Articles: emergency-services.
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Studies of adults suggest that metered-dose inhalers with spacers are as effective as hand-held nebulizers for bronchodilator delivery. We studied 13 children with acute asthma. ⋯ After titration, respiratory rate decreased by 12%, heart rate increased by 2%, and breath sounds improved in 92% of the patients. We concluded that the metered-dose inhalers with spacers are an effective device for the treatment of asthma in the pediatric emergency department and that the use of metered-dose inhalers with spacers with titration can achieve significant bronchodilation in the treatment of patients with acute asthma.
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Inappropriate attendances at Accident and Emergency departments is a problem affecting all such services around the UK. Different approaches have been and are being tried. We report the results of a detailed study of this subject and discuss the main cause of the abuse of this facility.
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Emergency department staff at Valley View Medical Center, a 48-bed rural hospital in Utah, implemented a computerized log and integrated a quality assessment program within their small department. A microcomputerized relational data base format is used to keep and cross-reference patient logs and audits. ⋯ It also provides rapid, flexible reporting functions for staff and patient feedback and aids in the collection and dissemination of data to regulatory agencies. The system minimizes physician and nurse time spent in recording and collecting data, while simultaneously increasing their QA involvement.