Annals of emergency medicine
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To determine whether the use of warning lights and sirens saves a significant amount of time for ambulances responding to requests for medical aid in an urban, 2-tiered EMS setting. ⋯ Code 3 operation by EMS personnel in an urban, 2-tiered EMS setting saved significant time over Code 2 operation when traveling to a call.
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This study was designed to identify patients who frequently use the emergency department, compare them with the general ED population, and determine why they choose the ED over other sources of medical care. ⋯ Frequent users of emergency care have access to other sources of primary care, but use the ED for complaints they believe are serious and need immediate attention. These patients often have chronic complaints and are more likely to be admitted to the hospital. Efforts to cut medical costs should not limit access to the ED, which often becomes an important source of medical care for such patients.
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Rapid evaluation of the hypotensive patient in the emergency department is essential. The availability of ultrasonography in the ED, performed by emergency physicians and surgeons, has made it easier to evaluate the hypotensive trauma patient. We describe a 44-year-old man transferred to our institution from a community hospital for evaluation of syncope and hypotension with no obvious cause. ⋯ A rapid ultrasound examination performed at bedside revealed the presence of intraperitoneal fluid. Examination of the spleen suggested likely rupture. The patient was promptly taken to surgery for splenectomy and discharged home in 4 days.
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Multicenter Study Comparative Study Clinical Trial
A multicenter study to improve emergency medicine residents' recognition of intracranial emergencies on computed tomography.
Cranial computed tomography (CT) has assumed a critical role in the practice of emergency medicine for the evaluation of intracranial emergencies. Several recent studies have documented a deficiency in the emergency physician's ability to interpret these studies. The purpose of this study was to quantify the baseline ability of emergency medicine residents to interpret cranial CTs, and to test a novel method of cranial CT interpretation designed for the emergency physician in training. ⋯ Emergency medicine residents are deficient in their ability to interpret cranial CT scans. A novel educational course was demonstrated to significantly improve this ability.
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An overview of emergency medical care in the New Delhi area is presented. Emergency medicine does not exist as an organized specialty, and emergency departments are staffed by a combination of residents and attending physicians from various specialties. An infrastructure for providing emergency care exists at all levels of the state-owned medical system, and in private hospitals. ⋯ Organized prehospital care is scanty. A survey conducted at a leading medical school and hospital in New Delhi shows medical students and physicians are highly interested in the development and practice of emergency medicine as a specialty. This interest can be nurtured through continued international collaboration.