Addition of a general practitioner to the accident and emergency department: a cost-effective innovation in emergency care

2011 ◽  
Vol 29 (3) ◽  
pp. 192-196 ◽  
Author(s):  
Judith E Bosmans ◽  
A Joan Boeke ◽  
Marguerite E van Randwijck-Jacobze ◽  
Sietske M Grol ◽  
Mark H Kramer ◽  
...  
Keyword(s):  
Emergency Department ◽  
General Practitioner ◽  
Emergency Care ◽  
Cost Effective ◽  
Accident And Emergency ◽  
Accident And Emergency Department

Who should treat epistaxis?

1987 ◽  
Vol 101 (2) ◽  
pp. 139-142 ◽  
Author(s):  
D. G. John ◽  
A. I. Alison ◽  
D. J. A. Scott ◽  
A. R. McRae ◽  
M. J. Allen
Keyword(s):  
Emergency Department ◽  
General Practitioner ◽  
Prospective Study ◽  
Successful Treatment ◽  
Successful Management ◽  
Bleeding Point ◽  
Accident And Emergency ◽  
Accident And Emergency Department ◽  
A Prospective Study

AbstractA prospective study was undertaken of 75 patients complaining of epistaxis who presented to an Accident and Emergency Department.The patients were placed into four groups according to their presenting features, and various forms of appropriate management applied.It was found that in the group that had ceased bleeding on presentation, whether or not a bleeding point was visible, there was no benefit obtained by treatment. If the nose was still bleeding on presentation, and the bleeding point was visible, successful management could be obtained by cauterising the bleeding point. This is a treatment that could be carried out by either the General Practitioner or the Accident Department. If the nose was actively bleeding, and the bleeding point could not be seen, then even initially successful treatment by the Accident Department was usually found to be ineffective within forty-eight hours. It is suggested that this group should be referred to an ENT unit on presentation.

scholarly journals How We Do It: A DIY Smart Phone based ENT Endoscopy

2017 ◽  
Vol 25 (3) ◽  
pp. 176-179
Author(s):  
Shyam Duvvi ◽  
P Neelapala ◽  
A S Duvvi ◽  
B Nirmal Kumar
Keyword(s):  
Emergency Department ◽  
Visual Inspection ◽  
Smart Phone ◽  
Cost Effective ◽  
Easy Access ◽  
Effective Solution ◽  
Simple Method ◽  
Treatment Room ◽  
Accident And Emergency ◽  
Accident And Emergency Department

We present a simple method of preparing a smart phone based ENT endoscopy for OPD clinic and for on call ENT to provide emergency ENT care in Accident and Emergency department when required. In our experience, this method is efficient, economical and ensures mobility and flexibility of remote visual inspection and documentation. This aids in better care for patients especially where there is no easy access to traditional ENT treatment room facility. This provides a fast and cost-effective solution to simultaneously view capture and save photos and videos with a smartphone and, if required, send these pictures to oncall Consultant. This enables quicker identification, documentation and support regardless of location.

Randomized trial on the treatment of oedematous acute otitis externa using ear wicks or ribbon gauze: clinical outcome and cost

2002 ◽  
Vol 116 (6) ◽  
pp. 415-419 ◽  
Author(s):  
Franklin Pond ◽  
Dan McCarty ◽  
Stephen O’Leary
Keyword(s):  
Emergency Department ◽  
Clinical Outcome ◽  
Randomized Trial ◽  
Otitis Externa ◽  
Cost Effective ◽  
Common Condition ◽  
Labour Costs ◽  
Accident And Emergency ◽  
Cost Effective Method ◽  
Accident And Emergency Department

