Articles: emergency-services.
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To determine whether triage and stabilization of severely injured rural trauma victims in outlying Level III emergency departments before transfer to Level I trauma centers results in outcomes similar to national normative data. ⋯ Triage and stabilization of severely injured rural trauma victims at Level III EDs before Level I transfer provide outcomes similar to national results. Unexpected death of severely injured trauma victims remains a problem in rural Level III EDs.
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Pediatric emergency care · Feb 1995
Childhood injuries and the importance of documentation in the emergency department.
The purpose of this study is 1) to evaluate the extent to which documentation of the medical record is completed for dependent children who present for evaluation of an acute injury, and 2) to examine the factors that favorably or adversely influence completion of the medical record. The emergency department (ED) ledgers of 669 children less than nine years of age were reviewed, including 172 (25.7%) who presented for evaluation of an acute injury. Each of the latter charts was examined for basic demographic data, as well as information about injury type and mechanism, ED provider, and involvement of social services personnel. ⋯ The 15 individual scores were equally weighted and summed, resulting in a total documentation score ranging from zero (failure to address or document any of the 15 variables) to 15 (all variables completely addressed/documented). The mechanisms of injury included falls from height (48.3%), direct blunt impact other than falls (26.7%), penetrating injury (6.4%), burn (5.2%), and ingestion (8.1%). Seventeen patients (9.9%) were admitted for primarily medical, and one (0.6%) for primarily social, indications; one patient died as a result of his injuries.(ABSTRACT TRUNCATED AT 250 WORDS)
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To determine whether nonemergency patients can be prospectively identified by triage nurses and safely triaged out of the emergency department without treatment. ⋯ A subset of patients with nonemergency problems can be prospectively identified and triaged out of the ED without significant adverse outcomes provided there is community support for follow-up care.
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Social science & medicine · Feb 1995
Heavy users of emergency services: social construction of a policy problem.
A relatively small subgroup of emergency department (ED) patients is responsible for a disproportionate amount of ED visits and costs. This subgroup, the heavy users of ED services, is identified as a medically and socially vulnerable population. ⋯ The problem is nested within a complex of larger, interdependent problems including access to care, lack of primary/preventive services, absent or inadequate social services, and fragmented service delivery. This article uses the literature on heavy users of ED services to argue that social constructions of the problem and articulation of solutions by different key players in health care reform are based on divergent and often conflicting premises.
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Health Care Law Newsl · Feb 1995
Special report on patient care. The new federal patient-dumping regulations: some commonly asked questions and answers.
Until both providers and government surveyors become more familiar with the new EMTALA regulations, there will be an uncomfortable period of adjustment, and perhaps some turmoil as well, particularly regarding the new requirement that facilities who receive suspicious transfers report those transfers to HCFA. Providers should carefully examine their internal policies on discharge and transfer of emergency patients to assure that those policies are consistent with the new regulations. Particular attention should be given to inservice training for medical and support personnel in the emergency department, because they must precisely comply with the law and their errors can subject the hospital to costly investigations and potential fines of $50,000 for each violation.