Articles: emergency-services.
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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.
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We evaluated the Revised Trauma Score (RTS) for the rapid identification of severely injured patients on their arrival at the accident and emergency department. A total of 1407 consecutively injured patients admitted to the Accident and Emergency Department of the Royal Victoria Hospital, Belfast, had their RTSs calculated on arrival. A trauma team, consisting of experienced senior doctors, was summoned for all patients with an abnormal RTS of 11 or less. ⋯ Second, systolic hypotension following trauma is an important sign of serious injury. We recommend the use of the RTS as an aid to junior doctors in the recognition of seriously injured patients in the accident and emergency department. Furthermore, the score should be recalculated at frequent intervals while the patient remains in the department.
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Qual Assur Util Rev · Jan 1991
GuidelineThe rational ordering of blood cultures in the emergency department.
A large number of patients with febrile illness are evaluated in emergency departments. Blood cultures are often obtained on such patients without reference to established guidelines. As a result of such practice, unnecessary blood cultures are being ordered with negative financial impact on both hospitals and patients. ⋯ Follow-up on these results directly impacts on patient care as these patients are often subjected to call backs, additional work up, and admission to the hospital. This study reviews the manner in which blood cultures were ordered before and after the introduction of general guidelines for their use. It outlines a process whereby excessive ordering of blood cultures can be eliminated and suggests that this approach may be effective in limiting inappropriate use of other laboratory and diagnostic studies.
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Investigative radiology · Jan 1991
The current status of faculty staffing and resident training in emergency radiology. Results of a survey.
The results of a survey of United States and Canadian radiology residency programs in hospitals maintaining major emergency departments indicate that (1) radiologic faculty assignment to emergency medicine may include "all faculty," "specific faculty," "specific and other faculty," "general," and "musculoskeletal" faculty; (2) a chief of emergency radiology section is designated in less than 35% of radiology departments providing emergency room services; (3) radiology resident rotation in emergency radiology occurs in less than 2/3 of the surveyed programs; and (4) radiology resident experience in emergency radiology ranges from two to 16 weeks in 40% of these programs, the remainder being "unspecified." The effect of this circumstance upon the emergency department patient care and resident teaching in emergency radiology is discussed and remedial suggestions presented.