Articles: emergency-medical-services.
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Health Care Manage Rev · Jan 1986
Satisfaction with hospital emergency department as a function of patient triage.
For most people, waiting is inherently dissatisfying and emergency department patients are no exception. Most patients and people accompanying the patient find the treatment waiting time in emergency medical care facilities to be a source of great dissatisfaction. The dissatisfaction is compounded in many cases by the anxiety of all associated with the patient and the discomfort or pain the patient feels. ⋯ With the trend toward new forms of health care delivery systems such as "emergicenters" and the increase in the number of physicians per capita, the emergency department will no longer be the most attractive or the only alternative available to the patients who have a nonemergency medical need. For emergency departments to remain profitable, it will be more important than ever before to meet the needs and expectations of their current and potential users. This can be accomplished by a program designed to reduce cost and waiting time and improve communication, and by other programs to educate the user so that the user's expectations more closely conform with what is actually needed or can be economically provided.
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Pediatric emergency care · Dec 1985
A pediatric emergencies training program for emergency medical services.
Accidents are the leading cause of death in children, accounting for more pediatric deaths than all other causes combined. Accidents also account for 21.7 million injuries to children that require medical care annually. ⋯ The course consists of 18 hours of lectures and skill stations focusing on medical emergencies, care of the injured child, the special needs of the infant, and the emotional response of the child and family in an emergency. Test evaluations before and after the course from the 190 participants demonstrate a significant improvement in their knowledge and skills in treating pediatric emergencies (P less than 0.001).
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The Trauma Score (TS) is a physiologic measure of injury severity that correlates with patient outcome. Application of the TS has shown that it is useful for patient triage, for predicting patient outcome, and as a means of normalizing for case mix when comparing prehospital care and transport modalities. ⋯ Results showed that 95.3% of the assessments made by prehospital personnel agreed with those made by a highly-trained nurse observer, despite slight variations in assessment techniques. The results have implications for prehospital field use of the TS.
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Both the Trauma Score (TS) and the CRAMS scale have been advocated for field triage of trauma victims to trauma centers. To determine which scale best serves this purpose, both scores were calculated by computer for 5,130 trauma cases in our statewide computer file of ambulance rescue runs from 1981 through 1983. A total of 3,231 patients (63%) were treated in the ED and released; 1,857 (36.2%) were admitted to the hospital (202 of whom were transferred directly from the ED to the operating room [OR] for immediate operation); and 42 (0.8%) were DOA or died in the ED. ⋯ The TS identified as major trauma more patients transferred from the ED to the OR than did the CRAMS scale (37% vs 21%; P less than .002). Both scales failed to identify as major trauma almost two out of three patients brought directly from the ED to the OR. The paramedics', or emergency medical technicians' qualitative judgements about injury severity, reflected in their coding injuries as life- or limb-threatening, was almost as good (more than 90% sensitive and specific) as either score (100% sensitive and specific) in identifying patients who died, and was better in identifying patients sent from the ED to the OR.(ABSTRACT TRUNCATED AT 250 WORDS)