Articles: emergency-services.
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In response to the spiraling anger and frustration voiced by the emergency room (ER) medical staff and the observed negative interactions between the alcohol-dependent patient and the ER staff, the author completed a 6-month retrospective review of all patients evaluated by the ER service with a complaint of alcohol abuse, chronic alcoholism, or requesting detoxification. As a result of that study, an ER-based comprehensive approach to the management of this population was proposed. Utilizing an existing Connecticut state statute, a specific approach to manage the skid-row alcoholic arriving repeatedly in the ER was developed. I report on this ER-based model and an approach to "capturing" the skid-row alcoholic.
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Operation of an emergency department satellite pharmacy in which the pharmacist provided clinical, educational, and drug distribution services during patient visits is described. In a Detroit trauma and ambulatory-care center, drugs were dispensed to outpatients 24 hours a day from a satellite pharmacy located in the 75-bed emergency department. ⋯ When reductions in the work force were necessary, the institution chose to retain 24-hour pharmacist coverage during emergency department patient visits and to eliminate 24-hour dispensing to outpatients. In this urban trauma center, the emergency department pharmacist's clinical, distributive, and educational services contributed substantially to delivery of patient care.
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Pediatric emergency care · Mar 1985
Has Medicaid promoted needless pediatric emergency department use?
The possibility that Medicaid has encouraged pediatric emergency department (ED) use was explored as part of a study of 8470 ED visits to a pediatric teaching hospital in the period from 1975 to 1976. The proportion of the population on Aid to Dependent Children (proportion on ADC) was taken as a reasonable proxy for prevalence of Medicaid coverage of children in an area. ⋯ The data show no differences in the mean proportion on ADC in the census tracts of origin of ED visits on weekdays as compared to weekends or for visits which resulted in admission as compared with those which did not. The data challenge the idea that Medicaid has encouraged pediatric ED use.
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The purpose of the study was to determine the basis for nonpsychiatrists' decisions to obtain psychiatric consultations in an emergency department (ED) for patients with transient to moderate psychiatric symptoms. The authors reviewed ED records during July-August 1982 and January-March 1983. Complete data were gathered for 133 of 134 patients with primary or secondary psychiatric discharge diagnoses and scores on the Global Assessment Scale (GAS) such that most clinicians would not think immediate consultation was required. ⋯ Social characteristics also distinguished between patients who received a psychiatric consultation in the ED and patients who did not. It was concluded that nonpsychiatrists base important management decisions on a history of psychiatric treatment for patients with transient to moderate symptoms. Whether this is appropriate needs to be studied.