Articles: hospital-emergency-service.
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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.
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Equipment assembled for use by an accident team is described. The aim is to provide independent lightweight units that a medical practitioner can easily carry yet which will contain the essential items which he may need. ⋯ Compromise is inevitable which makes planning difficult particularly if action is seldom needed. Some schemes may need alternative equipment and individual preferences must also be taken into account.
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The emergency department records at the St. Louis County Hospital were reviewed for 1973, 1974, and 1975. The distribution of patients was considered by the day of the week and hour of the day. ⋯ An analysis of peak patient load showed the first peak was around 11:00 am and the second, a higher peak, around 7:00 pm. By day of the week, more patients were seen on Tuesday and Saturday. Using data from such an analysis, emergency department personnel can devise an appropriate staffing pattern for their own situation.