Articles: emergency-services.
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Health services research · Jun 1993
Comparative StudyMeasuring quality of care in psychiatric emergencies: construction and evaluation of a Bayesian index.
This study was conducted to determine whether an index for measuring quality of care for psychiatric emergencies is reliable and valid. ⋯ The study demonstrated that a subjective Bayesian model can be used to develop a reliable and valid index for measuring quality of care, with potential for practical application in management of health services.
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Pediatric emergency care · Jun 1993
General trauma in a pediatric emergency department: spectrum and consultation patterns.
To assess the consultation patterns of pediatric emergency physicians in the management of injured children and to describe the spectrum of pediatric trauma, we retrospectively reviewed 601 patients treated in the emergency department for injuries during four one-week periods at a designated level I regional pediatric trauma center (50,000 patients/year) with a pediatric emergency medicine fellowship. The majority (94%) of pediatric trauma was minor; only 2% of children had injuries severe enough to require direct transfer to the operating room. The highest volume of patients, the greatest number of consultations, and the majority of admissions to the operating room occurred between 4 PM and midnight. ⋯ One half of all procedures involved laceration repair, and one third involved splinting or casting. Four hundred ten patients (68%) were managed by physicians in the emergency department without consultation. The orthopedic service performed one half of all consultations and admitted the largest number of patients; the majority of patients taken directly to the operating room had musculoskeletal injuries.(ABSTRACT TRUNCATED AT 250 WORDS)
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This study aimed to identify qualified nurses' perceptions of the helpfulness of selected nursing actions, derived from the literature, in meeting the needs of suddenly bereaved family members in the accident and emergency (A&E) department. The effect of age, length of professional experience and death education received on the respondents' perceptions was examined. The nurse subjects' feelings of preparation for this stressful role were also identified. ⋯ Analysis of the sample's responses to the 35 nursing actions included revealed that certain activities were ranked lower in terms of their perceived helpfulness, compared to the survivors' perceptions in other studies. All three variables considered had a statistically significant correlation with the perceptions of the sample as measured by the instrument (P < 0.05, using Mann-Whitney U-test). Only 42% of the sample had received any form of death education and 56% felt unprepared for this specialist role.
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To determine the use pattern of the emergency department by people 65 years of age and older. ⋯ Elderly persons do not misuse the services of the emergency department. They come because they are acutely ill; they are not frequent attenders, and their presenting complaints do require intervention (frequently hospitalization). The study findings are generalizable to the older population in the Hamilton-Wentworth region and raise such questions as whether some hospital admissions could have been avoided by earlier interventions in the community.
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Journal of medical ethics · Jun 1993
Postmortem procedures in the emergency department: using the recently dead to practise and teach.
In generations past, it was common practice for doctors to learn lifesaving technical skills on patients who had recently died. But this practice has lately been criticised on religious, legal, and ethical grounds, and has fallen into disuse in many hospitals and emergency departments. This paper uses four questions to resolve whether doctors in emergency departments should practise and teach non-invasive and minimally invasive procedures on the newly dead: Is it ethically and legally permissible to practise and teach non-invasive and minimally invasive procedures on the newly dead emergency-department patient? What are the alternatives or possible consequences of not practising non-invasive and minimally invasive procedures on newly dead patients? Is consent from relatives required? Should doctors in emergency departments allow or even encourage this use of newly dead patients?