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ANNALS OF EMERGENCY MEDICINE 2003年第4期41卷 457-462页

作者： Cone, DC Weir, SD Bogucki, S Yale Univ Sch Med Sect Emergency Med Div Emergency Med Serv New Haven CT USA

[ Ann Emerg Med. 2003;41:457-462.]

关键词：临床工作能力/标准临床方案决策组织救灾计划/组织和管理效率组织急救医疗服务/组织和管理急救医学/经济学急救医学/组织和管理机构间关系职务说明大众媒体需求估价纽约市俄克拉何马医师的作用救援作业/组织和管理安全措施/组织和管理恐怖主义/预防和控制志愿工作者/教育志愿工作者/组织和管理人类

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Work interrupted: A comparison of workplace interruptions in emergency departments and primary care offices

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ANNALS OF EMERGENCY MEDICINE 2001年第2期38卷 146-151页

作者： Chisholm, CD Dornfeld, AM Nelson, DR Cordell, WH Methodist Hosp Indiana Emergency Med & Trauma Ctr Clarian Hlth Partners Indianapolis IN 46202 USA Indiana Univ Sch Med Dept Emergency Med Indianapolis IN USA Methodist Hosp Indiana Dept Med Res Clarian Hlth Partners Indianapolis IN 46202 USA

Study objective: We sought to determine the number of interruptions and to characterize tasks performed in emergency departments compared with those performed in primary care off ices. Methods: We conducted an observational time-motion, task-analysis study in 5 nonteaching community hospitals and 22 primary care offices in 5 central Indiana cities. Twenty-two emergency physicians and 22 office-based primary care physicians (PCPs) were observed at work. The number of interruptions, tasks, simultaneous tasks, and patients concurrently managed were recorded in 1-minute increments during 150- to 210-minute observation periods. Results: Emergency physicians were interrupted an average of 9.7 times per hour compared with 3.9 times per hour for PUS, for an average difference of 5.8 times per hour (95% confidence interval [Cl] 4.2 to 7.4). PCPs spent an average of 11.4 minutes per hour performing simultaneous tasks compared with 6.4 minutes per hour for emergency physicians (average difference, 5.0 minutes;95% Cl 12 to 8.8). Emergency physicians spent an average of 37.5 minutes per hour managing 3 or more patients concurrently compared with 0.9 minutes per hour for PCPs. PCPs spent significantly more time performing direct patient care, and emergency physicians spent significantly more time in analyzing data, charting, and taking reports on patients. Conclusion: Emergency physicians experienced more interruptions and managed more patients concurrently than PCPs. PCPs spent more time performing simultaneous tasks than emergency physicians. Our study suggests there are important ergonomic differences between emergency medicine and off ice-based primary care work environments that may require different training approaches, design considerations, and coping strategies.

关键词：卡方分布效率组织急救医学/组织和管理急诊室医院/组织和管理医师/统计学和数值数据初级卫生保健/组织和管理统计学非参数时间和运动研究工作负荷量工作场所/统计学和数值数据成年人女(雌)性人类男(雄)性

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Frequent emergency department use in Sweden: Implications fur emergency medicine in the United States

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ANNALS OF EMERGENCY MEDICINE 2001年第6期37卷 627-629页

作者： Williams, RM Department of Health Management and Policy University of Michigan School of Public Health Ann Arbor MI United States School of Public Health University of Michigan 1420 Washington Heights Ann Arbor MI 48109-2029 United States

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Clinical policy: Critical issues in the evaluation and management of patients presenting with syncope

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ANNALS OF EMERGENCY MEDICINE 2001年第6期37卷 771-776页

作者： [Anonymous]

[American College of Emergency Physicians. Clinical policy: critical issues in the evaluation and management of patients presenting with syncope. Ann Emerg Med. June 2001;37:771-776.]

关键词：急救医学/组织和管理急诊处理/方法急诊处理/标准循证医学组织方针病人入院病人遴选体格检查/方法体格检查/标准危险因素晕厥/诊断晕厥/病因学晕厥/治疗人类

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Improving outcome after traumatic brain injury - progress and challenges

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BRITISH MEDICAL BULLETIN 1999年第4期55卷 910-926页

作者： Gentleman, D Royal Victoria Hosp Ctr brain Injury Rehabil Dundee DD2 1SP Scotland Ninewells Hosp Dundee DD1 9SY Scotland

This article describes the rapid advances in the head injury field which have taken place within the professional lifetime of many doctors in practice today. These have led to a better understanding of what happens in the injured brain and how these events might be manipulated to achieve better outcomes. Clinical tools we now take for granted, like the CT scanner and the Glasgow Coma Scale, were new developments 25 years ago. They provided a foundation on which clinicians and basic scientists could build what we now know: what to assess in the patient, how to respond to certain findings, what imaging to do, how to plan treatment rationally, how to minimise brain damage at different stages after injury, how to predict and measure outcome, what disabled survivors need, and how to organise the service to do the greatest good for the most people. Some of these topics raise as many questions as answers. The head injury field may be broad but it has essential unity. At one extreme, some patients have a life-threatening illness where the acts and omissions of the clinical team can powerfully influence not only survival but its quality. Later the drama of the acute phase gives way to the 'hidden disabilities' of the longterm deficits which so many survivors have. At the other end of the severity spectrum is the relatively vast number of people who suffer an apparently mild head injury, a few of whom deteriorate and need urgent treatment, and many of whom have unspectacular but, nevertheless, disabling problems. The article attempts to address this broad canvas. Clinicians, neuroscientists, policy makers, and service users must work together to address the major scientific, individual, and population challenges posed by head injury. Much has already been achieved, but much remains to be done, especially in translating 'what we know' into 'what we do'.

