Abstract:
STUDY OBJECTIVE:This study measures the degree to which parents of patients, in the course of evaluation and treatment in a pediatric emergency department (ED), could report what they were waiting for. METHODS:Brief in-person interviews were conducted with parents of nonemergency patients during an ED visit. After the patient had been seen by a resident physician and evaluation and treatment were in progress, parents were asked to report what they were waiting for. The patient's physician was also asked to report what the patient was waiting for. These answers were compared and coded as complete agreement, partial agreement, or disagreement. Association between lack of agreement and patient factors (age, sex), parent factors (sex, education, age), physician factors (sex, postgraduate year), and system factors (wait time, time of day, number of patients in the department) was examined. Logistic regression was used to calculate adjusted odds ratios. RESULTS:A total of 200 paired surveys were included in the data analysis. Two thirds of parental reports completely agreed with physician reports, 11.5% partially agreed, and 21.5% completely disagreed. Multivariate analysis revealed that disagreement between resident physician and parents was associated with parental educational level and physician training level. Parents with less than a high school education were more than 9 times more likely to disagree than those with at least some college education (odds ratio 9.3; 95% confidence interval [CI] 2.4 to 35.7). As the postgraduate level of the physician decreased, disagreement was more common; disagreement for patients of postgraduate level 1 residents was 5 times more likely (95% CI 1.8 to 14.5) than that of postgraduate level 3 and higher residents. CONCLUSION:As measured by asking the question "what are you waiting for," significant communication gaps were identified between physicians and the parents of their patients in this emergency department. One in five parents could not report what they were waiting for. Factors such as lower parental education and less physician experience increase the risk of such a gap. Further work in defining the source of the ineffective communication and interventions to remediate the problem is needed.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Cramm KJ,Dowd MDdoi
10.1016/j.annemergmed.2007.09.032subject
Has Abstractpub_date
2008-04-01 00:00:00pages
361-6issue
4eissn
0196-0644issn
1097-6760pii
S0196-0644(07)01627-7journal_volume
51pub_type
杂志文章abstract:STUDY OBJECTIVE:Patients who leave before being seen by a physician represent a significant problem for many emergency departments (EDs). We sought to determine the effect of a new ED rapid entry and accelerated care at triage (REACT) process on the frequency of patients who leave before being seen. METHODS:We conduct...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2005.06.013
更新日期:2005-12-01 00:00:00
abstract::Significant evidence identifies point-of-care ultrasound (PoCUS) as an important diagnostic and therapeutic tool in resource-limited settings. Despite this evidence, local health care providers on the African continent continue to have limited access to and use of ultrasound, even in potentially high-impact fields suc...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2016.07.030
更新日期:2017-02-01 00:00:00
abstract::Epiglottitis in adults, while uncommon, is certainly not rare. Despite the increasing reports of the disorder in the literature, it continues to be misdiagnosed in emergency departments. The first step in the diagnosis of acute epiglottitis is for the emergency physician to think of it. The literature concerning the e...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(81)80463-5
更新日期:1981-01-01 00:00:00
abstract::Blacks, Hispanics/Latinos, American Indians, Pacific Islanders, Alaska Natives, and Native Hawaiians make up 33% of the US population. These same groups are underrepresented in medicine. In 2013, the physician workforce was 4.1% black, 4.4% Hispanic/Latino, 0.4% American Indian or Alaska Native, 11.7% Asian, and 48.9%...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2019.01.039
更新日期:2019-06-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether physicians blinded to the serum potassium level can predict hyperkalemia (potassium concentration of more than 5.0 mmol/L) from the ECG. DESIGN:ECGs of patients at high risk for hyperkalemia were interpreted retrospectively by two physicians blinded not only to the specific clinica...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81476-3
更新日期:1991-11-01 00:00:00
abstract::Our study was conducted to determine the appropriate dose of lidocaine using the larynx and to characterize the onset and duration of therapeutic serum levels. A mean dose of 5.67 +/- 1.2 mg/kg was topically administered to the subglottic region of seven comatose patients through a cricothyroid membrane puncture. Seri...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(82)80062-0
更新日期:1982-09-01 00:00:00
abstract::This study was undertaken to determine the clinical circumstances of femoral fractures in children. The study was a retrospective investigation of 117 consecutive patients with femoral fractures admitted to The Children's Mercy Hospital, Kansas City, Missouri, from December 1975 to September 1979. Of the 117 patients....
