Articles: emergency-services.
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Our objective was to evaluate whether referral to primary care settings would be clinically appropriate for and acceptable to patients waiting for emergency department care for nonemergency conditions. ⋯ Public emergency departments could refer large numbers of patients to appointments at primary care facilities. This alternative would be viable only if the availability and coordination of primary care services were enhanced for low-income populations.
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Survival determinants were examined in patients undergoing ERT-PCI who were admitted to the Surgical Intensive Care Unit (SICU) between January 1, 1982 and August 1, 1991. Twenty-one of 290 patients undergoing ERT-PCI (aged 14-36 years) were admitted to the SICU. Of the 21, nine survived to discharge with normal neurologic function. ⋯ All survivors had vital signs either in the field or on ER arrival. Patients with penetrating chest wounds without vital signs in the field who do not recover vital signs by hospital arrival do not benefit from emergency room thoracotomy. Evidence of mentation in the field or on arrival may predict ultimate neurologic outcome of survivors.
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To assess the current practice of pediatric emergency care in the United States, a questionnaire was mailed to the directors of all 240 emergency departments (EDs) affiliated with pediatric residency training programs in the United States. One hundred seventy-two programs (72%) returned completed surveys, which comprised 32 questions highlighting staffing patterns, ancillary services, clinical issues, and resident education. The mean annual ED census was 39,290; the mean number of visits for children 0 to 18 years of age was 17,473. ⋯ During their first, second, and third years of training, pediatric residents spent an average of 5.2, 5.8, and 3.5 weeks in the ED, respectively. The majority of EDs handled all levels of pediatric trauma (84%), had dedicated trauma teams (73%), employed social workers specifically assigned to the ED (62%), and had child abuse teams (72%). Ninety-one percent of EDs had radio communications with prehospital care vehicles and 67% provided medical command for incoming pediatric patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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Patient satisfaction with emergency department care is enhanced by information distributed to patients on ED arrival. ⋯ ED information has a significant effect on patients' perceptions of the quality of care and overall satisfaction.
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To identify factors associated with outpatient follow-up of emergency department visits. ⋯ Compliance with follow-up is multifactorial. Consultant contact at the time of initial patient evaluation and provision of a return visit appointment at the time of ED release should improve compliance in a university hospital setting.