Articles: emergency-services.
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The utilization of psychiatric crisis teams in urban hospitals is well documented. However, little is reported describing patients who use crisis teams in suburban general hospital emergency rooms. This is a descriptive survey of 1707 suburban patient visits. ⋯ A regression model is used to analyze the duration of service time and utilization patterns in relation to eight variables: season, month, day, shift, diagnosis, method of payment, age, and disposition. Five predictors are identified as significantly relating to the duration of the psychiatric consultation process. These predictors may enable hospital administrators and medical staff to plan and implement psychiatric emergency room care.
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This literature review was written as part of a pilot study into staff perceptions of inappropriate attendance at accident and emergency (A&E) departments. The pilot study was carried out in the final year of the BSc Nursing Studies course at Birmingham Polytechnic. ⋯ The review covers quite a span of years, the oldest piece of literature under review dating back to 1849. Some 143 years show that indeed this particular problem is not necessarily a modern one but one that has its origins in another century.
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Comparative Study
Tissue and organ procurement in the emergency department setting.
A retrospective chart review of all emergency department (ED) deaths in patients younger than 65 years in seven area hospitals was performed for the calendar year of 1990. The number and percentage of families approached and consenting to tissue donation among the various EDs was compared and reasons for not approaching families were evaluated for their validity. Procurement rates between the years 1990 and 1991 were compared for two area hospitals, which made a specified (nonmedical) service responsible for tissue requests in 1991. ⋯ Tissue procurement rates in EDs with procurement systems in place are low despite consent rates of those approached of 36%. The major contributing factor is the failure to request tissue from the families of eligible candidates even when there are no exclusion criteria met. Suburban EDs had a higher success rate than urban EDs.
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Physician service time varies with patient service category, length of stay, and intensity of service. ⋯ Case mix of patient services affects emergency physician workload and should be considered in planning departmental staffing needs.