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(82)80492-7
更新日期:1982-04-01 00:00:00
abstract:STUDY OBJECTIVE:Previous studies suggest improved patient outcomes for providers who perform high volumes of complex medical procedures. Out-of-hospital tracheal intubation is a difficult procedure. We seek to determine the association between rescuer procedural experience and patient survival after out-of-hospital tra...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2009.12.020
更新日期:2010-06-01 00:00:00
abstract::The epidemiology of pediatric fever has changed considerably during the past 2 decades with the development of vaccines against the most common bacterial pathogens causing bacteremia and meningitis. The decreasing incidence of these 2 conditions among vaccinated children has led to an emphasis on urinary tract infecti...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/j.annemergmed.2012.10.034
更新日期:2013-05-01 00:00:00
abstract:STUDY OBJECTIVE:Video imaging of intubation as seen by the laryngoscopist has not been a part of traditional instruction methods, and its potential impact on novice intubation success rates has not been evaluated. METHODS:We prospectively tracked the success rates of novice intubators in paramedic classes who were req...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2001.111516
更新日期:2001-01-01 00:00:00
abstract::While remaining prominent in paramedic care and beneficial to some patients, out-of-hospital endotracheal intubation has not clearly improved survival or reduced morbidity from critical illness or injury when studied more broadly. Recent studies identify equivocal or unfavorable clinical effects, adverse events and er...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2006.01.016
更新日期:2006-06-01 00:00:00
abstract:STUDY OBJECTIVE:We compare the ability of 5 established risk scores to identify patients with suspected acute coronary syndromes who are suitable for discharge after a modified single-presentation high-sensitivity troponin result. METHODS:This was a prospective observational study conducted in a UK district general ho...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2015.07.006
更新日期:2015-12-01 00:00:00
abstract:STUDY OBJECTIVE:We characterize repeat pediatric emergency department visits and determine the cause for such visits as an indicator of potential need for quality improvement. We hypothesized that most repeat ED visits resulting in hospitalization do not represent medical errors. METHODS:The study was performed at a l...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2002.116595
更新日期:2002-02-01 00:00:00
abstract::We present the cases of three patients with preexisting bundle-branch block in whom wide-complex tachycardias were considered to be of supraventricular origin because QRS morphologies were essentially unchanged from those during normal sinus rhythm. The patients experienced adverse effects from medications for suprave...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(95)70245-8
更新日期:1995-07-01 00:00:00
abstract:STUDY OBJECTIVES:To determine why emergency department patients leave without being seen by a physician and whether they receive alternate medical care. DESIGN:A prospective, cross-sectional study of patients who left without being seen. Charts were reviewed for population demographics, presenting complaints, and clin...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70238-1
更新日期:1994-12-01 00:00:00
abstract::We have developed a new method of implementing a transcribed emergency record at minimum cost. Dictated emergency records are typed immediately by a transcriber located in the emergency department. This member of the medical record transcriber pool is given other non-urgent medical record material to type when there a...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(83)80297-2
更新日期:1983-09-01 00:00:00
abstract::The case of a patient who developed severe acute respiratory failure during therapy for salicylate intoxication is described. The individual with aspirin overdose is at risk for this complication because of the potential for treatment modalities to cause or worsen lung edema initiated by the effects of salicylates on ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(81)80349-6
更新日期:1981-02-01 00:00:00
abstract:STUDY OBJECTIVE:The benefit of epinephrine in cardiac arrest is controversial and has not been conclusively shown in any human clinical study. We seek to assess the effect of introducing intravenous epinephrine on the survival outcomes of out-of-hospital cardiac arrest patients in an emergency medical services (EMS) sy...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2007.03.028
更新日期:2007-12-01 00:00:00
