Articles: hospital-emergency-service.
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There is considerable variation in emergency department practices concerning the use of intravenous (IV) rehydration. Sixty-eight patients seen in a pediatric emergency room and requiring IV rehydration were studied prospectively. Fifty-eight patients were rehydrated in the emergency room, and 10 were admitted for rehydration. ⋯ To determine outpatient IV rehydration practices, 214 pediatric training programs were surveyed. Of 173 respondents, 77 (44.5%) carry out IV rehydration in the emergency department in less than 5% of cases, and 115 (66.4%) perform it in less than 10% of cases; only 11.7% of programs carry out IV rehydration in the emergency department in most cases requiring such therapy. It is concluded that from the standpoints of cost effectiveness and patient acceptance, outpatient IV rehydration should be considered more often as a treatment option.
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Comparative Study
Old people in the emergency room: age-related differences in emergency department use and care.
Little is known about how the care received in emergency departments (ED) by the elderly population differs from that received by younger people. We prospectively abstracted ED records of 1620 consecutive patients visiting a large community hospital ED over a 22-day period in 1984 for demographic and medical variables. Charts of patients presenting with five specific complaints (dyspnea, chest pain, abdominal pain, syncope, and motor vehicle accidents) were also analyzed for process of care variables and, for patients hospitalized, the accuracy of the ED diagnosis. ⋯ Therapy for specific complaints showed less age effect. Although generally more diagnostic tests were performed on older patients, the ED diagnosis tended to be more accurate for younger patients. Our data indicate that the process of ED care may be substantially different for the elderly population and have implications for future planning and financing of medical care.