Articles: emergency-services.
-
We performed a ten-week study to understand the feasibility of a fast track system within a teaching hospital setting. Our results show that 50% or fewer of patients entering an emergency department during evening and weekend day hours can be seen in Fast Track. Average turnaround time for all patients in the ED was 161 minutes. ⋯ Roentgenograms of the ankle, foot, and knee accounted for 80% of all radiographs. An evaluation questionnaire showed enhanced satisfaction with a reduction in the number of complaints from 79% to 22%. The Fast Track system failed when there was a predominance of acutely ill patients in the ED, as house officers were pulled to care for the acutely ill patients.
-
The American surgeon · Apr 1988
Impact of emergency room laboratory studies on the ultimate triage and disposition of the injured child.
One hundred sixty six surviving pediatric trauma patients were retrospectively studied to assess the contribution of initial laboratory evaluations to clinical decision making in the emergency department (ED). All laboratory tests ordered, the results of those tests and the number of test results available before patient disposition from the ED were reviewed. A total of 626 laboratory studies were ordered in 166 patients. ⋯ Based on this data, the current protocol has been revised to include hemoglobin/hematocrit determinations, type and screen, and urinalysis. Additional blood is obtained and appropriately labeled so that further studies can be performed if the patient's management should require baseline laboratory evaluations. This approach is more efficient, cost-effective, and no less sensitive in the initial evaluation and management of the injured child.
-
Southern medical journal · Apr 1988
Emergency department infraclavicular subclavian vein catheterization in patients with multiple injuries and burns.
We assessed the complications associated with emergency department placement of subclavian vein catheters in trauma and burn patients, reviewing the charts of all of the 441 patients admitted to the burn-trauma unit through the emergency department during 1983. Fifty-two patients (12%) had infraclavicular placement of subclavian catheters while in the emergency department. Sex, age, insertion site, blood pressure at time of insertion, indications for placement, catheters left in place, and complications were recorded. ⋯ Two upper extremity, 14 gauge percutaneously placed intravenous catheters are usually sufficient for resuscitation; femoral and cutdown routes offer additional sites for massive resuscitation. Subclavian catheterization is seldom needed in the emergency room. Any intravenous lines inserted in the emergency room should be changed within 24 hours to minimize infection.