Articles: emergency-services.
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In many institutions it is the "standard of care" to obtain serum chemistries and anticonvulsant levels as part of the emergency department evaluation of seizure patients. To determine the efficacy of such a workup in the ED, 163 seizure patients presenting to an inner-city teaching hospital were studied in a standardized, prospective manner. After the clinical examination all patients had CBC, serum electrolyte, BUN, creatinine, glucose, calcium, magnesium, and if indicated, anticonvulsant drug level determinations performed. ⋯ The clinical examination successfully predicted those abnormalities in all but two cases (one each of hyperglycemia and subdural hematoma). We contend tha routine serum chemistries in patients presenting to the ED are of extremely low yield, and that the clinical examination can predict accurately the need to obtain these studies. CCT scanning is useful in selected patients, and was found to be abnormal in five of 19 (25%) patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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This is an investigation of the impact of an emergency room triage by a medical specialist. The study encompassed patients who came to the medical section of the emergency room of a large university hospital during a two-week study period and a control period of the same length. The result showed that 36% of the patients could be sent home after the triage, thereby reducing the number of chemical tests and ECG examinations significantly (p less than 0.001). ⋯ No effect of the triage on hospital use of out-patient visits to the hospital during a one year follow-up period was noted. The triage procedure was safe for, and accepted by the patients, as was demonstrated by follow-ups involving investigation of the death register and personal interviews. The study shows that triage by a specialist is an effective method for reducing hospital service utilization and shortening patient treatment time.
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Health Care Manage Rev · Jan 1986
Satisfaction with hospital emergency department as a function of patient triage.
For most people, waiting is inherently dissatisfying and emergency department patients are no exception. Most patients and people accompanying the patient find the treatment waiting time in emergency medical care facilities to be a source of great dissatisfaction. The dissatisfaction is compounded in many cases by the anxiety of all associated with the patient and the discomfort or pain the patient feels. ⋯ With the trend toward new forms of health care delivery systems such as "emergicenters" and the increase in the number of physicians per capita, the emergency department will no longer be the most attractive or the only alternative available to the patients who have a nonemergency medical need. For emergency departments to remain profitable, it will be more important than ever before to meet the needs and expectations of their current and potential users. This can be accomplished by a program designed to reduce cost and waiting time and improve communication, and by other programs to educate the user so that the user's expectations more closely conform with what is actually needed or can be economically provided.