Articles: emergency-services.
-
Comparative Study
Improving the care of patients with major trauma in the accident and emergency department.
To determine whether improvement in the care of victims of major trauma could be made by using the revised trauma score as a triage tool to help junior accident and emergency doctors rapidly identify seriously injured patients and thereby call a senior accident and emergency specialist to supervise their resuscitation. ⋯ Care of patients in accident and emergency departments can be improved considerably at no additional expense by introducing two simple measures.
-
A retrospective study of the pattern of paediatric deaths at the children's emergency room (CHER) of the University College Hospital, Ibadan revealed a steady decline from 208 per 1000 admissions in 1978 to 179 per 1000 admissions in 1986. The study, however, showed that one in every five children admitted to the CHER died over the study period 1978, and 1981-1986. Measles has the highest proportionate death rate of 13.1% and it shares the highest fatality rate of 32.6% with tetanus. ⋯ The age distribution of the children who died shows that the highest proportion was in the age group 1-2 yr. The use of the proportion of deaths of children in the 1-2 yr age group as a more reliable index for assessing the health status of a community is discussed. Also discussed is the preponderance of males over females in emergency admissions.
-
Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of wound irrigation solutions used in the emergency department.
The purpose of our study was to examine which of the wound irrigants commonly used in the emergency department is the most efficacious in reducing the risk of wound infection. Five hundred thirty-one patients were randomized into three groups. All patients had their wounds irrigated using a 20-mL syringe with a 20-gauge IV catheter. ⋯ This was not statistically significant. We conclude that there is not a significant difference in infection rates among sutured wounds irrigated with NS, PI, or SC. The cost of NS was the lowest of the three treatments in our ED.
-
The object of this study was to assess the ability of junior doctors in the accident and emergency department to detect electrocardiographic (ECG) abnormalities. The ECG's performed in this department were monitored over a 4 week period. ⋯ Of those abnormalities which were graded as clinically significant only 2 (4.4%) were missed. The danger of missing acute changes is emphasized and proposals discussed which may reduce their frequency.