Emergency medicine journal : EMJ
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To develop and validate models to predict emergency department (ED) presentations and hospital admissions for time and day of the year. ⋯ Valid ED prediction tools can be generated from access to de-identified historic data, which may be used to assist elective surgery scheduling and bed management. The paper provides forecasting performance levels to guide similar studies.
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Consultant based delivery of emergency service is perceived to add value. This study aims to demonstrate the impact of such a service model based on consultant working in a UK emergency department. ⋯ A consultant based service delivery offers many advantages. These cannot be matched by either junior or middle grades. This would be in addition to the consultants' supervisory role. Consultant expansion is urgently required to achieve this sustainably. A further study evaluating the cost benefits of this service model is now underway.
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Emergency doctors must make decisions for many patients in a limited time. Various emergency cases are not compatible with routine conditions as described in textbooks, so doctors use clinical decision making (CDM) processes to act in the best possible way. In the present work, these processes and some of the related factors were assessed. ⋯ The rule-based process is the most common CDM process used by emergency doctors, perhaps because of the minimisation of human error in this process. CDM choice may be influenced by triage level, treatment room and doctors' educational levels. Revealing and studying these factors may help shift decisions to the best possible decision making levels, defining a model in future research.
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This is the first study of suicide attempts and completions in the emergency department (ED) in a large national medical system. ⋯ Based on these results the following recommendations are made for helping to reduce suicide attempts in the ED: (1) use a systematic protocol and checklist to review mental health holding areas periodically in the ED for suicidal hazards; (2) develop and implement specialised protocols for suicidal patients that include continuous observation when possible; (3) conduct thorough contraband searches with suicidal patients; (4) designate specialised holding areas, when practically possible, for suicidal patients that are free of anchor points for hanging, sharps and medications, and medical equipment; and are isolated from exits to reduce the risk of elopement.
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To describe the common medical presenting problems of children attending a paediatric emergency department (ED) compared with 10 years previously. ⋯ Over a 10-year period, there has been a rise in the number of people attending the ED with medical conditions. The 10 most common presenting problems account for 85% of medical attendees. These results suggest the increasing utilisation of ED services for children with common medical presenting problems and should inform further research exploring the pathways for attendance and the thresholds in seeking medical advice in order to inform the commissioning of paediatric emergency and urgent care services.