Annals of emergency medicine
-
To determine the number of weapons confiscated and assaults reported in an urban county emergency department before and after the implementation of a security system. ⋯ The implementation of an ED security system increased the number and percentage of weapons confiscated before patients were placed in patient care areas, but did not decrease the number of assaults. This emphasizes the importance of continued training of ED personnel in the management of violent patients and potentially violent situations.
-
This article describes the history and current status of the practice of hospital-based accident and emergency (A&E) medicine in the United Kingdom of Great Britain and Northern Ireland. Included are comments on training and certification, the operations of the typical A&E department, and developments in research and academics. Also included are the authors' thoughts on issues of future importance to A&E medicine. As transatlantic links at all levels become increasingly common in this dynamic specialty, we clarify unfamiliar terminology and practices for international readers.
-
Comparative Study
Comparison of patient and practitioner assessments of pain from commonly performed emergency department procedures.
To compare patient and practitioner assessments of pain associated with commonly performed emergency department procedures and use of anesthetics before these procedures. ⋯ The most painful procedures for ED patients were nasogastric intubation, incision and drainage of abscesses, fracture reduction, and urethral catheterization. Although practitioners also identified these procedures as most painful, the correlation between patient and practitioner pain assessments in individual patients was highly variable. Overall use of anesthetics before these procedures was low. Practitioners should be attentive to their patients' individual anesthetic needs before performing painful procedures.
-
Screening for intimate partner violence has been widely advocated in the health care setting, but efforts to assess effectiveness and ensure adequacy of universal screening are largely untested. We sought to identify barriers to screening of female emergency department patients for intimate partner violence during the first year of implementation of a screening protocol. ⋯ In this random sample of female patients, screening rates varied by severity of the patient's condition, type of presenting complaint, and presentation time.
-
We conducted a national survey of emergency medicine residency program directors to determine which alternative devices were available in their emergency departments for difficult airway management. We also assessed the residency directors' experience in use of these devices. ⋯ The availability of devices for difficult airway management varies tremendously across emergency medicine residency programs. Only half of residency program directors had any experience with these devices, and among those that reported any experience, they are used rarely.