Emergencias
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The aim of this cross-sectional study was to analyze transport by helicopter emergency medical services (HEMS) in cases of ischemic cerebral stroke in Poland in 2011 and 2012. We assessed the role of the HEMS in reducing prehospital times and analyzed changes in patients' status during transport. ⋯ Helicopter transport of these patients is safe and ensures their transfer to the nearest hospital or ambulance within the treatment time window. Time spent on care at the scene of the emergency should probably be as short as possible.
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To design and validate a clinical simulation method for training nurses to use the Emergency Severity Index (ESI) for triage. ⋯ This study supports the relevance of clinical simulations for training nurses to implement structured triage, and in particular to use the ESI. We can state that this study opens the door to further research into whether the reliability of triage can be improved by using this approach, specifically whether it can facilitate better interobserver agreement.
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To determine differences in certain variables reflecting clinical practice in a group of emergency physicians with varying levels of experience and to explore whether differences are associated with experience. ⋯ The practice of emergency physicians with more accumulated experience shows slight but significant differences from the practice of less experienced physicians.
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To determine whether the Identification of Seniors at Risk (ISAR) score predicts short-term adverse outcomes in elderly patients discharged from a short-stay unit. ⋯ An ISAR score of 3 or higher is able to identify elderly individuals at high risk of an adverse outcome within 30 days of discharge from a short-stay unit.
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The purpose of this paper is to describe the main proposals for ensuring national health service sustainability, in the light of a review of the most relevant diagnostic reports and guidelines published since the onset of the economic crisis. The following proposals are among the most frequently mentioned in the literature: selective financing of technology, reorganization to provide more care for chronic conditions and better coordination between levels of care and the network of social and health care services, and the reinforcement of primary care. Also commonly suggested is the reform of health care governance. Likewise, the authors briefly examine the measures adopted to date to promote the system's sustainability and discuss how the emergency department can further this aim.