Articles: emergency-services.
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Comparative Study
Survival after trauma--experience at an acute-care general hospital.
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In response to recent reports questioning the adequacy of management of major trauma in the United Kingdom, the routine for handling such emergencies in one district general hospital was examined. Deficiencies in the current system of management were identified and are described. In order to improve the standard of care a protocol for the assessment and resuscitation of the seriously injured was devised. ⋯ In addition, a new form of documentation was designed to facilitate the recording of injuries, resuscitation measures required and physiological parameters. This documentation is described in detail. These measures have been favourably received by medical and nursing staff and have stimulated interest in the management of major injuries.
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To determine the scope and magnitude of patient and visitor aggression directed toward emergency department staff. ⋯ ED violence is a significant and under-reported problem at our medium-sized university teaching hospital. These data are useful in objectively quantifying the scope of violence in our institution, and they underscore the potential risk to emergency patients, visitors, and staff. There is an acute need for additional studies in other settings so that appropriate and cost-effective security recommendations can be formulated.
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The outcome of care has traditionally been defined as a "change in the patient's current and future health status that can be attributed to antecedent health care." However, this definition provides a "unidimensional view of quality." It fails to take into account the customer's attributes and the many small steps or process variances that can contribute to an unexpected outcome. This failure can be especially pronounced in the emergency department.
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To examine current thrombolytic protocols in Oregon emergency departments with regard to variations in patient evaluation, inclusion and exclusion criteria, initiation of therapy, and available thrombolytic agents. ⋯ Thrombolytic protocols are highly variable in Oregon EDs.