Acute otitis externa is a common condition that can be extremely painful. When there is considerable canal oedema, packing is necessary to facilitate the passage of medication. The experience at the Royal Victoria Eye and Ear Hospital is that ear wicks generally require removal in two to three days by medical staff and can be labour intensive as they often involve serial removals following re-insertions. Alternatively, medicated ribbon gauze is cheap and can be removed by the patient at home. Ear wick and mediated ribbon gauze were investigated by a prospective randomized trial involving 94 patients.Fewer out-patient visits were required for the ribbon gauze group (two vs. three, p<0.0001) with considerably less material and labour costs than the wick group. Similar resolution rates were achieved (70 per cent vs. 64 per cent, p = 0.58). Following development of guidelines, theproportion of otitis externa patient reviews in the accident and emergency department declined from 49 per cent to 36 per cent.Compared with the ear wick, medicated ribbon gauze is a cost-effective method of treating oedematous acute otitis externa.

scholarly journals Patient characteristics of the Accident and Emergency Department of Kenyatta National Hospital, Nairobi, Kenya: a cross-sectional, prospective analysis

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e014974 ◽  
Author(s):  
Justin Guy Myers ◽  
Katherine M Hunold ◽  
Karen Ekernas ◽  
Ali Wangara ◽  
Alice Maingi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Head Injury ◽  
Emergency Care ◽  
Burden Of Disease ◽  
Communicable Diseases ◽  
National Hospital ◽  
Resource Limited Settings ◽  
Resource Limited ◽  
Accident And Emergency ◽  
Accident And Emergency Department

BackgroundResource-limited settings are increasingly experiencing a ‘triple burden’ of disease, composed of trauma, non-communicable diseases (NCDs) and known communicable disease patterns. However, the epidemiology of acute and emergency care is not well characterised and this limits efforts to further develop emergency care capacity.ObjectiveTo define the burden of disease by describing the patient population presenting to the Accident and Emergency Department (A&E) at Kenyatta National Hospital (KNH) in Kenya.MethodsWe completed a prospective descriptive assessment of patients in KNH’s A&E obtained via systematic sampling over 3 months. Research assistants collected data directly from patients and their charts. Chief complaint and diagnosis codes were grouped for analysis. Patient demographic characteristics were described using the mean and SD for age and n and percentages for categorical variables. International Classification of Disease 10 codes were categorised by 2013 Global Burden of Disease Study methods.ResultsData were collected prospectively on 402 patients with an average age of 36 years (SD 19), and of whom, 50% were female. Patients were most likely to arrive by taxi or bus (39%), walking (28%) or ambulance (17%). Thirty-five per cent of patients were diagnosed with NCDs, 24% with injuries and 16% with communicable diseases, maternal and neonatal conditions. Overall, head injury was the single most common final diagnosis and occurred in 32 (8%) patients. The most common patient-reported mechanism for head injury was road traffic accident (39%).ConclusionThis study estimates the characteristics of the A&E population at a tertiary centre in Kenya and highlights the triple burden of disease. Our findings emphasise the need for further development of emergency care resources and training to better address patient needs in resource-limited settings, such as KNH.

scholarly journals Use and Misuse of an Accident and Emergency Department in the East End of London

1983 ◽  
Vol 76 (1) ◽  
pp. 37-40 ◽  
Author(s):  
Anthony G Davison ◽  
A C C Hildrey ◽  
M A Floyer
Keyword(s):  
Emergency Department ◽  
General Practitioner ◽  
Ambulance Service ◽  
Second Opinion ◽  
Accident And Emergency ◽  
Accident And Emergency Department ◽  
East End

A study was made of all 587 new patients attending an accident and emergency department in the East End of London during one week. Two hundred and twenty-six (39%) cases were not accidents or emergencies; of these, 67% were self-referrals who had not previously seen their general practitioner (GP) and 21% were self-referrals who had previously seen their GP. The four main reasons that these self-referred patients had for attending were that they thought their condition needed immediate attention; they were insufficiently organized to see their GP; they were not registered with a GP; or they wanted a second opinion. Twenty-eight (12%) of the cases which were not accidents or emergencies were referred by a GP. Sixty-nine (12%) of all cases were not registered with a GP. The frequency of cases who, were not accidents or emergencies was significantly higher in those not registered than in those registered (0.01 ≥ p ≥ 0.001). Nineteen (3%) patients were living rough or in hostels. Little abuse of the ambulance service was found.

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