Articles: emergency-services.
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Perimortem cesarean section is rarely required in the ED. However, since trauma now represents a leading cause of nonobstetric maternal death, emergency physicians (EPs) may more commonly be faced with the difficult decision of performing an emergency cesarean section. Two cases are described of severely traumatized pregnant patients for whom perimortem cesarean section in the ED led to birth of viable infants, with one long-term survivor. The rationale and guidelines for the procedure are discussed, and it is emphasized that the EP should be thoroughly familiar with the procedure and prepared to perform it when indicated to enhance fetal (and potentially maternal) survival.
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Pediatric emergency care · Dec 1995
Comparative StudyPreferences of parents for pediatric emergency physicians' attire.
While several studies have evaluated patient/parent's preference for physicians' attire in pediatric clinics, pediatric wards, and in adult emergency settings, none has been done in a pediatric emergency department (PED). Furthermore, factors that may influence these preferences such as severity of illness, time of visit, and type of emergency department (ED) visit (surgical vs medical) have not been considered. This study was designed to evaluate parents' attitudes toward pediatric emergency department physicians' professional appearance. ⋯ Our study demonstrated that: 1) pediatric emergency physician's attire does not matter to most parents. However, when asked to choose, clear preferences for likes and dislikes become evident. 2) Parents/guardians prefer pediatric emergency physicians who wear formal attire, including white laboratory coat, and do not like casual dress with tennis shoes. 3) Severity of illness, insurance type, and age, race, and gender of guardians do not affect preferences. 4) Parents of patients with surgical emergencies are more likely to prefer doctors wearing surgical scrubs. 5) Parents visiting the ED during night shift (11 PM to 7 AM) showed less interest in formal attire. Our findings may assist in parent/physician interaction in a PED setting.
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Pediatric emergency care · Dec 1995
Comparative StudyCharacteristics of frequent pediatric emergency department users.
The purpose of this study was to examine the medical and demographic characteristics of patients who frequently seek emergency care at a pediatric emergency department (ED). Registration information of ED visits during the study period from 11/1/87 to 5/31/92 (4.6 years) was stored in a data base. Patients with 10 or more ED visits during this study period were considered to be "frequent" ED users. ⋯ We conclude that cultural differences appeared to be an important factor associated with frequent ED use by healthy persons. Medical care resources as measured by immunizations, insurance, and identification of a primary care physician did not appear to be deficient in this cohort of frequent ED users. Since recurrent wheezing is a dominant chronic condition among frequent ED users, pediatric emergency medicine training programs may consider the inclusion of the chronic management of wheezing in their curriculum.
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In a prospective study of 4234 patients with acute poisoning in the Emergency Department of the University Hospital of Gent in Belgium between 1983 and 1990, we observed a decline in the number of poisonings from 665 in 1983 to 424 in 1990. This was due to a decrease in the number of deliberate self-poisonings. Fifty-six per cent of patients were female and the most prevalent age group was 20 to 24 years. ⋯ With regard to treatment, a reduction in gastric lavage was observed. The patients were transferred to the intensive care unit (29.2%), the psychiatry ward (23.6%) or discharged home (27.8%). Only 0.3% of the patients died in the Emergency Department.