Articles: emergency-services.
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Qual Assur Health Care · Mar 1993
Comparative StudyMajor differences in trauma care between hospitals in Sweden: a preliminary report.
The quality of trauma care has been studied at five different Swedish hospitals. The results suggest that improvements in the quality of medical care for patients with severe road traffic injuries can be achieved by reorganizing the highly decentralized trauma care system in Sweden. Above all there is a need for a better structure and organization of the on-call system and of the cooperation of physicians of different specialties within the hospital. ⋯ The greatest problems arose in early diagnosis and treatment of bleeding in abdominal injuries. This was caused by inexperience in the first on-call team in combination with late assessment by second on-call consultants. Fractures of the femoral shaft in almost half of the cases did not get definitive surgery until several days after the accident.
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Survival determinants were examined in patients undergoing ERT-PCI who were admitted to the Surgical Intensive Care Unit (SICU) between January 1, 1982 and August 1, 1991. Twenty-one of 290 patients undergoing ERT-PCI (aged 14-36 years) were admitted to the SICU. Of the 21, nine survived to discharge with normal neurologic function. ⋯ All survivors had vital signs either in the field or on ER arrival. Patients with penetrating chest wounds without vital signs in the field who do not recover vital signs by hospital arrival do not benefit from emergency room thoracotomy. Evidence of mentation in the field or on arrival may predict ultimate neurologic outcome of survivors.
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To identify factors associated with outpatient follow-up of emergency department visits. ⋯ Compliance with follow-up is multifactorial. Consultant contact at the time of initial patient evaluation and provision of a return visit appointment at the time of ED release should improve compliance in a university hospital setting.
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Our objective was to evaluate whether referral to primary care settings would be clinically appropriate for and acceptable to patients waiting for emergency department care for nonemergency conditions. ⋯ Public emergency departments could refer large numbers of patients to appointments at primary care facilities. This alternative would be viable only if the availability and coordination of primary care services were enhanced for low-income populations.
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The recent changes in NHS management structure have allowed us for the first time, to estimate the cost of treatment of an illness. We wanted to determine the treatment cost of a case of deliberate self-harm (DSH) to a large University Teaching Hospital and to this aim, we reviewed the case notes of 190 consecutive cases of deliberate self-harm presenting to A&E. On average, each attendance costs 425.24 pounds, from attendance to A&E to hospital discharge.