Emergency medicine journal : EMJ
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Reduction in admissions is an important aim of emergency department working policy to overcome the problems of a shortage of inpatient beds, overcrowding, rising costs and exhausted resources. A new policy was instituted in the emergency department of a hospital in Kuwait with the following components: (1) an admission avoidance team of emergency department doctors; (2) implementation of disease management guidelines; and (3) maximising the use of an emergency department observation unit. ⋯ A multidisciplinary emergency department policy, using as much available evidence as possible, was successful in significantly reducing medical hospital admissions in spite of the rising numbers of patients visiting the emergency department and observation unit.
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Randomized Controlled Trial Comparative Study
Observational pain assessment versus self-report in paediatric triage.
To examine if observational pain assessment can be used for purposes of triage in children aged >3 years. ⋯ Observational pain assessment underestimates children's perception of pain and should not be recommended in children aged >3 years. Triage has a calming effect on children.
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To evaluate the hypothesis that using an automated external defibrillator (AED) with video telephony-directed cellular phone instructions for untrained laypersons would increase the probability of successful performance of AEDs. Real-time communication with visual images can provide critical information and appropriate instructions to both laypersons and dispatchers. ⋯ Correct pad placement and shock delivery can be performed using an AED when instructions are provided via video telephone because a dispatcher can monitor every step and provide correct information.
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To examine the correlation between the AMPDS prioritisation category at dispatch and the use of alternative clinical dispatch using data from an emergency care practitioner (ECP) service dispatching on likely clinical need. ⋯ Clinically directed dispatch for ECPs allows utilisation of alternative pathways across all AMPDS categories, suggesting that AMPDS alone is not a good predictor of potential for avoiding emergency department attendance and possible hospital admission.