Articles: emergency-services.
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Southern medical journal · Jun 1991
Comparative StudyPoison control centers: can their value be measured?
Most regions of the United States are served by poison control centers that provide 24-hour toxicologic guidance resulting in the home management of most poison exposures. It has been suggested that without public access to a poison control hotline the majority of poison-exposed patients would seek medical care in emergency departments or other outpatient visits. ⋯ Before the closing of the Louisiana center, Alabama and Louisiana triage patterns for poison exposures were nearly identical. The maximum annual cost attributable to unnecessary outpatient service utilization in Louisiana was estimated to be $1.4 million, an amount more than three times the annual poison control center state appropriation.
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Successful treatment of acute intoxications should include early urgent measures, use of specific antidotes, polysymptomatic and polysyndromic treatment. It is an error to delay intensive care until laboratory identification of the toxicant. Only combined use of methods directed to potentiate natural urocesses, intra--and extracorporal detoxication allows to improve treatment results of treating acute intoxications.
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To examine the variability and define the normal ranges of orthostatic vital signs in an emergency department population. ⋯ The data from this study indicate that there is a wider than expected variation in orthostatic vital signs among presumed euvolemic ED patients.
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Pediatric emergency care · Jun 1991
Complaints and compliments in the pediatric emergency department.
We conducted an analysis of all communications received from patients or their families by the director of a pediatric emergency department over a three-year period, during which approximately 150,000 visits occurred. Communications were characterized as complaint or compliment and subclassified by type: waiting time, staff attitude, quality of medical care, and billing. ⋯ The problems that we identified might be addressed by providing families improved access to non-emergency department care sources, education regarding the role of an emergency department, and better explanation of billing procedures during the registration process. Additionally, our findings serve as a reminder that many parents appreciate the care given to their children, particularly for life-threatening emergencies.
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To evaluate whether the capillary refill test can correctly differentiate between hypovolemic and euvolemic emergency department patients. ⋯ Capillary refill does not appear to be a useful test for detecting mild-to-moderate hypovolemia in adults.