Articles: emergency-services.
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Hospital disaster planning should encompass events that affect the safety of the hospital environment and address those measures that ensure the availability of necessary services. Although most of the emphasis has been placed on general disaster planning, there is little written about disasters occurring within a hospital. In recent years, several incidents at our medical center involving fire, flood, and power failure resulted in a reevaluation of our preparedness to handle such situations. These experiences prompted this discussion and literature review of internal disaster plan because it is likely that at some time an internal emergency may occur.
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Pediatric emergency care · Apr 1994
Comparative StudyBurn injuries among children in an urban emergency department.
To determine the profile of burn injury among an ambulatory population, we conducted a retrospective chart review over a one-year period of all first visits by patients under age 18 receiving burn care in our emergency department. Of the 109 visits, contact burns were most numerous (43.1%) followed by scalds (33.9%), flame/explosion (11.0%), cigarettes (5.5%) and electrical (2.8%). For children under 11 years of age, contact burns caused over half of all burns. ⋯ Contact burns were more likely to be smaller and more localized when compared with other burns. The cause and causative agents of burns differ in frequency and relative importance depending on the patient population studied and the level of medical care being provided. Specific burn prevention strategies should be directed toward particular patterns of injury within defined patient groups.
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To determine the feasibility of a case-finding program for cognitive impairment in elderly emergency department patients, and to describe the prevalence of cognitive impairment in screened patients and identify factors associated with impairment. ⋯ Screening for cognitive impairment in elderly ED patients using the OMC Test is feasible. There is a high prevalence of cognitive impairment in elderly ED patients, and the prevalence increases with age. Identification of cognitive impairment is important in the assessment of elderly ED patients and may affect clinical evaluation, patients' understanding of medical information, and compliance with discharge instructions.
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Pediatric emergency care · Apr 1994
Comparative StudyThe utility of autopsies in a pediatric emergency department.
The role of the autopsy in verifying clinical diagnosis and as a quality assurance tool in pediatric emergency medicine has not been studied. We reviewed the charts of all children who died soon after arriving at to the pediatric emergency department between October 1985 and December 1989. Opinions as to clinical diagnoses and cause of death were obtained by presenting a summary of patient data, in a blinded fashion, to three emergency pediatricians. ⋯ Class II error rate was 15%. Most Class II errors occurred in patients between one and five years of ate (57%), and in patients who had sepsis or underlying disease (95%). Our data show that autopsy is useful in determining the cause of death and may be useful for education and quality assurance in pediatric emergency medicine.
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Using exit interviews, we determined parental recall of their child's diagnosis, treatment, and follow-up instructions after a visit to the emergency department (ED). Over 2 weeks, 159 parents were interviewed. Exclusion criteria were: parental language other than Spanish or English, admission, trauma, child abuse, or a primary psychiatric diagnosis. ⋯ Of those parents given a single medication, 51% (34 of 67) knew how to administer it, while only 10% (three of 31) knew how to administer multiple medications (P < 0.001). Similarly, 58% (46 of 79) of parents given a single appointment knew the date and place of their child's follow-up, while only 16% (three of 19) given multiple appointments knew all dates and locations (P = 0.001). These data suggest that despite high parental satisfaction with communication, many parents cannot fully recall their child's diagnosis, treatment, and follow-up--especially when multiple diagnoses, medications, or appointments are given.