ED management : the monthly update on emergency department management
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A study has shown that EDs are unprepared to handle mass casualties of bioterrorism, and plans must be revamped. Alternate care and triage areas must be selected in advance and may include parking lots and hallways between buildings. Care for contaminated patients in areas that can be abandoned, so regular patient care areas are not disrupted. Have a system in place to decontaminate patients before they enter the ED.
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Patients with difficult airways are rarely encountered, so these skills need to be practiced, and you must have the right equipment available. Difficult airways courses are helpful. Fiberoptic intubations are rare, so ED physicians should use fibroscopes rountinely for other procedures. Use stainless steel laryngoscopes with fiberoptic light.
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Outsourcing of patient calls can save significant time, increase satisfaction among patients and nursing staff, and reduce unnecessary ED visits. The program provides 24-hour triage for patient calls, at a cost of approximately $80,000 a year. Each forwarded call saves ED nurses about five or 10 minutes. Patient calls are a liability risk for the hospital because of inconsistent information and inadequate documentation.
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New accreditation standards require you to work with community agencies as part of preparation for disasters. Invite community first responders to critique your disaster drills. Offer to use your ED as a training site for other agencies. Include jobs for volunteers in your disaster plan.