Articles: hospital-emergency-service.
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Gen Hosp Psychiatry · Dec 1981
Emergency psychiatry in the general hospital: staffing, training, and leadership issues.
Psychiatric services in general medical hospitals have increased in the past two decades. More and more, emergency services are being used for less urgent problems, and have created difficulties in health care delivery for all physicians. This is especially true for psychiatrists, since emergency psychiatric care is more time - and staff-intensive, and the need for it is unpredictable. The important issues of staffing, training, and the need for creative leadership for emergency psychiatric services are discussed.
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Levels of nitrous oxide were monitored in the emergency department during the use of a Nitronox machine after four and eight minutes of breathing gas. Levels near the user's head were found to be 800 to 1,200 parts per million. ⋯ Ventilation was measured in the test room and was found to influence the peak level of nitrous oxide and the rapidity of washout of the gas from the room. The results of this study should prompt the development of guidelines for the use of nitrous oxide in the emergency department setting.
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Hypothermia, especially in an urban environment, is often an unsuspected and therefore underdiagnosed clinical entity. Of 60 cases recorded over a two-year period in a typical community hospital in Philadelphia, 26 (43%) involved patients under 60 years of age; ambient air temperatures at admission exceeded 50 F (10 C) in 28 (47%) of the 60 cases. ⋯ Diabetes and alcohol abuse appear to be risk factors for hypothermia, being present in 18 (30%) and 14 (23%) of our patients, respectively. Every emergency department should have a protocol for identification and management of the hypothermia victim to allow timely institution of appropriate rewarming techniques.