Articles: emergency-services.
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Comparative Study
Use of advisers in the diagnosis and management of abdominal pain in accident and emergency departments.
The performance of senior house officers (SHOs) and their advisers in accident and emergency departments was compared in the diagnosis of abdominal pain in 711 patients. Accuracy of diagnosis was 63 per cent for advisers and 54 per cent for SHOs. ⋯ The SHOs refer accurately in 94 per cent of cases, and the advisers improve the SHO referrals in only 1 per cent of patients. It is argued that the time-consuming process of calling a surgeon away from a ward or theatre to advise in the receiving room is of little value, and avoidance of this step would enable patients to be admitted more rapidly.
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To assess the surveillance of alcohol intoxication by surgical house staff, we examined the charts of 346 motor vehicle accident patients who presented to the trauma center of an urban teaching hospital emergency department. Half of the charts were reviewed before and half were reviewed after June 1986, when Connecticut enacted PA86-345, a law changing court rules of evidence so that the analysis by a hospital of a patient's blood could be used to establish probable cause for driving while under the influence of an intoxicant. ⋯ Not one patient was referred for alcohol abuse evaluation or treatment. We recommend more vigorous attempts to evaluate, diagnose, and refer patients who abuse alcohol since they threaten the public health.