Organizing the hospital for pediatric trauma care
David E. Wesson, Bindi Naik-Mathuria in Pediatric Trauma, 2017
The emergency department is the primary entry point into the hospital for the injured child and family. Since pediatric spans the ages from neonates to adolescents, equipment must be readily available and appropriate for all sizes. Published data have suggested that many emergency departments in the United States lack basic equipment and supplies needed to care for children of all ages [17]. In 2009, a nationwide assessment of all emergency departments began, based on the published 2009 Guidelines for the Treatment of Children in the emergency department [18]. Starting in 2012, the EMSC Program implemented the National Pediatric Readiness Project. This comprehensive project used a variety of communication strategies, including direct mailings, coupled with a state-level management strategy, a web media presence, and a comprehensive public relations campaign. The overall purpose of this national quality improvement project is to ensure that all emergency departments are ready to care for children. The first documented review of the project demonstrated increased pediatric readiness compared to previous reports [19]. A careful review of the pediatric readiness toolkit should be performed to ensure appropriate resources are available. Information is available on the website http://www.pediatricreadiness.org/readiness-toolkit.
EMS support of executive protection and counter-terrorism operations
Jan de Boer, Marcel Dubouloz in Handbook of Disaster Medicine, 2020
While the ‘man in the street’ might not readily appreciate it, not all ERs were created equal, nor were all doctors. Depending upon the country, state, city, neighbourhood, time of day, and day of the week, a huge spectrum of personnel and services may be available in any given emergency department, or not. For example, many hospitals will analyse ‘utilisation data’ which indicates how many patients come to the emergency department (and other departments in the hospital), with what problems, at what time of day, on what day of the week. They will then make decisions about manpower and primary service requirements, as well as support personnel and back-up services (such as the operating room function). Therefore, while the emergency department at ‘St. Elsewhere’ may be fully staffed and ready for anything on a Tuesday morning, on a Thursday night at 2 a.m. there may be only a skeleton staff on duty. Moreover, the operating room may be closed and subject to a 30 or 60 min activation schedule. This means that if you burst through the door of the ER with your principal having suffered an event which requires immediate surgery at the wrong hospital at the wrong time of day, you lose!
Theories and Models of Health Behavior Change
Deborah Fish Ragin in Health Psychology, 2017
Contrary to popular belief, the frequent users of emergency medical service for routine care issues are not individuals with limited or no access to care. Rather, they are those who are dissatisfied with their health care options. A nationwide study examining the reasons why patients sought care from hospital emergency departments (EDs) illustrates this point. In their study of 28 hospital emergency departments nationwide, Ragin and colleagues (2005b) identified five main reasons why patients sought emergency medical treatment: a medical emergency (95.0%), preference for the ED (88.7%), convenience (86.5%), affordability (25.2%), and limitations of insurance (14.9%). Few people consider an emergency department a convenient source of care, and fewer still think of it as a place where they prefer to go for care. So, what do these results mean?
Need for social work interventions in the emergency department
Published in Social Work in Health Care, 2023
Jobin Tom, Elizabeth K. Thomas, A. Sooraj, Seema P. Uthaman, Harish M. Tharayil, Akhil S.L., Chandni Radhakrishnan
An emergency department is part of a hospital that provides 24/7 emergency care to patients who need urgent medical attention. Emergency Department (ED) medical teams provide trauma treatment, triage for admission into the hospital for acute medical conditions, as well as medical care to those who do not or cannot access primary care. Patients with multiple medical, social, and economic needs also utilize the ED as a safety net system of care. The availability of low-cost tertiary level care treatment in the government hospitals, as opposed to the relatively high cost of treatment in private hospitals, may be a factor in choosing health care services in the emergency departments as well as the increased patient load. One of the critical aspects in the operation of an emergency department is the prioritization of cases based on clinical needs, known as triage. It is the first stage through which every patient goes when they are availing ED services and consists of a brief assessment and later assigned to another area of the department.
Understanding barriers and facilitators to speech-language pathology service delivery in the emergency department
Published in International Journal of Speech-Language Pathology, 2023
Pranika B. Lal, Laurelie R. Wishart, Elizabeth C. Ward, Maria Schwarz, Marnie Seabrook, Anne Coccetti
The emergency department (ED) plays an integral role in providing acute assessment and intervention for individuals with primary and secondary diseases and is often the first point of contact within the hospital system for patients who present with life-threatening conditions or sudden illness or injury (Anderson, Petrino, Halpern, & Tintinalli, 2006; Australian Institute of Health & Welfare, 2014; Cowling, Soljak, Bell, & Majeed, 2014). EDs are often the entry point to further inpatient hospital care, and where patient care coordination first occurs (Cowling et al., 2014). Although designed to manage medical emergencies, ED services are also accessed by patients with non-urgent medical conditions, resulting in high service demand (Cusick, Johnson, & Bissett, 2009). During the 2017/2018 financial year, more than eight million patients presented to Australian EDs, with patients aged 65 years and over accounting for over 22% of these presentations (Australian Institute of Health & Welfare, 2017). A third of those patients presenting to the ED were subsequently admitted to hospital (Australian Institute of Health & Welfare, 2017).
Identifying Patient Phenotype Cohorts Using Prehospital Electronic Health Record Data
Published in Prehospital Emergency Care, 2022
Rachel Stemerman, Thomas Bunning, Joseph Grover, Rebecca Kitzmiller, Mehul D. Patel
The identification of patients who satisfy specific criteria from a large population in the prehospital setting has numerous use cases, including clinical trial recruitment, outcome prediction, and patient phenotyping (i.e. influenza like illness). Despite emergency medical services (EMS) playing a key role in providing critical care and timely interventions for acute illness and injury, most research concerning emergency care interventions is done in the emergency department (ED) and hospital settings. This results in insufficient scientific evidence to guide prehospital treatment decisions and patient care (1, 2). More high-quality clinical trials in EMS settings are needed to advance prehospital emergency care especially among high acuity, low frequency events (3). The large number of prehospital providers, difficulty in training prehospital providers and constrained time for research activities during a clinical episode, create fundamental barriers to prehospital research. As a result, prehospital trial sites frequently struggle to meet recruitment schedules and accrual goals and may necessitate EMS personnel trial protocol re-training due to personnel turnover. Thus, participant screening, recruitment and data collection present immense challenges for those investigating prehospital care (1, 4, 5).
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