Articles: emergency-services.
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Emergency ward doctors and nurses define patients whose illnesses require prolonged and comprehensive care as threats to the mission of the ward. Data were collected by means of direct observation and interviewing of emergency ward doctors and nurses in a 600-bed hospital in the Midwestern United States. In 1973, a total of 270 hours of observational data was collected as part of a larger study of emergency ward social organization. ⋯ Since these patients often present behavior problems on the ward, one way for medical staff to cope with such patients is to define these patients as management problems rather than as medical cases to be diagnosed and treated. Success or failure with management problems is no longer based on medical criteria, but upon the outcome of management activities. The most successful outcomes are those where the amount of patient's disruptive behavior and the amount of staff time and resources devoted to the patient are held to a minimum.
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At Brooke Army Medical Center the Emergency Services Section has developed an algorith,-directed triage system to be used by "screeners" who may be basic medical corpsmen but sometimes have had no previous medical experience. After 25 hours of classroom and 120 hours of on-the-job training, the screeners use the algorithms to triage patients into one of three treatment areas in the emergency section or to clinics outside the emergency section during the day and evening. The screeners may consult with a triage physician if the algorithm-directed disposition appears inappropriate, Triage dispositions of 78,822 patient visits during the calendar year 1975 are presented.