Articles: emergency-services.
-
To assess the feasibility and the validity of an audit using major trauma outcome study methods in an accident and emergency department. ⋯ Audit of management of major injuries should be carried out by every hospital, and the methodology of the major trauma outcome study is an excellent system for carrying out such audit. The study of all patients admitted with trauma requires appreciable extra resources, but most hospitals should be able to monitor the care of seriously injured patients as their numbers are much fewer.
-
Because cases of unrecognized carbon monoxide (CO) poisoning have been described among patients admitted to the hospital with other diagnoses, screening hospital admissions with carboxyhemoglobin testing has the potential for preventing morbidity among patients as well as among their cohabitants. Carboxyhemoglobin levels were obtained on 753 patients admitted to the hospital from the emergency department over a 3-month period during the winter. Patients in whom CO poisoning was diagnosed in the emergency department prior to admission were excluded. ⋯ The carboxyhemoglobin levels of the two patients were only marginally elevated, with levels of 10.9% and 11.3%. The cost of the carboxyhemoglobin screening program was $2.26 per patient result, or approximately $2,100 over a 3-month winter heating season. A program for screening emergency department admissions with carboxyhemoglobin testing, although feasible in terms of cost, detected few cases of unrecognized CO poisoning.