats. Pragmatic conclusions are drawn regarding physician-physician communication in patient transfers, and recommendations are offered for medical education.
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Ambulance response time is typically reported as the time interval from call dispatch to arrival on-scene. However, the often unmeasured "vertical response time" from arrival on-scene to arrival at the patient's side may be substantial, particularly in urban areas with high-rise buildings or other barriers to access. ⋯ The time from arrival on-scene to the patient's side is an important component of overall response time in large urban areas, particularly in multistory buildings.
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To determine emergency medicine (EM) residents' perceptions and reported practices of obtaining informed consent for emergency department procedures. ⋯ Few residents have had formal training in informed consent, and there is wide variability in the perception of which procedures require informed consent. Residents are not confident in their knowledge of all risks and benefits of common procedures, and comfort levels in obtaining informed consent are low. Residents can benefit from additional resources that provide standardized information and formal training on the issue.
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Emergency department (ED) crowding has been a frequent topic of investigation, but it is a concept without an objective definition. This has limited the scope of research and progress toward the development of consistent and meaningful operational responses. ⋯ The basic pattern of ED census can be represented by a straightforward expression. This expression can be quickly adapted to a variety of inquiries regarding ED crowding, daily surge, and operational efficiency.