Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2020
High-sensitivity troponin T use in non-chest pain presentations in the emergency department.
To explore troponin testing yield in patients who present to the ED without chest pain. ⋯ Despite ED troponin testing in the absence of chest pain being common practice, it rarely assisted in a meaningful diagnosis. Consequences of testing may include delays to patient discharge and additional downstream testing.
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EDs in Indonesia face an unprecedented increase in patient influx after the expansion of national health insurance system coverage. The present study aims to describe EDs' characteristics and capabilities utilisation in Jakarta. ⋯ Physicians with limited experience and EDs with heterogeneous emergency care capabilities likely threatened the consistency of quality emergency care, particularly for time-sensitive conditions. Our study provides a benchmark for future improvements in emergency care.
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As a complex space that can be interpreted on individual, societal and systemic levels, there is a need for analysis of emergency medicine that transcends the biomedical paradigm to explore its sociological influences. The ED is a social structure of different roles, responsibilities and relationships that can be analysed through observation of the different institutionalised activities which highlight the hierarchies and culturally influenced interactions taking place between actors. Institutionalised activities that provide insight into the social structure of the ED include deference to doctors by patients in the context of environmental chaos, segregated handover of information and discharge-oriented patient care that de-emphasises the impact of social background.