Articles: emergency-services.
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Emerg. Med. Clin. North Am. · Feb 2015
ReviewHospital Preparedness for Chemical and Radiological Disasters.
Hospital planning for chemical or radiological events is essential but all too often treated as a low priority. Although some other types of disasters like hurricanes and tornadoes may be more frequent, chemical and radiological emergencies have the potential for major disruptions to clinical care. ⋯ Planning needs to include all 4 phases of an event: mitigation (preplanning), preparation, response, and recovery. Mitigation activities should include the performance of a hazards vulnerability analysis and identification of local subject-matter experts and team leaders.
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Comparative Study
Effect of the Affordable Care Act's young adult insurance expansions on hospital-based mental health care.
Insurance coverage for young adults has increased since 2010, when the Affordable Care Act (ACA) required insurers to permit children to remain on parental policies until age 26 as dependents. This study estimated the association between the dependent coverage provision and changes in young adults' use of hospital-based services for substance use disorders and non-substance use psychiatric disorders. ⋯ ACA dependent coverage provisions produced modest increases in general hospital psychiatric inpatient admissions and higher rates of insurance coverage for young adults nationally. Lower rates of emergency department visits were observed in California.
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Emerg. Med. Clin. North Am. · Feb 2015
ReviewPersonal Protective Equipment and Decontamination of Adults and Children.
Accurate identification of the hazardous material is essential for proper care. Efficient hospital security and triage must prevent contaminated victims from entering the emergency department (ED) and causing secondary contamination. The decontamination area should be located outside the ambulance entrance. ⋯ Decontamination proceeds in a head-to-toe sequence. Run-off water is a hazardous waste. Hospital and Community Management Planning for these emergencies is essential for proper preparation and effective response to the hazardous materials incident.
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Observational Study
Accuracy of Reduced-Dose Computed Tomography for Ureteral Stones in Emergency Department Patients.
Reduced-dose computed tomography (CT) scans have been recommended for diagnosis of kidney stone but are rarely used in the emergency department (ED) setting. Test characteristics are incompletely characterized, particularly in obese patients. Our primary outcome is to determine the sensitivity and specificity of a reduced-dose CT protocol for symptomatic ureteral stones, particularly those large enough to require intervention, using a protocol stratified by patient size. ⋯ CT with substantial dose reduction was 90.2% (95% CI 82.3% to 95.0%) sensitive and 98.9% (95% CI 85.0% to 100.0%) specific for ureteral stones in ED patients with a wide range of BMIs. Reduced-dose CT was 96.0% (95% CI 80.5% to 99.3%) sensitive for ureteral stones requiring intervention within 90 days.