Imagine the emergency department of the future

To the Editor.— In the article "Primary Care: The Future of Pediatric Education"1 Dr Alpert addresses many issues facing pediatrics. I agree with his list of problems. However, I doubt that the social, economic, and cultural changes he describes will ever occur. My informal survey of pediatricians in practice is a song of frustration and boredom. The ringing telephone provides the rhythm. How does a patient-physician relationship develop in an environment of missed appointments, 3 AM emergency department visits, and managed care? Many families change physicians whenever employers change health benefits packages.

Download Full-text

The experience of the non-medical prescriber in the emergency department in Ireland

Journal of Prescribing Practice ◽

10.12968/jprp.2019.1.5.240 ◽

2019 ◽

Vol 1 (5) ◽

pp. 240-245 ◽

Cited By ~ 3

Author(s):

Roger Connor ◽

Áine McHugh

Keyword(s):

Emergency Department ◽

Professional Support ◽

Professional Relationships ◽

Role Development ◽

The Future ◽

Role Expansion

Aim: this study set out to evaluate the position of the non-medical prescriber in the emergency department in Ireland. It aims to explore how the role is developing and determine possible barriers to role expansion. Results: six main themes were identified: the process of role development, changes in professional relationships, nurses' awareness of non-medical prescribing, role progression, the future of the role of the non-medical prescriber, and nursing management's understanding of the role. Conclusion: the findings suggest that despite major leaps in the progression of the non-medical prescriber role, many barriers remain. There have been great improvements in professional support from medical and pharmacy colleagues, but nurses themselves were identified as impeding the progression of the role.

Download Full-text

Cerebral oximetry and stroke distance: the future of emergency department monitoring?

Emergency Medicine Journal ◽

10.1136/emj.13.5.313 ◽

1996 ◽

Vol 13 (5) ◽

pp. 313-315 ◽

Cited By ~ 2

Author(s):

I Sammy ◽

J Hanson ◽

M R James

Keyword(s):

Emergency Department ◽

Cerebral Oximetry ◽

The Future ◽

Stroke Distance

Download Full-text

Bedside emergency department ultrasonography availability and use for blunt abdominal trauma in Canadian pediatric centres

CJEM ◽

10.2310/8000.2011.110475 ◽

2012 ◽

Vol 14 (01) ◽

pp. 14-19 ◽

Cited By ~ 3

Author(s):

Robin Cardamore ◽

Joe Nemeth ◽

Christine Meyers

Keyword(s):

Emergency Department ◽

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Positive Impact ◽

Pediatric Trauma ◽

Great Majority ◽

Pediatric Emergency ◽

Perceived Barriers ◽

Emergency Physicians ◽

The Future

ABSTRACT Objectives: To quantify the current availability and use of bedside emergency department ultrasonography (EDUS) for blunt trauma at Canadian pediatric centres and to identify any perceived barriers to the use of bedside EDUS in such centres. Methods: An electronic survey was sent to 162 pediatric emergency physicians and 12 site directors from the 12 pediatric emergency departments across Canada. Results: Ninety-two percent (11 of 12) of centres completed the survey. The individual physician response rate was 65% (106 of 162), with 100% of site directors responding. Ultrasound machines were available in 45% (5 of 11) of centres. Forty-two percent (32 of 77) of emergency physicians working in equipped pediatric centres used bedside EDUS to evaluate blunt abdominal trauma (BAT). In the subgroup of staff who also worked at adults sites, the frequency of ultrasonography use for the evaluation of pediatric BAT was 75%. In the 55% (6 of 11) of centres without ultrasonography, 88% of staff intend to incorporate its use in the future and 81% indicated that they believed the incorporation of ultrasonography would have a positive impact on patient care. The main perceived barriers to the use of ultrasonography in the evaluation of BAT were a lack of training (41%) and a lack of equipment (26%). Conclusion: Bedside EDUS is currently used in almost half of pediatric trauma centres, a frequency that is significantly lower than adult centres. Physicians in pediatric centres who use ultrasonography report that it has a high utility, and a great majority of physicians at pediatric centres without EDUS plan to incorporate it in the future. The main reported barriers to its use are a lack of training and a lack of equipment availability.

Download Full-text