abstract:STUDY OBJECTIVE:The prevalence of agitation among emergency department (ED) patients is increasing. Physical restraints are routinely used to prevent self-harm and to protect staff, but are associated with serious safety risks. To date, characterization of physical restraint use in the emergency setting has been limite...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2018.06.020
更新日期:2019-02-01 00:00:00
abstract:STUDY OBJECTIVE:We describe the characteristics and outcomes of enrollee-health plan disputes over insurance coverage for emergency department (ED) services at 2 large health maintenance organizations (HMOs) that apply the prudent layperson standard. METHODS:We abstracted information from a stratified random sample of...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(03)00637-1
更新日期:2004-02-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the accuracy of four methods of endotracheal tube size selection in the pediatric population. STUDY DESIGN:Prospective, blinded comparison. SETTING:The Children's Hospital of Philadelphia. PARTICIPANTS:Two hundred thirty-seven children aged 1 month to 9 years old undergoing elective surg...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81937-7
更新日期:1993-03-01 00:00:00
abstract::The Trauma Score (TS) is a physiologic measure of injury severity that correlates with patient outcome. Application of the TS has shown that it is useful for patient triage, for predicting patient outcome, and as a means of normalizing for case mix when comparing prehospital care and transport modalities. Our study ex...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(85)80917-3
更新日期:1985-11-01 00:00:00
abstract::Clinical presentations and pathogeneses of endocarditis and aspects of its diagnosis and management relevant to emergency department practice are reviewed. Guidelines for admission, laboratory evaluation, and decisions regarding the initiation of therapy in the ED are offered. Also discussed are the role of the emerge...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(05)81663-4
更新日期:1991-04-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the interrater reliability of previously defined risk criteria for cervical spine injury. METHODS:Two emergency physicians independently evaluated patients with blunt trauma to determine whether they exhibited any of four risk criteria: (1) altered neurologic function; (2) evidence of into...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(98)70306-3
更新日期:1998-02-01 00:00:00
abstract:STUDY OBJECTIVE:Throughout the coronavirus disease 2019 pandemic, many emergency departments have been using passive protective enclosures ("intubation boxes") during intubation. The effectiveness of these enclosures remains uncertain. We sought to quantify their ability to contain aerosols using industry standard test...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2020.08.033
更新日期:2021-01-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the effect of different doses of the vasopressor angiotensin II on aortic diastolic and coronary perfusion pressures in a swine model of cardiac arrest. DESIGN:Immature swine were anesthetized and hemodynamically monitored. Ventricular fibrillation was induced; CPR was begun after ten minut...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)80213-6
更新日期:1993-02-01 00:00:00
abstract::Glyburide, a second-generation sulfonylurea hypoglycemic agent, is metabolized by the P-450 hepatic enzyme system. Ciprofloxacin, a widely used quinolone antibiotic, is a recognized P-450 enzyme inhibitor. Conflicting data exist in the medical literature on the ability of quinolone antibiotics to inhibit glyburide hep...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2000.108617
更新日期:2000-08-01 00:00:00
abstract::An important responsibility of emergency departments is the management of injuries sustained in assaults. Most assaults, including many causing serious injury, are not reported and not recorded by the police. This is important because police investigation and the conviction of offenders has a substantial deterrent eff...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1067/mem.2001.114317
更新日期:2001-10-01 00:00:00
abstract::Experimental ischemia by the classic frostbite rabbit ear model clearly defined the role of thromboxane as a mediator of progressive dermal ischemia in frostbite injuries. The therapeutic groups consisted of the antiprostanoids, methylprednisolone, and aspirin combined with anti-thromboxane agents Aloe vera and methim...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(87)80758-8
更新日期:1987-09-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether a set of published triage guidelines identifies patients who can safely be refused emergency department care. DESIGN:Historical cohort study. SETTING:A public hospital ED. TYPE OF PARTICIPANTS:All patients triaged during a one-week period who were not in the most acute triage cat...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(94)70042-7
更新日期:1994-02-01 00:00:00