Emergency medicine journal : EMJ
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Comparative Study
Influence of the Manchester Triage System on waiting time, treatment time, length of stay and patient satisfaction; a before and after study.
To compare waiting time, treatment time, length of stay (LOS), patient satisfaction and distribution of waiting times over levels of urgency before and after the implementation of the Manchester Triage system (MTS) at an emergency department (ED). ⋯ Implementing MTS on its own is not sufficient to improve efficiency and quality of EDs. More complex interventions including process redesigning that targets various groups of ED patients should be evaluated in the future by using rigorous research designs for quality improvement of EDs.
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To investigate the clinical characteristics and outcomes of adults with occult bacteraemia and the clinical impact of appropriate antibiotics. ⋯ For adults with occult bacteraemia, a lower severity of illness and death rate than those of bacteraemic patients hospitalised for ED visit could be demonstrated, demonstrating the importance of appropriate antibiotic therapy.
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Although it has been suggested that the increase in older population contributes to overcrowding in emergency departments (EDs), there are limited data defining this relationship. This study examines whether patients' mean age per day affects length of ED stay. ⋯ The increase in older patients visiting the ED has a direct significant negative effect on overcrowding in the ED.
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The aim of this study is to investigate the antioxidant status (TAS), oxidant status (TOS) and oxidative stress index (OSI) in patients with snake envenomation and to learn more about the pathophysiology of snake envenomation. ⋯ Serum TAS, TOS and OSI levels increase in snake envenomation patients. The results obtained in this study indicate that the snake bite was associated with a shift to an oxidative state, and oxidative stress plays an important role in the pathophysiology of snake envenomation.
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This paper describes the first 16-months experience of prehospital rapid sequence intubation (RSI) in a rural and suburban helicopter-based doctor-paramedic service after the introduction of a standard operating procedure (SOP) already proven in an urban trauma environment. ⋯ We have demonstrated the successful introduction of a prehospital care SOP, already tested in the urban trauma environment, to a rural and suburban air ambulance service operating a fulltime doctor-paramedic model. We have shown a zero failed intubation rate over 16 months of practice during which time over 750 missions were flown, with 11.5% of these resulting in an RSI.