Articles: emergency-services.
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Pediatric emergency care · Jun 1988
Why not your pediatrician's office? A study of weekday pediatric emergency department use for minor illness care in a community hospital.
To determine the rationale for using a community hospital's emergency department for minor illness care on weekdays, we surveyed 150 parents of children 15 years of age or younger. Fifty (33.3%) participants had no identified source of routine pediatric care, and 31 (20.7%) had pediatric providers not locally available. ⋯ The results of this study demonstrate that the utilization pattern and sociodemographic profile of children seen in our emergency department on weekdays is more characteristic of an inner-city hospital than of a non-metropolitan setting. There are a number of feasible measures which could improve access to routine pediatric care for low socioeconomic families and reduce unnecessary emergency department utilization.
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Comparative Study
Accuracy of detection of radiographic abnormalities by junior doctors.
This study assessed the ability of junior doctors in accident and emergency to detect radiographic abnormalities. Their assessments of 505 radiographs taken at nights and weekends over a period of 8 months and showing abnormalities were examined. Each assessment by a senior house officer (SHO) was compared with the subsequent diagnosis of a radiologist of senior registrar or consultant status. ⋯ It is considered that the proportion of missed abnormalities gives a truer index of SHOs' abilities. No improvement in performance was evident over the 6-month period of the SHOs tenure of post. It is argued that it is unrealistic to expect accident and emergency SHOs to acquire this complex skill simply through experience and that more formal training and guidance is needed.
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Traditionally, treatment in the emergency department is noted for brief doctor-patient encounters, fragmented service, and lack of follow-up care. This atmosphere can lead to patient dissatisfaction and may contribute to the high rate of noncompliance with discharge instructions and medications. To cope with this problem, a prospective study was designed to evaluate a telephone follow-up system and its effect on patient care and satisfaction. ⋯ Of the patients contacted 42% (97/229) required further clarification of their discharge instructions. The calls resulted in direct medical intervention in the majority of patients (6/7) who stated their clinical condition had worsened. Ninety-five percent of the patients questioned (112/118) felt that the call was useful.(ABSTRACT TRUNCATED AT 250 WORDS)