Articles: emergency-services.
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Hypothermia, especially in an urban environment, is often an unsuspected and therefore underdiagnosed clinical entity. Of 60 cases recorded over a two-year period in a typical community hospital in Philadelphia, 26 (43%) involved patients under 60 years of age; ambient air temperatures at admission exceeded 50 F (10 C) in 28 (47%) of the 60 cases. ⋯ Diabetes and alcohol abuse appear to be risk factors for hypothermia, being present in 18 (30%) and 14 (23%) of our patients, respectively. Every emergency department should have a protocol for identification and management of the hypothermia victim to allow timely institution of appropriate rewarming techniques.
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The families of 441 children seen in accident and emergency departments over a 10 week period were interviewed to find the reasons why they bypassed their general practitioner and took the child to the department. One-quarter of the children did see the general practitioner first. ⋯ The closer the child's home was to either the general practitioner or the accident and emergency department, the more likely that service was to be used. Children from lower socio-economic status families were more likely than other children to see their general practitioner first.