OBJECTIVES: To discuss the demands and countermeasures for outpatients and emergency patients during the outbreak of coronavirus disease 2019 (COVID-19) in large general hospital. METHODS: By analyzing patients' demands, outpatient service system and emergency system complemented each other with the help of "internet medical" to provide online medical treatment, self-diagnosed pneumonia program, online pharmacies, outpatient appointment and online pre-examination services, open green channels for special patients, and to provide referral services for critical patients. The COVID-19 suspected patients and other common fever patients were separated from other patients. RESULTS: From January 28 to March 1, we have received 26 000 patients online, 1 856 special patients, 2 929 suspected patients and common fever patients including 31 confirmed patients, 0 case of misdiagnosis and cross-infection. CONCLUSIONS Targeting patient's demands and taking appropriate measures are effective on meeting the needs of outpatients' and emergency patients' medical services.
Betacoronavirus ; Coronavirus Infections ; epidemiology ; prevention & control ; Cross Infection ; prevention & control ; Emergency Medical Services ; organization & administration ; Health Services Needs and Demand ; Hospitals, General ; organization & administration ; Humans ; Outpatients ; Pandemics ; prevention & control ; Pneumonia, Viral ; epidemiology ; prevention & control

INTRODUCTIONA significant percentage of paediatric emergency department (ED) attendances worldwide are nonurgent, adversely affecting patient outcomes and healthcare systems. This study aimed to understand the reasons behind nonurgent ED visits, in order to develop targeted and effective preventive interventions.

METHODSIn-depth interviews were conducted with 49 caregivers to identify the decision-making factors related to taking children to the ED of KK Women's and Children's Hospital, Singapore. Interviews were carried out in the emergency room of the hospital after the children had been diagnosed with nonurgent conditions by the attending physician. Interview transcripts were analysed based on grounded theory principles.

RESULTSThe demographics of our study cohort were representative of the target population. The main reasons given by the caregivers for attending paediatric EDs included perceived severity of the child's symptoms, availability of after-hours care, perceived advantage of a paediatric specialist hospital and mistrust of primary care physicians' ability to manage paediatric conditions. Insurance or welfare was a contributing factor for only a small portion of caregivers.

CONCLUSIONThe reasons provided by Singaporean caregivers for attending paediatric EDs were similar to those reported in studies conducted in Western countries. However, the former group had a unique understanding of the local healthcare system. The study's findings may be used to develop interventions to change the knowledge, attitudes and behaviours of caregivers in Singapore.

Adolescent ; Caregivers ; Child ; Child, Preschool ; Cohort Studies ; Craniocerebral Trauma ; therapy ; Decision Making ; Emergencies ; Emergency Medical Services ; Emergency Service, Hospital ; organization & administration ; Epistaxis ; therapy ; Fathers ; Female ; Hospitals, Pediatric ; Humans ; Infant ; Infant, Newborn ; Male ; Mothers ; Patient Acceptance of Health Care ; Pediatrics ; organization & administration ; Respiratory Tract Infections ; therapy ; Singapore

PURPOSE: Empathy in medical practice is related to medical communication and clinical competence. In previous studies, low quality of life and other factors play an integral role in low empathy among physicians. We evaluated the relationships between empathy, quality of life, and other factors among Korean emergency physicians. METHODS: The survey was conducted using email to emergency physicians. The respondents completed a questionnaire including demographic information, the Jefferson Scale of Empathy, and the Brief version of the World Health Organization Quality of Life assessment instrument. Correlation analyses were performed, along with sub-analyses according to gender. RESULTS: A total of 180 questionnaires were analyzed. The median value of the empathy scale was 89.0, and quality of life 64.8. Empathy was positively correlated with quality of life, age, and work experience as a specialist in total samples and males. Only work experience as a specialist showed correlation with empathy in females. Quality of life showed no association with age, work experience, and work load. However, quality of life showed negative correlation with age and work experience in female physicians. CONCLUSION: The more experienced specialist emergency physicians are, and the better quality of life they have, the higher level of empathy scale they have. Therefore, good quality of life could lead to good empathy, and vice versa. Good quality of life and good empathy could lead to the better outcome in emergency care. However, because the female physicians show different patterns of empathy and quality of life, further study is needed.
Clinical Competence ; Electronic Mail ; Emergencies* ; Emergency Medical Services ; Empathy* ; Female ; Humans ; Male ; Quality of Life* ; Specialization ; Surveys and Questionnaires ; World Health Organization

