Articles: emergency-services.
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Clinical Trial
Impact of portable pulse oximetry on arterial blood gas test ordering in an urban emergency department.
To determine the impact of portable pulse oximetry on physician use of arterial blood gas tests (ABGs) in an urban emergency department. ⋯ Portable pulse oximetry can provide a simple, noninvasive way to determine oxygen saturation in the ED. Routine use of portable pulse oximetry may substantially reduce rates of ABG testing and associated patient charges without adversely affecting the quality of emergency care.
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Emerg. Med. Clin. North Am. · Feb 1991
ReviewEvaluation of behavioral and cognitive changes: the mental status examination.
Patients who present to the Emergency Department with a behavioral or cognitive disorder should be treated in an organized fashion. The most important element of their care is determining the etiology of their abnormality, whether organic or functional. ⋯ It must be focused and brief. By focusing on seven major areas (affect, attention, language, orientation, memory, visual-spatial ability, and conceptualization), a quick and thorough examination of the patient's mental status can be performed.
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Nursing home residents are frequently transferred to hospital emergency departments. Delayed transfer may lead to poor outcomes. However, inappropriate transfer of the frail elderly may cause social and financial problems. ⋯ The results indicate that the problems of nearly half the study group could have been treated at the nursing home by a visiting physician with minimal medical equipment. Those admitted to the hospital (52%) were seriously ill, had prolonged lengths of stay (23.6 days), and had a high mortality rate (11%). Complex issues of physician reimbursement, proprietary nursing home budgeting, and day-to-day expediency appear to be involved in decisions to transport patients by ambulance to VA emergency departments.
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This paper describes an evaluation of the short-stay ward at Guy's Hospital Accident and Emergency Department. It includes an audit of the operational policy, the care provided to patients, and the impact of the short-stay ward on hospital admissions. The results indicate that by concentrating patients in a short-stay ward, the quality of care is improved, delays are reduced, and the pressure on inpatient beds is relieved.