Articles: emergency-services.
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There is considerable variation in emergency department practices concerning the use of intravenous (IV) rehydration. Sixty-eight patients seen in a pediatric emergency room and requiring IV rehydration were studied prospectively. Fifty-eight patients were rehydrated in the emergency room, and 10 were admitted for rehydration. ⋯ To determine outpatient IV rehydration practices, 214 pediatric training programs were surveyed. Of 173 respondents, 77 (44.5%) carry out IV rehydration in the emergency department in less than 5% of cases, and 115 (66.4%) perform it in less than 10% of cases; only 11.7% of programs carry out IV rehydration in the emergency department in most cases requiring such therapy. It is concluded that from the standpoints of cost effectiveness and patient acceptance, outpatient IV rehydration should be considered more often as a treatment option.
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Comparative Study
A retrospective study of adolescents' visits to a general hospital psychiatric emergency service.
Characteristics of 100 visits by adolescents (less than 18 years old) to a psychiatric emergency service were examined and compared with those of 100 visits by adults. Adolescents were less likely than adults to receive diagnoses of psychosis and personality disorder but more likely to receive diagnoses of adjustment and conduct disorders, were less likely to have had previous psychiatric treatment but equally likely (40%) to be in current treatment, and required more time to evaluate. Self-destructive ideation or behavior was present in 40% of the adolescents. Nearly all visits were judged to have represented genuine emergencies.