Articles: emergency-services.
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To describe the current use, effectiveness and safety of Bier's block within Australian emergency departments. ⋯ Bier's block is a popular, reliable and relatively safe anaesthetic technique for use in emergency departments. Increased surveillance of local anaesthetic morbidity associated with the technique, as well as a standardisation of the procedure in the emergency department setting, are required.
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Health Serv Manage Res · Feb 1994
Comparative StudyDo formal controls always achieve control? The case of triage in accident and emergency departments.
Triage is the term used to describe the formal process of assigning urgency categories to patients arriving in a hospital accident and emergency department. This paper uses insights from literature on management control, medical sociology and nursing to illuminate the results of a research study comparing formal triage with an informal prioritisation process carried out by nurses. Topics discussed include whether triage is a bureaucratic process, whether it allows nurses' intuition to be expressed, whether it masks the urgency of the condition of the small number of seriously injured or ill patients, and whether responsibility for decisions on urgency should be separated from responsibility to act on those decisions. It is concluded that managers must consider these questions in the light of arrangements in their own hospital; departmental layout as well as the nursing staff's experience and commitment need to be taken into account.
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Sedation and analgesia are essential components of the ED management of pediatric patients. Used appropriately, there are a number of medications and techniques that can be used safely in the emergency care of infants and children. Emergency physicians should be competent in the use of multiple sedatives and analgesics. Adequate equipment and monitoring, staff training, discharge instructions and continuous quality management should be an integral part of the ED use of these agents.
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To ascertain the quality of electrocardiogram (ECG) use in a pediatric emergency department (PED). ⋯ We recommend education of pediatric residents in ECG interpretation and subsequent review by a pediatric cardiologist of each ECG performed in the PED.