Articles: emergency-services.
-
We sought to determine the impact of general practitioner communication on the efficient management of patients who present to the emergency department. Casemix, severity, time of presentation, the quality of the letter and the reception of a telephone call were considered. ⋯ Despite the ability of general practitioners to select appropriate cases for referral, only the telephone call results in a quantifiable benefit for patients who attend their general practitioner. The high inter-rater reliability affirms the use of referral letters as audit tools in general practice. Better practical use could be made of general practitioners' referral communication to the emergency department.
-
To assess the therapeutic role and cost effectiveness of resuscitative thoracotomy in an urban trauma center, a retrospective review of thoracotomies (n = 273) performed in a trauma unit between 1986 and 1992 was undertaken. A total of 252 thoracotomies were performed for penetrating injuries (92%), and 21 (8%) were performed for blunt trauma. Ten neurologically intact survivors (3.7%) were identified. ⋯ Total charges during the study period for resuscitative thoracotomy were approximately $932,000. This represents an expenditure of $93,000 per successful thoracotomy. If thoracotomy was limited to patients sustaining penetrating trauma who demonstrated signs of life, total charges would be approximately $201,367, representing an expenditure of $20,137 per successful thoracotomy.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Comparative Study
ED length-of-stay and illness severity in dizzy and chest-pain patients.
Emergency department (ED) length of stay, illness severity, and patterns of ED-based testing can be used to compare different ED patient populations. To assess the relative significance of ED patients with dizziness and chest pain in emergency medicine practice, the investigators formed a retrospective chart review of 3,864 adults (age > or = 16 years) seen at the University of North Carolina Hospitals' ED during May and June of 1991. Patients were eligible if they had any complaint of dizziness (n = 259), nontraumatic chest pain (n = 168), or both (n = 18). ⋯ Chest-pain patients were more likely to undergo electrocardiogram and x-ray testing, whereas dizzy patients more often received testing such as brain computed tomography scanning (10.8% v 3.6%, P = .01). ED patients with dizziness and chest pain were similar with regard to ED length of stay. Given their overall similarities to the chest-pain group, dizzy patients appear to represent a significant population of ED patients and may warrant more clinical study.
-
Critical care medicine · Jul 1994
Plasma cytokine determinations in emergency department patients as a predictor of bacteremia and infectious disease severity.
To determine the predictive value of plasma interleukin (IL)-6 and tumor necrosis factor-alpha (TNF) measurements in assessing bacteremia and subsequent morbidity and mortality rates in emergency department patients. ⋯ Measurement of plasma IL-6 concentrations in a population of emergency department patients with apparent bacterial infections predicted bacteremia and death from infection. The characteristics of the test indicated a potential use in selecting patients for the administration of novel therapies for sepsis.
-
The aim of this study was to enable a research-based standard to be set in relation to waiting times. This would be in accordance with the recommendations of the Patient's Charter (Department of Health 1992). ⋯ Between 1 January and 31 December 1992 a random sample of 230 casualty cards were drawn and analyzed. Analysis showed that 90.5% of patients in the sample were assessed by a nurse at or within 10 minutes of arrival, and 83.25% of patients in the sample were seen by the doctor at or within 60 minutes of arrival.