Articles: emergency-services.
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Critical care medicine · Mar 1987
Value of a conventional approach to the diagnosis of traumatic cardiac contusion after chest injury.
We wanted to evaluate whether current screening techniques effectively determine a patient's need for hospital admission and intensive care monitoring after blunt chest trauma. Consequently, we reviewed 104 consecutive admissions for "blunt chest trauma; rule out cardiac contusion." Neither clinical findings, cardiac enzyme levels, chest x-rays, nor ECGs predicted the high-risk patients who would subsequently develop complications related to myocardial contusion. Since only 23% of the study patients developed such complications, the plurality of study patients did not require admission and monitoring. There is, therefore, a definite need to develop new, accurate screening tests for patients at risk for myocardial contusion complications.
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The police have become one of the primary referral agencies for psychiatric assistance in the community. They utilize certain factors that determine the decisions affecting case disposition for every mental health assistance call they receive. This study of a police department's mental health responses for the year 1985 attempts to analyze the police officers' placement decisions for the mentally ill and the criteria for which such dispositions are made.
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This article discusses current applications of computers in the Emergency Department. Different approaches for computerization are compared, and difficulties and problems of computerization are discussed.
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This article discusses risk management and control of malpractice risk in the Emergency Department. Particular emphasis is placed on actuarial information related to Emergency Department losses.
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This article has presented an overview of the duties, responsibilities, and management roles of the emergency department Medical Director, a position that can be among the most challenging, stimulating, and exciting in medicine. However, prior to accepting a position as an Emergency Department medical director, one should have a clear understanding of what the job entails. ⋯ Once the job has been accepted, using the roles, responsibilities, and duties detailed herein may be of benefit--but should always be applied with good judgment, tactful cooperation, and common sense. Finally, it should not be surprising to a medical director to find, as Spinoza did many years ago, that the excellent thing he aspires to are as difficult as they are rare.