A career path in emergency and critical care medicine: The time is ripe David Crippen
DOI: http://dx.doi.org/10.1016/0735-6757(90)90204-D
The American Journal of Emergency Medicine , Vol. 8 , Issue 2 ,
Published in issue: March 1990
The limits of health care resources Kenneth V. Iserson
DOI: http://dx.doi.org/10.1016/0735-6757(92)90191-Y
The American Journal of Emergency Medicine , Vol. 10 , Issue 6 ,
Published in issue: November 1992
How well do General EMS 911 dispatch protocols predict ED resource utilization for pediatric patients? Stephanie J. Fessler, Harold K. Simon, Arthur H. Yancey II, Michael Colman, Daniel A. Hirsh
DOI: http://dx.doi.org/10.1016/j.ajem.2013.09.018
The American Journal of Emergency Medicine , Vol. 32 , Issue 3 ,
Published online: December 26 2013
x The use of Emergency Medical Services (EMS) for low-acuity pediatric problems is well documented. Attempts have been made to curb potentially unnecessary transports, including using EMS dispatch protocols, shown to predict acuity and needs of adults. However, there are limited data about this in children. The primary objective of this study is to determine the pediatric emergency department (PED) resource utilization (surrogate of acuity level) for pediatric patients categorized as “low-acuity” by initial EMS protocols.
Correlation of the Canadian Pediatric Emergency Triage and Acuity Scale to ED resource utilization Warren Ma, Amiram Gafni, Ran D. Goldman
DOI: http://dx.doi.org/10.1016/j.ajem.2008.02.024
The American Journal of Emergency Medicine , Vol. 26 , Issue 8 ,
Published in issue: October 2008
x The aim of this study was to find if there is a correlation between acuity measured by the Canadian Pediatric Emergency Triage and Acuity Scale (Ped-CTAS) and resource utilization in a large tertiary academic emergency department (ED). If correlation exists, it may indicate that resource allocation was done in accordance with needs (the more acute the patient, the more resources needed). This may also be the basis for future consideration regarding resource allocation decisions.
Answering clinical questions in the ED Mark A. Graber, Bradley D. Randles, John W. Ely, Jay Monnahan
DOI: http://dx.doi.org/10.1016/j.ajem.2007.03.031
The American Journal of Emergency Medicine , Vol. 26 , Issue 2 ,
Published in issue: February 2008
x The objective of the study was to determine how many patient-related questions emergency medicine physicians have and how they answer them at the point of care.
Demand on ED resources during periods of widespread influenza activity Paul A Silka, Joel M Geiderman, Joshua B Goldberg, Linda Park Kim
DOI: http://dx.doi.org/10.1016/j.ajem.2003.08.011
The American Journal of Emergency Medicine , Vol. 21 , Issue 7 ,
Published in issue: November 2003
x The purpose of this study was to investigate ED resource demand during periods of Centers for Disease Control and Prevention (CDC)-declared widespread influenza activity (WIA). An observational analysis of secondary data describing ED resource demand was performed using computerized ED patient data over a 130-week period. Measures of ED resource utilization were compared during WIA and non-WIA periods. These measures included weekly census; percentage of patients triaged as having fever, infection, or respiratory (flu index) chief complaints; admission rate, ED LOS (length of stay), total bed time (TBT), the number of patients who left the ED without being seen by a physician (LWBS), and ED saturation time.
The impact of age and gender on resource utilization and profitability in ED patients seen and released Philip L. Henneman, Brian H. Nathanson, Kara Ribeiro, Hari Balasubramanian
DOI: http://dx.doi.org/10.1016/j.ajem.2014.06.030
The American Journal of Emergency Medicine , Vol. 32 , Issue 10 ,
Published online: July 1 2014
x To determine how age and gender impact resource utilization and profitability in patients seen and released from an Emergency Department (ED).
The intravenous use of coconut water Darilyn Campbell-Falck, Tamara Thomas, Troy M Falck, Narco Tutuo, Kathleen Clem
DOI: http://dx.doi.org/10.1016/S0735-6757(00)90062-7
The American Journal of Emergency Medicine , Vol. 18 , Issue 1 ,
Published in issue: January 2000
x Medical resources routinely used for intravenous hydration and resuscitation of critically ill patients may be limited in remote regions of the world. When faced with these shortages, physicians have had to improvise with the available resources, or simply do without. We report the successful use of coconut water as a short-term intravenous hydration fluid for a Solomon Island patient, a laboratory analysis of the local coconuts, and a review of previously documented intravenous coconut use.
