Articles: hospital-emergency-service.
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Critical care medicine · Mar 1987
Value of a conventional approach to the diagnosis of traumatic cardiac contusion after chest injury.
We wanted to evaluate whether current screening techniques effectively determine a patient's need for hospital admission and intensive care monitoring after blunt chest trauma. Consequently, we reviewed 104 consecutive admissions for "blunt chest trauma; rule out cardiac contusion." Neither clinical findings, cardiac enzyme levels, chest x-rays, nor ECGs predicted the high-risk patients who would subsequently develop complications related to myocardial contusion. Since only 23% of the study patients developed such complications, the plurality of study patients did not require admission and monitoring. There is, therefore, a definite need to develop new, accurate screening tests for patients at risk for myocardial contusion complications.
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This article has presented an overview of the duties, responsibilities, and management roles of the emergency department Medical Director, a position that can be among the most challenging, stimulating, and exciting in medicine. However, prior to accepting a position as an Emergency Department medical director, one should have a clear understanding of what the job entails. ⋯ Once the job has been accepted, using the roles, responsibilities, and duties detailed herein may be of benefit--but should always be applied with good judgment, tactful cooperation, and common sense. Finally, it should not be surprising to a medical director to find, as Spinoza did many years ago, that the excellent thing he aspires to are as difficult as they are rare.