Articles: emergency-services.
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Multicenter Study Clinical Trial
The impact of unstable angina guidelines in the triage of emergency department patients with possible acute coronary syndrome.
The primary aim of this study is to determine whether implementing the Agency for Health Care Policy and Research (AHCPR) Unstable Angina Practice Guideline improves emergency physician's decision making in patients with symptoms of possible acute coronary syndrome (ACS), including those for whom the diagnosis of unstable angina is uncertain. ⋯ Implementation of the AHCPR guideline did not improve triage decisions in emergency department patients with possible ACS. Assessing physician triage solely based on concordance with the AHCPR guideline may not accurately reflect the quality of patient care.
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Pediatric emergency care · Nov 2006
Multicenter StudySurvey of parental willingness to pay and willingness to stay for "painless" intravenous catheter placement.
This study examined how much parents are willing to pay and/or willing to stay to make their child's intravenous (IV) catheter placement painless. ⋯ Parents are willing to spend both time and money to make their child's IV placement painless. This information should be considered when choosing therapies to reduce the pain of IV placement.
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The Journal of pediatrics · Nov 2006
Multicenter StudyAssociation of emergency department care factors with admission and discharge decisions for pediatric patients.
We evaluated overutilization or underutilization of inpatient resources to measure the emergency department (ED) decision-making process and its association with the following care factors: annual pediatric volume, presence or absence of a pediatric emergency medicine specialist; and presence or absence of ED residents. ⋯ There is significant variability in ED decision-making for children. Residents but not volume or presence of a pediatric emergency medicine specialist are associated with increased differences in admission decisions. The process by which these differences occur was not investigated.
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The impact of misinterpretation of the ECG in patients with acute myocardial infarction (AMI) in the emergency department (ED) setting is not well known. Our goal was to assess the prevalence of the failure to identify high-risk ECG findings in ED patients with AMI and to determine whether this failure is associated with lower-quality care. ⋯ The failure to identify high-risk ECG findings in patients with AMI results in lower-quality care in the ED. Systematic processes to improve ECG interpretation may have important implications for patient treatment and outcomes.
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The purpose of this study was to describe the violence experienced by Emergency Department (ED) workers from patients and visitors during the 6 months before the survey. Two hundred forty-two employees at five hospitals who came in direct contact with patients or visitors completed a survey. The study found that most workers had been verbally harassed by patients or visitors at least once. ⋯ There were significant relationships among violent experiences, feelings of safety, and job satisfaction. ED workers are at high risk for violence, and efforts are needed to decrease the incidence of violence. Such efforts are likely to have a positive impact on job satisfaction and retention of ED workers.