Tianjin Medical University General Hospital treated 233 wounded in 8.12 Tinjin Port explosion. Here we would like to analyze the treatment process for the wounded, and share the experiences of orga- nization and management for emergency rescue operation.
Blast Injuries ; therapy ; China ; Emergency Medical Services ; organization & administration ; Explosions ; Hospitals, University ; organization & administration ; Humans ; Mass Casualty Incidents ; Triage

OBJECTIVETo study the weak loop in the treatment of children with out-of-hospital cardiac arrest (OHCA) and the treatment strategy for improvement.

METHODData of a total of 133 patients with OHCA who were rescued by Wuxi pre-hospital care center during the 2005 - 2011 were analyzed.

RESULTThe main causes of pediatric OHCA were drowning (52/133) and accidental injury disease (30/133). The cases of OHCA were mainly located in public places (60/133) and the majority occurred in winter and summer. The emergency rescue response time was (13.21 ± 8.09) min, the rate of first witness treatment was 3.91%, intubations was performed in 11.11%, opening of vein access was 23.15% and one case got restoration of spontaneous circulation (ROSC).

CONCLUSIONThe rate of ROSC of pre-hospital cardiac arrest in children was significantly lower than that of hospital cardiac arrest. Preventive interventions on children's accidents and the skills of pre-hospital staff on pediatric advanced life support (PALS) need to be urgently improved.

Advanced Cardiac Life Support ; education ; Cardiopulmonary Resuscitation ; methods ; Chi-Square Distribution ; Child ; Child, Preschool ; China ; epidemiology ; Emergency Medical Services ; methods ; organization & administration ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Out-of-Hospital Cardiac Arrest ; epidemiology ; etiology ; therapy ; Pediatrics ; education ; Retrospective Studies ; Risk Factors ; Survival Rate ; Time Factors ; Treatment Outcome

PURPOSE: Pediatric facial laceration takes a huge part of patients visiting emergency room and generates social attention for its proper emergency care. So much more attention should be paid to the proper treatment at emergency care unit, and furthermore, thorough survey of background information of the pediatric facial laceration may offer more proper prevention. METHODS: According to annual reports of 2009 and 2010, out of 5149 facial laceration patients who were given primary medical care at our clinic, 1452 patients were aged under 15 years old. Retrospective analysis of each pediatric facial lacerations were evaluated according to gender, age, periodic table, cause of injury, place of injury, sites of injury and so on. RESULTS: Pediatric facial laceration was found to occur mostly at 1 year old as they learn to walk and explore their environment. Evaluated analysis revealed that pediatric facial accidents occurred mostly on forehead region (75%), on Sundays, from 5 p.m. to 8 p.m., at home(61.5%). Most common cause of injury was collision(54.5%). CONCLUSION: In large group of pediatric facial laceration cases provided us with an surprising fact that accidents most commonly occur under parental supervision. This fact gives an actual understanding regarding pediatric facial laceration and more realistic approach in its prevention strategy.
Aged ; Emergencies ; Emergency Medical Services ; Facial Injuries ; Forehead ; Humans ; Hypogonadism ; Lacerations ; Mitochondrial Diseases ; Ophthalmoplegia ; Organization and Administration ; Parents ; Pediatrics ; Retrospective Studies

Accidents, Occupational ; prevention & control ; Emergency Medical Services ; organization & administration ; Humans ; Occupational Exposure ; prevention & control ; Occupational Health ; Poisoning ; prevention & control ; Risk Assessment

Disaster Planning ; organization & administration ; Emergencies ; Emergency Medical Services ; organization & administration ; Humans ; Public Health ; methods

Adult ; Chemical Hazard Release ; prevention & control ; China ; Emergency Medical Services ; organization & administration ; statistics & numerical data ; Female ; Health Personnel ; Humans ; Male ; Middle Aged ; Poisoning ; prevention & control ; Surveys and Questionnaires

Adult ; China ; Emergency Medical Services ; organization & administration ; Female ; Health Knowledge, Attitudes, Practice ; Health Personnel ; Humans ; Male ; Middle Aged ; Poisoning ; prevention & control ; therapy ; Professional Competence ; Sampling Studies ; Surveys and Questionnaires