Emergency medicine Australasia : EMA
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Emergency medicine in the highly advanced world is traditionally performed in two different ways. The first is the well-known Anglo-American system with skilled EDs, and a pre-hospital emergency medical service utilizing paramedics. The second is the so-called Franco-German system, with a highly developed pre-hospital emergency physician service, but only a basic organization of hospital-based emergency medicine. ⋯ The last milestone, the development of academic emergency centres, has only just started. This process will take some time. The present paper describes the present and future of emergency medicine in some European countries using these criteria.
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Emerg Med Australas · Aug 2007
Factors affecting severity of bicycle-related injuries: the role of helmets in preventing head injuries.
To identify factors that affect the severity of bicycle-related injuries in patients with head injury compared with those without, so as to find whether the effect of using helmets extends beyond head protection, and to explore a direct protective effect of helmets on head injuries. ⋯ The reduced severity of injury in helmeted patients is because of protection of the head and not other body regions.
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Emerg Med Australas · Aug 2007
Multicenter StudyWhy patients attend emergency departments for conditions potentially appropriate for primary care: reasons given by patients and clinicians differ.
To compare reasons identified by clinical staff for potential primary care attendances to the ED with those previously identified by patients. ⋯ These data confirm that clinician perspectives on reasons for potential primary care patients' use of ED differ quite markedly from the perspectives of patients themselves. Those differences do not necessarily represent a punitive or blaming philosophy but will stem from the very different paradigms from which the two protagonists approach the interactions, reflecting the standard tension in a provider - consumer relationship. If policy is to be developed to improve system use and access, it must take both perspectives into account with respect to redesign, expectations and education.
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Emerg Med Australas · Aug 2007
From emergency department to general practitioner: evaluating emergency department communication and service to general practitioners.
To survey general practitioners' (GPs) opinions of communication and service received from the ED of a tertiary metropolitan hospital. ⋯ Half of GPs surveyed supported the current system of patient delivered discharge letters and of those who did not the majority preferred faxed discharges. There was little support for email communication. GPs reported problems with the current communication system including discharge letters not reaching GPs and deficiencies in the discharge information. GP reported substantial difficulties in accessing outstanding investigation results. Most GPs felt that assessment and treatment of their patients in the ED was of above average quality, as was the overall service they received from the ED. There was GP support for the ED admitting officer role.
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Increasing demand to reduce patient waiting times and improve patient flow has led to the introduction of a number of strategies such as fast track and patient streaming. The triage nurse is primarily responsible for identifying suitable patients, based on prediction of likely admission or discharge. The aim of the present study was to explore the accuracy with which triage nurses predict patient disposition. ⋯ Triage nurses can accurately predict likely discharge in specific subgroups of ED patients. This supports the role of triage nurses in appropriately identifying patients suitable for 'fast track' or streaming.