Annals of emergency medicine
-
To determine whether routine performance of an ECG could have been safely avoided in a subset of emergency department patients admitted to a university hospital. ⋯ The admission ECG could have been avoided in an identifiable subset of ED patients admitted to the medical service of our hospital, with no adverse effect on patient outcome. This finding, if corroborated in other patient populations, suggests the potential for significant cost savings for the US health care system as a whole.
-
To investigate the frequency of emergency department analgesic use in children with presumably painful fractures who are also at risk for associated multiple injuries and to determine whether there are specific factors that distinguish those who are prescribed analgesics from those who are not. ⋯ Our results suggest that ED analgesic use was low in these mildly to moderately injured children with presumably painful fractures who are also at risk for associated multiple injuries. Head injury was associated with especially low analgesic use. We did not identify other specific factors that distinguished those who received analgesics from those who did not. Further investigation is required to determine if after the initial evaluation, a larger proportion of mildly to moderately injured trauma victims with fractures are appropriate candidates for ED analgesic use.
-
To evaluate the usefulness of routine radiographs and arterial blood gases in children with blunt trauma. ⋯ In children with a GCS score of 15, selected radiologic and laboratory tests based on clinical findings are recommended. Careful observation and repeat examinations by trained clinicians can select a group of children at low risk for occult injury.
-
To determine the hospital characteristics associated with patients leaving emergency departments prior to physician evaluation. ⋯ More than 4% of patients who seek care at EDs in Los Angeles County leave without being seen by a physician. A greater proportion of patients leave without medical evaluation from EDs with long waiting times for ambulatory patients and from those that serve uninsured populations. These findings should be interpreted in light of existing data on the health consequences faced by patients who leave hospital EDs without treatment.