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Images in emergency medicine 总被引:1,自引:0,他引:1
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A Parasyn R M Hanson MBBCh MPH MRACMA FRACP FACEM J K Peat M De Silva 《Journal of digital imaging》1998,11(1):45-49
Picture Archiving and Communication Systems (PACS) make possible the viewing of radiographic images on computer workstations located where clinical care is delivered. By the nature of their work this feature is particularly useful for emergency physicians who view radiographic studies for information and use them to explain results to patients and their families. However, the high cost of PACS diagnostic workstations with fuller functionality places limits on the number of and therefore the accessibility to workstations in the emergency department. This study was undertaken to establish how well less expensive personal computer-based workstations would work to support these needs of emergency physicians. The study compared the outcome of observations by 5 emergency physicians on a series of radiographic studies containing subtle abnormalities displayed on both a PACS diagnostic workstation and on a PC-based workstation. The 73 digitized radiographic studies were randomly arranged on both types of workstation over four separate viewing sessions for each emergency physician. There was no statistical difference between a PACS diagnostic workstation and a PC-based workstation in this trial. The mean correct ratings were 59% on the PACS diagnostic workstations and 61% on the PC-based workstations. These findings also emphasize the need for prompt reporting by a radiologist. 相似文献
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Integrated major haemorrhage management in the retrieval setting: Damage control resuscitation from referral to receiving facility 下载免费PDF全文
Julian D Wijesuriya MBBS DipIMC MAcadMEd FRCA FFICM Sean Keogh FRCS FRCP FIMC FRCEM FACEM 《Emergency medicine Australasia : EMA》2017,29(4):470-475
Major haemorrhage is a leading cause of death in critically ill or injured patients requiring medical retrieval and presents significant clinical and logistic challenges irrespective of patient location, primary pathophysiology or mode of transport. It is essential that all care providers involved in the retrieval patient pathway, including referring hospitals, ambulance services, retrieval teams and tertiary receiving centres, adopt a common approach to the management of this complex patient group through the use of retrieval‐specific, integrated protocols. These should incorporate the latest clinical evidence base, recognise the differences between primary and inter‐facility missions and clearly define the roles and responsibilities of the retrieval clinical coordinator. By unifying the response across services, the aim is to facilitate seamless transition of care with ongoing damage control resuscitation from point of referral, during transfer and on arrival at the receiving centre. 相似文献
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Neil Waldman MD FACEM Ian K. Densie Peter Herbison DSc 《Academic emergency medicine》2014,21(9):1064-1065
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Antony George Attokaran FRACP FCICM Mahesh Ramanan MMed FCICM Lisa Hunt MBBS Kavita Chandra MBBS Rajbir Sandha FACEM Stacey Watts RN BN GC Balasubramanian Venkatesh MD FCICM FAHMS 《Emergency medicine Australasia : EMA》2023,35(4):657-663
Objective
To test the hypothesis that fluid resuscitation in the ED with plasmalyte-148 (PL) compared with 0.9% sodium chloride (SC) would result in a lower proportion of patients with diabetic ketoacidosis (DKA) requiring intensive care unit (ICU) admission.Methods
We performed a prespecified nested cohort study at two hospitals within a cluster, crossover, open label, randomised, controlled trial comparing the effects of PL versus SC as fluid therapy for patients who presented to the ED with DKA. All patients presenting within a fixed recruitment period were included. The primary outcome was the proportion of patients admitted to ICU.Results
Eighty-four patients were enrolled (SC n = 38, PL n = 46). The SC group had a lower median pH on admission (SC: 7.09 [interquartile range (IQR) 7.01–7.21], PL: 7.17 [IQR 6.99–7.26]). The median volume of intravenous fluids administered in ED was 2150 mL (IQR 2000–3200 mL; SC) and 2200 mL (IQR 2000–3450; PL); respectively. A higher proportion of patients in the SC group, 19 (50%), was admitted to ICU compared with PL group, 18 (39.1%); however, after adjustment for pH at presentation and diabetes type in a multivariable logistic regression model, the PL group did not have a significantly different rate of ICU admission compared with the SC group (odds ratio for ICU admission 0.73, 95% confidence interval 0.13–3.97, P = 0.71).Conclusion
Patients with DKA treated with PL compared with SC in the EDs had similar rates of requiring ICU admission. 相似文献7.
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Objectives
Collegiality is considered to be any extra-role behaviour that is discretionary, not recognised by a formal reward system and that promotes the effective functioning of the organisation. Although there is much literature on the concept of collegiality, there are few studies examining collegiality in the medical profession and none looking at collegiality among emergency physicians (EPs). The aim of the present study is to explore the perceptions of different ED healthcare professionals on the meaning of collegiality among EPs, the benefits of collegiality and behaviours they identify as indicative of collegiality.Methods
This was a qualitative study using grounded theory. Data collection was via focus group interviews of three to four participants per group. Participants included EPs, emergency medicine trainees, senior emergency nurses and nurse practitioners. Three questions were explored: ‘what does collegiality mean to you?’; ‘what are the benefits of collegiality?’; and ‘what specific behaviours do you see as part of collegiality?’Results
Ten focus group interviews involving a total of 33 participants were conducted. Several themes were identified for both the meaning of collegiality and the benefits of collegiality among EPs. Eight themes regarding collegial behaviour were identified: (i) mutual respect and trust; (ii) mutual support; (iii) attitude; (iv) work ethic; (v) staff welfare; (vi) patient management; (vii) handover; and (viii) education.Conclusion
The present study identified distinct themes and behaviours indicative of collegiality among EPs. Promoting these behaviours could improve staff well-being, ED efficiency, patient safety and productivity. 相似文献9.
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