Articles: emergency-services.
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The effectiveness of patient triage by a specially trained registered nurse in the emergency department of an urban county hospital, San Francisco General Hospital, was evaluated over a three-month period. Ambulatory patients thought to have nonemergent illnesses were directed to the Walk-In Service for physician evaluation and treatment; the remainder were seen in the Emergency Service. In three months, 11,329 patients registered for care, and 4,150 (37%) were referred to the Walk-In Service. ⋯ There were no deaths. Error in triage was about equally divided between mistaken diagnosis and underestimated severity of illnes. The overall accuracy of triage was 98%.
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Optimal management of a severely injured child depends upon instant availability of a wide variety of emergency equipment and supplies. Some of these items are not commonly found in trauma rooms designed for adults, and others are required in a range of sizes unique to child care. After a major resuscitative effort the trauma room is a shambles from which it must be restored rapidly to receive the next trauma victim. ⋯ This list was patterned after a similar checklist used in the Emergency Department of the Parkland Hospital in Dallas and was developed for children by the Trauma Committee of the American Pediatric Surgical Association. It has been tested and refined in the Trauma Room of the Children's Hospital, Columbus, Ohio, during a 2-year period in which 100,000 children presented to the emergency department. It should be helpful in any emergency department which receives seriously injured children.
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The Cincinnati General Hospital Emergency Department has a training program for emergency medicine residents on a multidisciplinary emergency psychiatry team. This essential training should occur in the emergency department setting rather than in psychiatric inpatient units of state hospital settings. ⋯ Some observations are made about how the emergency medicine residents deal with emotionally disturbed patients. Finally, 80% of emergency medicine residents responded to questionnaire on their reactions to the multidisciplinary emergency psychiatry team.