Articles: emergency-services.
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The American College of Surgeons' Committee on Trauma (ACSCOT) has developed field triage guidelines intended to identify seriously injured patients. Unlike the 1990 version, the 1993 revision calls for on-line medical control assistance with the triage decision for patients whose only marker of severe injury is the mechanism of their injury. We prospectively examined the application of the 1990 ACSCOT field triage guidelines to evaluate Emergency Medical Service (EMS) utilization of these guidelines and the potential effects of the 1993 revision. ⋯ The current ACSCOT field triage guidelines are appropriate when applied by field EMS personnel.
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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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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.