European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Multicenter Study Comparative Study
Equestrian injuries in the paediatric age group: a two centre study.
This study's objective was to examine the nature, cause and frequency of injury resulting from equestrian sport in paediatric patients attending two accident and emergency departments. We recorded the attendances of patients aged less than 16 years with equestrian-related trauma in 1 year. Demographic details, injury, mechanism of injury, rider experience and use of protective equipment were noted. ⋯ The majority of equestrian-related trauma was minor in this study. The possibility of severe trauma exists. Emergency physicians working in areas where equestrian sport is popular should be aware of the likely injuries and their treatment.
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A prospective study was undertaken to describe the pattern of utilization of an observation ward in an emergency department (ED). During a 1-month study period, the following data were collected for all patients admitted to the observation ward: (1) patient demographics, (2) purpose of observation, (3) interventions at the observation ward, (4) disposal destinations, (5) disposal diagnosis, (6) outcome categories, and (7) duration of stay. A total of 12188 patients attended our ED and 1042 (8.51%) patients were admitted into the observation ward. ⋯ The percentage of patients admitted to the hospital was 23%. There were 42 chest pain and 46 trauma patients. The impact of an observation ward on the service in ED was discussed.
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This paper discusses criterion for the appropriateness of admission to the hospitalization ward in the internal medical sector of the emergency department, and analyses the bedridden patients in the emergency department of the major hospital in the city of Genoa. The analysis covers 1930 patients, for which considerations are made, globally and separately in two different age groups, as to the appropriateness of admission to the hospitalization ward of the emergency department, the occurrence of subjective urgencies and objective instabilities, and progression subsequent to hospitalization (discharge, transfer into other hospital wards, decease). The most significant results of the analysis were the following: (1) no significant difference was found between younger and older patients regarding appropriateness of admission; (2) in cases of appropriate admission subjective urgency was clearly prevalent in relation to objective instability, the latter being much more frequent in the older age group; (3) a lack of self-sufficiency and the absence of adequate family support were important factors regarding inappropriate admission of older patients; (4) the greater frequency of objective instability in the older patients-as well as a lack of self-sufficiency-was the major factor in their greater length of stay in the emergency department. These results challenge the misconceived but diffused conviction that there is widespread mishandling of the elderly regarding admission to the emergency department, while at the same time stresses the need for alternative services and structures concerning hospital admission of older patients.