Articles: emergency-services.
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Pediatric emergency care · Dec 1994
Comparative StudyEvaluation of QBC Autoread performance in an emergency department setting.
The objective of the study was to examine the accuracy and clinical utility of technology using a quantitative buffy coat analysis in determining complete blood cell count results in an emergency department. A prospective observational study was done at an urban pediatric emergency department. One hundred ninety-one patients who had a complete blood cell count (CBC) ordered by the managing emergency physician from 11 AM to 3 AM participated. ⋯ The mean time for collection to QBC result was 17.3 +/- 11.6 minutes compared with 42.2 +/- 17.9 minutes for collection to CBC result. One hundred thirty-five clinical utility forms were completed by the managing physicians after a review of their patient's QBC result. In 20% of cases, physicians felt the QBC result would have shortened the patient's length of stay in the emergency department, and in 85% they felt the result confirmed their clinical impression.(ABSTRACT TRUNCATED AT 250 WORDS)
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To determine the rate and cause of death of patients who were evaluated in the emergency department and discharged and how the cause of death related to the ED visit. ⋯ Death after discharge from the ED is uncommon. The most common cause of unexpected, directly related death is ruptured aortic aneurysm.
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To determine which adult patients with new-onset seizures require admission and whether those who require admission can be identified in the emergency department. ⋯ One half of patients with new-onset seizures require admission. Patients with new-onset seizures who require admission can usually be detected by a standardized medical evaluation in the ED.
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To assess factors related to emergency department use in the Ontario population. ⋯ Our study estimated that approximately one in five Ontario residents had reported one or more visits to the ED in the past 12 months. There were identifiable subgroups in the population with increased ED usage even after adjustment for health needs factors.
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Forty-six patients were identified who attended an accident and emergency (A&E) department having previously attended a different A&E department in the same city for the same problem. Of these patients, 20% had been referred to the second department by the general practitioner (GP) or practice nurse. A diagnostic error had been made in 17.5% of patients at their first visit and some management errors were discovered. ⋯ A review of unplanned reattenders to an A&E department is an important opportunity for audit and normally an error will not be discovered if a patient attends a different department. We recommend that in cities where there is more than one A&E department a system should be set up whereby if a patient attends one department having previously attended another, the first department should be informed of the patients reattendance, especially if any diagnostic or management error has been discovered. Patients should be educated that if they have sought medical help for any problem and the condition does not improve, then they should return to see the same doctor or A&E department for continuity of care and avoidance of unnecessary duplication of investigations including exposure to X-rays.