Probability of survival, early critical care process, and resource use in trauma patients Kazuaki Kuwabara, Shinya Matsuda, Kiyohide Fushimi, Koichi B. Ishikawa, Hiromasa Horiguchi, Kenji Fujimori
DOI: http://dx.doi.org/10.1016/j.ajem.2009.02.030
The American Journal of Emergency Medicine , Vol. 28 , Issue 6 ,
Published online: February 8 2010
x Trauma Injury Severity Score is a frequently used prediction model for mortality. However, few studies have assessed the probability of survival (P s) and early resource use after trauma. We studied the impact of P s on early critical care or costs to test its applicability to efficient trauma care.
Using discrete event computer simulation to improve patient flow in a Ghanaian acute care hospital Allyson M. Best, Cinnamon A. Dixon, W. David Kelton, Christopher J. Lindsell, Michael J. Ward
DOI: http://dx.doi.org/10.1016/j.ajem.2014.05.012
The American Journal of Emergency Medicine , Vol. 32 , Issue 8 ,
Published online: May 19 2014
x Crowding and limited resources have increased the strain on acute care facilities and emergency departments worldwide. These problems are particularly prevalent in developing countries. Discrete event simulation is a computer-based tool that can be used to estimate how changes to complex health care delivery systems such as emergency departments will affect operational performance. Using this modality, our objective was to identify operational interventions that could potentially improve patient throughput of one acute care setting in a developing country.
Collaboration among emergency medicine physician researchers and statisticians: Resources and attitudes Nancy M.Fenn Buderer, Michael C Plewa
DOI: http://dx.doi.org/10.1016/S0735-6757(99)90162-6
The American Journal of Emergency Medicine , Vol. 17 , Issue 7 ,
Published in issue: November 1999
x We examined the statistical resources within emergency medicine residency programs, and the attitudes of emergency medicine physician researchers toward activities wherein collaboration with a statistician is useful. Anonymous surveys were mailed to 104 emergency medicine physician researchers (1/program). Sixty-four (62%) responses were analyzed. Sixty-seven percent of respondents were their program's research director. Their highest level of statistical training was self-taught/nondegree course work for 88% of respondents.
Performance of a system to determine EMS dispatch priorities Liz Palumbo, John Kubincanek, Charles Emerman, Nick Jouriles, Rita Cydulka, Bruce Shade
DOI: http://dx.doi.org/10.1016/S0735-6757(96)90056-X
The American Journal of Emergency Medicine , Vol. 14 , Issue 4 ,
Published in issue: July 1996
x Inappropriate use of emergency medical services (EMS) for nonemergencies strains EMS resources and limits efficiency. Protocol-driven dispatch systems attempt to correct the imbalance that exists between demand and available resources by prioritizing 911 calls. This study compared dispatch priority decisions with apparent patient need, based on emergency department (ED) presentation, by matching 320 ED charts with corresponding EMS dispatch and run information. The priorities assigned by the system based on dispatch information were compared with those assigned by a three-member panel of physicians based on ED presentation.
International EMS: Lessons learned in Costa Rica Connie Mitchell
DOI: http://dx.doi.org/10.1016/0735-6757(91)90062-O
The American Journal of Emergency Medicine , Vol. 9 , Issue 4 ,
Published in issue: July 1991
x Health care planners in Costa Rica, seeking to upgrade their emergency medical services, contracted with United States agencies for additional funding and established a national program for the development of an emergency medical service system. Three years later some of the problems and accomplishments of both the planning and early implementation phases have been identified and include the importance of a detailed assessment of current system components, resources, and priorities; the early implementation of an accurate data collection system; early planning for system self-sufficiency; the vital role of the lead agency with formal lines of authority; the careful development of local expertise and leadership.
