Canadian family physician Médecin de famille canadien
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Hemodynamic monitoring gives early warning of changes in a critically ill patient's condition. Accuracy is essential; for example, a blood pressure cuff is inaccurate at low pressures. Hospitalized adults will usually have a higher central venous pressure, so a CVP less than 4 cm H(2)O may indicate hypovolemia. ⋯ Measurement of cardiac output eliminates the need for arterial and mixed venous blood samples, and can be valuable in decision-making. Calculation of vascular resistance can also be very important in management of the critically ill. With today's facilities, routine clinical assessment is no longer adequate care for these patients.
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One-third of all injuries seen at The Hospital for Sick Children's emergency department in 1977 resulted from falls; 10% of the children who had fallen were admitted. Falls from heights and those from the same level were of equal proportion (49%). Superficial injuries were most common. Family physicians may help prevent injuries due to falls by giving parents anticipatory guidance about their child's developmental stages and the risk situations that may be encountered at each level of development.
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Doctors are in both a privileged and precarious position concerning the law. Because the conduct of their daily work requires them to perform many acts which would not be permitted to anyone else, they may find themselves in legally compromising situations through simply doing their job. This new series, contributed by the staff of the Canadian Medical Protective Association, will address exactly those situations. We welcome readers' comments and queries.
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The patients of a community health centre who visited a hospital emergency department were compared with a random sample of the patients who visited the health centre during the same four months. Visiting rate to the emergency department was higher for teenagers and patients over 60. Emergency department visitors were more frequent users of health care, both at the health centre and in the emergency department. No differences were found between the two groups concerning sex, length of time as a patient, continuity of care, and distance of home from hospital or health centre.