Articles: emergency-services.
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Arch Pediat Adol Med · Oct 1997
Multicenter StudyEffect of 2 urban emergency department immunization programs on childhood immunization rates.
Emergency departments (EDs) are recommended as sites for immunizing children. However, there is little information about the effect of ED immunization programs on immunization rates. ⋯ This ED immunization program temporarily improved the immunization rates of the ED population, but substantial personnel time was required to achieve these small gains. Urban ED immunization programs are unlikely to be cost-effective.
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To determine the frequency of utilization, yield for brain injury, incidence of missed injury, and variation in the use of computed tomography (CT) for ED patients with minor head injury. ⋯ There was considerable variation among institutions and individual physicians in the ordering of CT for patients with minor head injury. Although emergency physicians were selective when ordering CT, the yield of radiography was very low at all hospitals. None of the cases of "missed" intracranial hematoma came from the lowest ordering institutions, indicating that patients may be managed safely with a selective approach to CT use. These findings suggest great potential for more standardized and efficient use of CT of the head, possibly through the use of a clinical decision rule.
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Southern medical journal · Jun 1997
Multicenter Study Comparative StudyUse of emergency departments by the elderly in rural areas.
Sparse information is available concerning use of emergency departments (EDs) by the elderly in rural areas. We reviewed records of all patients seeking care at EDs of three rural hospitals during 7 days in October 1991. We found that elderly people did not use EDs in proportion to their numbers in the community (15.2% versus 19.3%). ⋯ Falls/injuries (18.7%) and cardiac illness (18.1%) were the most frequent reasons for ED visits by the elderly, and relatively few (2.8%) had confusion. More elderly patients arrived during daytime hours than during the night, and more on weekends than weekdays. Also, we found no difference between patients in the 65- to 74-year-old age group and those aged 75 years and older.
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Multicenter Study
Use of physician extenders and fast tracks in United States emergency departments.
To describe current practice regarding the use of physician extenders (PEs) and the "fast track" (FT) concept in United States emergency departments (EDs), a telephone survey of 250 US health care facilities offering emergency services was conducted. Of the EDs surveyed, 21.6% were using PEs at the time of the survey, and of those not using PEs, 23.5% intended to do so within the next 2 years. Those using PEs had been using them for a mean duration of 3.5 years (the mode was 2 years). ⋯ The mean estimated percentage of ED patients going through FT was 30.1%. The mean number of hours per day of FT operation was 13.4 hours on weekdays and 13.7 hours on weekends (the mode was 12 hours/day both on weekdays and weekends). Of hospitals using PEs in the ED, 56.0% had FT; of hospitals without PEs in the ED, 23.5% had FT.
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Multicenter Study
Hazardous materials preparedness in the emergency department.
This study was conducted to examine the preparedness of emergency departments (EDs) to safely receive, decontaminate, and treat chemically contaminated patients. ⋯ Hospital hazmat preparedness in this area varies tremendously. A significant proportion of hospitals lack a written plan and equipment to allow the ED to safely and effectively handle the chemically contaminated patient. There is reluctance to discuss this topic.