关键词：脑损伤/分类脑损伤/诊断脑损伤/治疗急救医学/组织和管理循证医学病人转诊研究复苏术体层摄影术 X线计算机治疗结果人类

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The role of the emergency physician in emergency medical services for children

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ANNALS OF EMERGENCY MEDICINE 2003年第2期42卷 206-215页

作者： Gausche-Hill, M Johnson, RW Warden, CR Brennan, JA Univ Calif Los Angeles Geffen Sch Med Dept Emergency Med Torrance CA 90509 USA Univ Calif Los Angeles Little Co Mary Hosp Ctr Med Torrance CA USA Childrens Hosp Mission Mission Med Hosp Reg Med Mission Viejo CA USA Oregon Hlth & Sci Univ Doernbecher Mem Hosp Children Pediat Emergency Serv Portland OR 97201 USA Univ Med & Dent New Jersey Dept Emergency Med New Brunswick NJ USA St Barnabas Hlth Care New Brunswick NJ USA

Emergency physicians have a duty to advance the care of pediatric patients in the emergency medical services (EMS) system. This policy resource and education paper, designed to support the American College of Emergency Physicians policy paper "The Role of the Emergency Physician in Emergency Medical Services for Children," describes the development of the federal EMS for Children Program, the importance of the integration of EMS for children into EMS systems, and the role of the emergency physician in EMS for children.

关键词：儿童保健服务/组织和管理儿童福利临床方案病人医护连续性/组织和管理数据库事实型急救医疗服务/组织和管理急救医学/教育急救医学/组织和管理卫生政策美国国立医学研究所医疗差错/预防和控制模型组织管理儿科学/教育儿科学/组织和管理医师的作用学会医学全面质量管理/组织和管理美国美国卫生和人类服务部儿童人类

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Emergency medicine in southern Brazil

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ANNALS OF EMERGENCY MEDICINE 2001年第2期37卷 223-228页

作者： Tannebaum, RD Arnold, JL De Negri, A Spadoni, VS Provena St Joseph Med Ctr Sect Emergency Med Joliet IL 60435 USA Univ Illinois Coll Med Dept Emergency Med Chicago IL USA Cedars Sinai Med Ctr Dept Emergency Med Los Angeles CA 90048 USA Univ Fed Rio Grande Sul Porto Alegre RS Brazil

Emergency medicine is developing rapidly in southern Brazil, where elements of both the France-German and the Anglo-American models of emergency care are in place, creating a uniquely Brazilian approach to emergency care. Although emergency medical services (EMS) in Brazil have been directly influenced by the French mobile EMS (SAMU) system, with physicians dispatched by ambulances to the scenes of medical emergencies, the first American-style emergency medicine residency training program in Brazil was recently established at the Hospital de Pronto Socorro (HPS) in Porto Alegre. Emergency trauma care appears to be particularly developed in southern Brazil, where advanced trauma life support is widely taught and SAMU delivers sophisticated trauma care en route to trauma centers designated by the state.

关键词：巴西卫生保健提供/组织和管理急救医疗服务/组织和管理急救医学/教育急救医学/组织和管理预测实习医师和住院医师职务/组织和管理生命支持疗法/组织和管理模型教育模型组织管理技术转让人类

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Convergence behavior in disasters

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ANNALS OF EMERGENCY MEDICINE 2003年第4期41卷 463-466页

作者： de Heide, EA US DHHS Agcy Tox Subst & Dis Registry Div Hlth Educ & Promot Atlanta GA USA

[ Ann Emerg Med. 2003;41:463-466.]

关键词：救灾计划/组织和管理急救医疗服务/组织和管理急救医学/教育急救医学/组织和管理地理信息系统机构间关系大众媒体需求估价救援作业/组织和管理恐怖主义/预防和控制志愿工作者/组织和管理志愿工作者/心理学人类

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Osteopathic physicians in emergency medicine

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ANNALS OF EMERGENCY MEDICINE 2003年第2期42卷 261-265页

作者： Pollard, JA Leveque, EA Lewin, MR Calif State Univ Fresno Dept Emergency Med Fresno CA 93702 USA Oklahoma State Univ Coll Osteopath Med Tulsa OK USA Calif State Univ Fresno Emergency Med Residency Program Fresno CA 93740 USA

[ Ann Emerg Med. 2003;42:261-265.]

关键词：聘任鉴定/组织和管理教育医学研究生/组织和管理急救医学/教育急救医学/组织和管理实习医师和住院医师职务/组织和管理骨病医学/教育骨病医学/组织和管理医师的作用院校医学/组织和管理学会医学/组织和管理美国人类

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The emergency medicine workforce study: More questions than answers

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ANNALS OF EMERGENCY MEDICINE 2002年第1期40卷 16-18页

作者： Augustine, JJ Kellermann, AL Emory Univ Sch Med Dept Emergency Med Atlanta GA 30322 USA

[Augustine JJ, Kellermann AL. The emergency medicine workforce study: more questions than answers. Ann Emerg Med . July 2002;40:16-18.]

关键词：文化多样性急救医学/组织和管理急救医学/发展趋势急诊室医院卫生政策实习医师和住院医师职务/统计学和数值数据职业满意医务人员医院/组织和管理医务人员医院/供应和分配诊疗工作管理医学/组织和管理美国工作负荷量/统计学和数值数据女(雌)性人类男(雄)性

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