Articles: emergency-services.
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To evaluate the impact of a fast track triage system for patients with acute myocardial infarction. ⋯ This fast track system requires no additional staff or equipment, and it halves inhospital delay to thrombolytic treatment without affecting the accuracy of diagnosis among patients requiring thrombolysis.
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An analysis was made of 82 public hospitals surveyed by the ACHS in 1990 that had received recommendations for improvement within their Accident and Emergency service. The major areas requiring attention included quality assurance, scope of service, policy and procedure manuals, signposting and the appointment of a medical practitioner responsible for the service. The analysis also revealed that 90% of the recommendations for improvement made by ACHS surveyors at a previous survey had been fully or partially implemented upon resurvey in 1990.
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Eight records used in six accident and emergency (A/E) departments in the Mersey Region were reviewed. We studied (1) the structure of records; (2) the printed matter on the record; (3) the designated areas for documentation by the administrative, nursing and medical staff; and (4) the advantages of the records in transferring information to other departments and general practitioners. The use of computers in the departments was investigated. ⋯ None of the accident and emergency departments used computers for either delayed or real-time recording of patients' details. A computer-structured A/E Record will produce a legible, factual patient history, examination and care plan. The information recorded will be easily transferred to relevant hospital departments and ultimately to the community practitioners.
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In our accident service department all trauma radiographs are reported acutely and those misinterpreted by the casualty officers are presented at the daily clinicoradiological conference. We have reviewed this practice over a 6-month period. From over 25,000 patients attending the accident service, 16,246 radiographs were requested and reported. ⋯ However, the incidence of misinterpretation was highest in examination of the fingers, especially in children. We believe that these low figures are principally the result of involving both orthopaedic surgeons and radiologists at the formal daily conference. We regard our system of audit as beneficial to patients' care and anticipate reduced litigation which may offset the increased cost of audit.