Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To define risk factors for infections from dog- bite wounds and to model the probability of wound infection in patients presenting without infection who are treated as outpatients. ⋯ A low wound infection rate was seen in this cohort of dog-bite victims who were treated on an outpatient basis. Wound depth, patient gender, and wound debridement were the clinical variables that best predicted the likelihood of developing infection. Future interventional studies should concentrate on wounds with high probabilities of infection.
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To determine if stress levels of emergency medical services (EMS) personnel can be reduced by adjusting work schedules to personnel preferences. ⋯ Stress in EMS personnel increased despite a new schedule pattern designed to accommodate the preferences of EMS personnel.
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Case Reports
Social-work services in an emergency department: an integral part of the health care safety net.
To quantify and describe the activities of social workers dedicated to a large urban emergency department (ED). ⋯ Social workers provide valuable services to ED patients. The availability of social workers in the ED reduces the demands for emergency physicians and nurses to arrange home health care, nursing home placement, and other social-service functions. Cost savings through diversion of nonacute social admissions are possible. The types of services provided vary and depend to a large extent on patient age. The availability of dedicated social-work personnel in the ED and the education of emergency personnel regarding the services that they can provide should be beneficial for patients, staff, and the hospital served.
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For educational purposes, the Residency Review Committee for Emergency Medicine requires that emergency medicine residencies "provide a mechanism for each resident to obtain information on outcomes of patients the resident has evaluated in the emergency department." The authors analyzed the current patient follow-up systems of emergency medicine residencies and, based upon survey results propose a comprehensive organized system of follow-up. ⋯ Most emergency residency-affiliated hospitals in our survey had follow-up systems in place. Of existing systems, only a minority were rated by residency directors as effective or satisfactory. A model for a comprehensive system of patient follow-up is proposed.
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Multicenter Study Comparative Study
Emergency-department diagnosis of acute myocardial infarction and ischemia: a cost analysis of two diagnostic protocols.
To assess the potential cost savings of the emergency-department (ED) diagnosis of acute myocardial infarction (AMI) and other myocardial ischemia using a nine- hour ED evaluation protocol. ⋯ At both centers, hospital charges related to the acute evaluation of chest pain were significantly lower with this ED diagnostic protocol for AMI and myocardial ischemia.