Articles: emergency-services.
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This article outlines the various legal responsibilities attendant to a hospital's provision of emergency medical services. Specifically, the article focuses on various issues relating to emergency department staffing, including the hospital's duty to provide emergency medical services and the liability of various parties for patient injuries sustained during the course of emergency treatment.
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Seventy-eight cases of cardiac arrest occurring outside intensive care units and emergency rooms were analysed. 44% of patients were initially resuscitated, and 14% were still alive at 28 days. The previously well documented relationships between survival and location of arrest, age of patient and initial dysrhythmia were confirmed. A diurnal variation in the incidence of cardiac arrest has recently been postulated, but was not noted in this survey. However, the proportion of arrest patients who were initially resuscitated did show a significant fluctuation over the 24-hour period as tested by a sinusoidal logistic regression.
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Screening for alcoholism and associated psychiatric disorders using preselected research criteria demonstrated an overall prevalence of alcoholism of 20% in 200 emergency department patients. The nighttime prevalence of alcoholism was 29%, while the daytime prevalence was 11%. ⋯ The alcoholics had chief complaints relating to trauma in 63% of the cases, vague neuropsychiatric complaints in 23% of the cases, and complaints directly related to alcohol in 8% of the cases. Screening for alcoholism and associated psychiatric illnesses is important in determining an overall treatment strategy for emergency patients.
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Triage is the process by which patients are assessed upon their arrival at a health care facility to determine the urgency of their problem and to determine the appropriate health care resource. Of the five major types of triage, advanced triage is the most comprehensive system. It includes initial assessment, initiation of diagnostic procedures, appropriate physical examination, documentation, and a referral system. Implementation of a triage system should include didactic components, a clinical trial, written examinations, and documented certification.