Articles: emergency-services.
-
Arch Pediat Adol Med · Jan 1994
A statewide evaluation of pediatric prehospital and hospital emergency services.
To evaluate the extent of pediatric emergency training and the availability of pediatric equipment and patient care protocols in the prehospital and hospital settings. ⋯ These survey data are inexpensive to obtain and demonstrate EMS system deficiencies. The survey information provides a baseline measurement that can lead to measurable, targeted changes in the state's EMS system for children.
-
The hypothesis that the use of an observation unit (OU) in the emergency department (ED) results in monetary savings by lowering the hospital admission rate for asthma was studied in a retrospective comparative cohort at an urban university county hospital. All acute asthmatic patients seen in the ED during a 22-month period were included. Preobservation patients were seen before the OU opened (n = 834); postobservation patients were treated afterward (n = 390). ⋯ However, 5.3% less patients were admitted directly to the hospital (P = .01), and 6.7% less patients were discharged directly from the ED (P = .005). The OU produced no demonstrable cost savings. The use of an OU for asthmatic patients results in lower initial discharge rates from the ED and does not reduce eventual hospital admission appreciably.
-
Ann R Coll Surg Engl · Jan 1994
Intravenous sedation in accident and emergency departments: a nationwide survey.
Anonymous questionnaires regarding the practice of intravenous sedation were sent to all accident and emergency departments in England and Wales. The response rate was 63%. Intravenous sedation was used by 94% of the departments who replied. ⋯ In 16% of the units no monitoring was used routinely. ECG monitoring was carried out by 48% of the departments, non-invasive blood pressure monitoring by 67% and pulse oximetry by 65%. Our findings indicate there is a need for guidelines regarding patient selection, the choice of drugs and the monitoring of patients.
-
Infection control for health care workers caring for critically injured patients: a national survey.
Prevention of transmission of bloodborne pathogens to health care workers (HCWs) involved in resuscitation of critically injured patients presents special challenges. As a step toward creation of a standard, a telephone survey of the infection control practices in this setting of the 100 busiest EDs in the United States (US) was performed. Departmental staff who were knowledgeable about ED infection prevention protocols were questioned about general policy, barrier protection measures, sharps management, and educational programs directed to HCWs. ⋯ Only 59 EDs (72%) reported that sharp containers were always within arm's reach of HCWs with material to discard. Specially adapted equipment included self-sheathing intravenous catheters (21, 26%) and needle/syringe combinations (16, 20%). Considerable variation exists in infection control practices in busy US EDs during resuscitation of critically injured patients.(ABSTRACT TRUNCATED AT 250 WORDS)