The American journal of emergency medicine
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Modern health care reform emphasizes efficient resource and facility management and the need to develop strategies to direct patients with lower-acuity concerns away from the relatively cost-inefficient full-service pediatric emergency department (ED). This study examined a pediatric fast track system for triage accuracy and turnaround times. Egleston Children's Hospital is a regional, urban, tertiary-care academic center which is a major teaching affiliate of Emory University School of Medicine. ⋯ Only 63 of the 2,243 (2.8%) patients assigned to fast track were found to have higher acuity levels than suspected at initial triage. In all cases they were appropriately cared for in the fast track area. The fast track system appears to be an effective method by which an urban pediatric ED can efficiently maintain patient flow in light of limited resources, space constraints, limited manpower, and an increasing census.
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In an attempt to provide comprehensive and timely patient care, emergency physicians have begun to use ultrasonography to perform and interpret goal-oriented examinations. Reducing time to diagnosis can potentially have a major impact on the treatment of patients with ruptured ectopic pregnancy, leaking aortic aneurysm, and cardiac tamponade, who require time-sensitive surgical intervention. A review of three cases reveals how ultrasonography performed by emergency physicians can rapidly provide valuable diagnostic information and expedite patient care in three different clinical scenarios.