Practice variation in the management for nontraumatic pediatric patients in the ED Yu-Che Chang, Chip-Jin Ng, Yu-Chuan Chen, Jih-Chang Chen, David Hung Tsang Yen
DOI: http://dx.doi.org/10.1016/j.ajem.2008.11.021
The American Journal of Emergency Medicine , Vol. 28 , Issue 3 ,
Published in issue: March 2010
x To improve the management quality and monitoring for common pediatric illnesses in the general emergency department (ED), we examined the effect of physician specialty training on medical resource use and patient outcomes.
Accessing and using the internet's World Wide Web for emergency physicians Loren G. Yamamoto, Philip J. Suh
DOI: http://dx.doi.org/10.1016/S0735-6757(96)90183-7
The American Journal of Emergency Medicine , Vol. 14 , Issue 3 ,
Published in issue: May 1996
x This report describes the use of the internet's World Wide Web (WWW) for emergency physicians. WWW is a graphic means of presenting information over the internet. Because this graphic presentation is derived from a point-and-click method of navigating through information, emergency physicians with little or no computer background should be able to benefit. There are currently many resources available to emergency physicians on the WWW that can be viewed at no charge. It is essentially a worldwide library of information that is growing at a rapid rate.
Predicting resource use at mass gatherings using a simplified stratification scoring model Nicholas Hartman, Allen Williamson, Benjamin Sojka, Kostas Alibertis, Marjorie Sidebottom, Thomas Berry, Jay Hamm, Robert E. O'Connor, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2008.03.042
The American Journal of Emergency Medicine , Vol. 27 , Issue 3 ,
Published in issue: March 2009
x Mass gathering events require varying types and amounts of medical resources to deal with patient presentations. The needs of various events have so far been difficult to predict with precision, yet likely are impacted by several factors which may be used in a predictive fashion.
Resource reallocation in an emergency medical service system using computer simulation Syi Su, Chung-Liang Shih
DOI: http://dx.doi.org/10.1053/ajem.2002.35453
The American Journal of Emergency Medicine , Vol. 20 , Issue 7 ,
Published in issue: November 2002
x Emergency medical service (EMS) policy makers must seek to achieve maximum effectiveness with finite resources. This research establishes an EMS computer simulation model using eM-Plant software. The simulation model is based on Taipei city's EMS system with input data from prehospital care records from December 2000; it manipulates resource allocation levels and rates of idle errands. Presently, EMS ambulance utilization is about 8.78%. On average, 20.89 minutes are required to transport a patient to the hospital.
Are there high-risk groups among physicians that are more vulnerable to on-call work? Tarja Heponiemi, Anna-Mari Aalto, Laura Pekkarinen, Eeva Siuvatti, Marko Elovainio
DOI: http://dx.doi.org/10.1016/j.ajem.2015.01.034
The American Journal of Emergency Medicine , Vol. 33 , Issue 5 ,
Published online: January 27 2015
x Work done in the emergency departments is one stressful aspect of physicians’ work. Numerous previous studies have highlighted the stressfulness of on-call work and especially of night on call. In addition, previous studies suggest that there may be individual differences in adjusting to changes in circadian rhythms and on-call work.
Patterns and factors associated with intensive use of ED services: implications for allocating resources Jennifer Prah Ruger, Lawrence M. Lewis, Christopher J. Richter
DOI: http://dx.doi.org/10.1016/j.ajem.2012.04.001
The American Journal of Emergency Medicine , Vol. 30 , Issue 9 ,
Published online: July 16 2012
x This study aims to better understand the patterns and factors associated with the use of emergency department (ED) services on high-volume and intensive (defined by high volume and high-patient severity) days to improve resource allocation and reduce ED overcrowding.
Ultrasound-guided pediatric forearm fracture reductions in a resource-limited ED Bobby M. Wellsh, Jerzy M. Kuzma
DOI: http://dx.doi.org/10.1016/j.ajem.2015.09.013
The American Journal of Emergency Medicine , Vol. 34 , Issue 1 ,
Published online: September 19 2015
x Pediatric forearm fractures are a common presentation in emergency departments in Papua New Guinea. Often these children undergo “blind” closed reduction with reduction adequacy assessed by standard radiographs. This study aims to demonstrate the safety and efficacy of ultrasound (US) in guiding closed reduction of pediatric forearm fractures in a resource-limited setting.
