Articles: hospital-emergency-service.
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Acta psychiatrica Belgica · Sep 1977
[Emergency and psychiatric emergency at the General Hospital (author's transl)].
First, the author examines the requests made on the consulting psychiatrist (Prof. Luminet Service) within a 1.000 beds' hospital, administered by the Public Assistance and with a university status. He compares data on three months to a similar study done in the same hospital four years ago and lasting for six months. ⋯ Secondly, the functioning of the psychiatric emergency unit (11 beds) is examined for a period of four months. The 59 patients in transit in this unit are examined for age, diagnosis, place of origin, length of stay. Some factors in favor and against this type of stay are discussed, in relation to the teaching role of the unit for the students and in relation to the type of hospitalised patients (Acta psychiat. belg., 1977, 77, 639-652).
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The function of a pharmacist in emergency medicine, encompasing clinical practice, education and research, are described, and an evaluation of physicians' and nurses' attitudes toward pharmacist involvement in these areas is presented. In July 1974, a pharmacist joined the staff of a department of emergency health services in a medical center. ⋯ All respondents felt the pharmacist was an important component of the department and a benefit to its patient care and educational programs. Eighty-seven percent of the physicians stated that the pharmacist is capable of offering primary care to certain patients once the diagnosis has been made by a physician; 95% felt the role of the pharmacist is transferrable to other emergency room facilities and 83% were willing to have their patients charged for his services.
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In a review by questionnaire of the emergency visits to 185 Florida hospitals, the number of annual estimated visits appears to exceed national estimates. In addition, the concept that in excess of 75% of patients are not true emergencies is not borne out. In spite of changes in the emergency medical services system, only 10% of patients came by ambulance or rescue vehicle. ⋯ Some 40% of Florida's emergency departments have full-time emergency physicians. Although nearly 70% of the emergency patients were seen by these physicians, 2.4% were seen by interns only, and a total of 10% were seen by house officers only. There was a great variety of referral patterns among the Health Service Agencies.
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The contribution of the electrocardiogram to the clinical judgment used by the physician in the emergency room to determine the necessity for hospitalizing patients was evaluated. Thirty-five percent of all 1,578 patients with presumed myocardial infarction referred to the Chaim Sheba Medical Center, Tel Hashomer, Israel, for a one-year period had subsequently diagnosed myocardial infarctions. The ECG in the emergency room detected only 65 percent of these. ⋯ When the myocardial infarction was not evident on the ECG and the abnormalities on the tracings were identical for patients with subsequent myocardial infarctions and those without, again the physician made the right choice more often than the wrong. The follow-up ECG also attested to the good judgment of the physician in the emergency room. Of the emergency room ECGs of patients without subsequent myocardial infarctions who were admitted to the hospital, 17 percent showed myocardial infarction by follow-up, while this happened to only 2 percent of those denied admission.