Emergency medicine journal : EMJ
-
To determine the causes of emergency department (ED) crowding and to identify evidence-based solutions. ⋯ While current evidence is poor, this does not justify maintaining current practice which risks lives. Building up an evidence base is critical, but requires agreed definitions, measures and methods, which can be applied to systematic evaluation of plausible solutions.
-
To estimate the potential of alternative providers of care for minor health problems to reduce demands on emergency departments (EDs). ⋯ Although there appears to be considerable potential for minor conditions to be managed in settings other than the ED, our findings indicate that patients will continue to present these conditions to the ED. Patient perceptions of the urgency of their treatment need, and also the availability and capacity of alternative services may be offsetting their potential to substitute for the ED. Advice from other services may be contributing to demands on the ED.
-
The simplified motor score (SMS) is a three-point measure of traumatic brain injury (TBI) severity, which is easier to calculate than the 15-point Glasgow coma scale (GCS). Using a state trauma registry, the accuracy of the emergency medical services (EMS)-obtained SMS was compared with the GCS for predicting neurological outcomes and mortality. ⋯ In a state trauma registry including both trauma and non-trauma centres, the EMS-obtained SMS performs as well as the 15-point GCS.
-
The aim of this study was to determine whether prehospital endotracheal intubation (ETI) and chest tube placement is unnecessarily time consuming in severely injured patients. ⋯ In a physician-based emergency medical service, prehospital ETI and chest tube placement do not prolong the total TRT of severely injured patients.