Articles: emergency-services.
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To assess current standards of care in pediatric emergency medicine, a questionnaire was mailed in May 1988 to the medical directors of all existing pediatric emergency medicine fellowship programs. Twenty-three programs (96%) completed this survey, which consisted of questions regarding census, staffing patterns, ancillary services, patient follow-up, and various clinical issues. The major deficiencies in pediatric emergency care identified by this survey concerned patient waiting time, weekend radiology coverage, patient follow-up, feedback to referring physicians, and feedback to emergency department housestaff on hospitalized patients. The data suggest that pediatric EDs associated with fellowship training programs are improving their quality of care, yet room for advancement in many categories remains.
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Prehosp Disaster Med · Apr 1990
Prehospital and emergency department verification of endotracheal tube position using a portable, non-directable, fiberoptic bronchoscope.
Verification of endotracheal tube (ETT) location in prehospital setting and the emergency department (ED) is a challenging task. Unrecognized esophageal intubations with potentially dangerous consequences may occur more frequently in these environments than in less hectic settings. To evaluate the capabilities of a portable, non-directable, fiberoptic bronchoscope (Visicath; Saratoga Medical, Saratoga, Calif., USA) to detect appropriate ETT placement, a prospective series of 22 intubated prehospital, air-medical, or ED patients underwent fiberoptic verification (FOV) of a newly placed ETT. ⋯ FOV confirmed placement in 23 intubations (96%) in less than 25 seconds. Seven intubations (29%) were judged to be "difficult." FOV resulted in five minor changes in management (22%) and was the sole confirmation method for five intubations. We conclude that fiberoptic verification is a promising method of ETT position in air-medical and ED intubations.
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In an attempt to establish what the general practitioner expects from an accident and emergency department, and how closely the service provided correlates with that view, a 12-point questionnaire was sent to the general practitioners in the Glasgow Royal Infirmary catchment area. Out of the 61.2% of general practitioners who replied, the majority wish to have responsibility for their own patients for conditions which are neither accidents nor emergencies. There is less agreement as to how much should be done within an accident and emergency department and on the appropriate modes of referral and communication between the general practitioner and the hospital service. Further consultation and cooperation are necessary to interpret and resolve these differences.