Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine
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The perception of emergency medicine as a defined specialty may vary widely in different locations around the world. While no single emergency medical system can fulfil the needs of all countries, there are three main models of delivery: the European model, the Anglo-American model, and the neglect model. This article reviews aspects of emergency medical systems around the world and compares the European and Anglo-American models of emergency care. The current state of emergency medicine in Hong Kong is also presented, including challenges facing the specialty as we enter the 21st century.
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To study the profile of airlifted patients and their outcomes after arrival at the hospital, and to evaluate the appropriateness of their prehospital care and the decision to use aeromedical evacuation. ⋯ Scene and interfacility transfers by helicopter have different patient profiles, and a substantial proportion of scene transfers may be inappropriate. Guidelines such as field triage and helicopter dispatch criteria need to be established.
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A quick and efficient prehospital emergency response depends on immediate ambulance dispatch, patient assessment, triage, and transport to hospital. During 1999, the Ambulance Command of the Hong Kong Fire Services Department responded to 484,923 calls, which corresponds to 1329 calls each day. ⋯ Furthermore, the 'first crew at the scene' model has been adopted, whereby the command is established and triage process started by the first ambulance crew members to reach the scene. The development of emergency protocols should be accompanied by good field-to-hospital and interhospital communication, the upgrading of decision-making skills, a good monitoring and auditing structure, and commitment to training and skills maintenance.
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This article reviews the history and progress of the computerisation of accident and emergency departments in Hong Kong. The Hospital Information System was the first computerisation project to be launched in a public hospital in Hong Kong, when the Princess Margaret Hospital was selected as a pilot site in April 1991. The network infrastructure comprised a central processor that linked to all workstations in the hospital in an integrated network. ⋯ Laboratory, diagnostic radiology, and electrocardiography results were also available in this system. With the extensive development of Internet technology within the Hospital Authority, clinical information can now be retrieved in any hospital in a couple of minutes. The availability of important clinical information will be of great help to emergency physicians in the delivery of quality care to patients.
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To compare the contributions of patients, emergency physicians, and surgeons in the delay of diagnosis and treatment of appendicitis, and the effects of delay on disease stage and complication rate. ⋯ There should be a higher index of suspicion, better surgical training, and better senior supervision at accident and emergency departments, to avoid preventable morbidity and mortality in acute appendicitis.