Emergency medicine journal : EMJ
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To determine the interaction and waiting times of patients in Barbados Queen Elizabeth Hospital Accident and Emergency Department (A&E), identify their determinants, and compare them to international benchmarks. ⋯ The A&E could improve patient care processes by shortening waiting times, especially for laboratory results, triage, and seeing a doctor, particularly for older medicine patients.
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Triage at the site of a major incident is key to effective scene management. A number of triage algorithms have been suggested to assist the triage officer to determine triage priorities. However, many advocated scores were not specifically developed for use in major incidents, nor are they designed for multiple age groups. Many of these algorithms have not been validated: those that have were validated against the Injury Severity Score, which is of little relevance in a major incident--it is the urgency of medical intervention that is of importance in this setting. ⋯ Delphi may be used to identify which clinical criteria define triage priority in a major incident setting. These criteria and the associated triage categories may be used as for the validation of specific major incident triage algorithms. This method may be used to develop specific criteria for other triage algorithms.
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To evaluate the effect of triage rapid initial assessment by doctor (TRIAD) on waiting time and processing time of an emergency department (ED) without extra staff. ⋯ The waiting time and processing time of the ED were greatly reduced by TRIAD without extra manpower.
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To ascertain the annual number of users who were discharged home after visits to the emergency department (ED), grouped by age, sex, and number of visits during the calendar year, and to assess whether a higher number of visits to the department predicted a higher mortality. ⋯ The mortality of those who had used the ED and been discharged home was found to be higher than that of the general population. Frequent users of the ED had a higher mortality than those visiting the department no more than once a year. As the ED serves general medicine and surgery patients, not injuries, the high mortality due to drug intoxication, suicide, and probable suicide is interesting. Further studies are needed into the diagnosis at discharge of those frequently using the ED, in an attempt to understand and possibly prevent this marked mortality rate.
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To determine the efficacy of the Mortality in Emergency Department Sepsis (MEDS) score in the stratification of patients who presented to the emergency department (ED) with severe sepsis. ⋯ Our results showed that mortality risk stratification of severe sepsis patients in the ED with MEDS score is effective. The MEDS score also discriminated better than the APACHE II model in mortality prediction.