24-hour coverage.
Explore the source record for details and available documents.
Emergency Service, Hospital↗
Biomedical subjects
R S Hockberger
Publications and source records attributed to R S Hockberger.
Attending coverage in academic emergency medicine: a national survey.
We surveyed the 66 accredited emergency medicine residency programs in the United States during 1986 on the issue of attending coverage. Responses were received from 411 residents and 288 faculty; this accounted for 42% of the residents and 56% of the faculty from the 56 responding programs. Seventy-three percent of emergency medicine residency programs had 24-hour attending coverage. According to residents, faculty from programs with 24-hour coverage spent a greater percentage of their shift doing primary patient care than faculty from programs without 24-hour coverage (35% vs 17%, respectively, P less than .0001), and a smaller percentage of their shift educating residents (21% vs 30%, respectively, P less than .0001). Ninety-five percent of faculty and 71% of residents thought that the quality of patient care was better when faculty were present in the ED (P less than .0001). Sixty-one percent of residents and 60% of faculty did not think that 24-hour attending coverage in academic emergency medicine should be mandated. The impact of night-time attending coverage in emergency medicine residency programs on patient care, resident education, and faculty development is unclear and minimally studied.
Emergency Medicine↗
Ectopic pregnancy.
Ectopic pregnancy is a potentially lethal disorder that is often difficult to diagnose clinically. More than 70,000 ectopic pregnancies are reported annually in the United States, and the incidence is rising. A thorough knowledge of predisposing factors, clinical presentation, common misdiagnoses, and recent advances in diagnostic modalities should help the Emergency Department physician avoid the pitfalls that lead to misdiagnosis with resulting morbidity and, occasionally, mortality.
Diagnosis, Differential↗
Assessment of suicide potential by nonpsychiatrists using the SAD PERSONS score.
We were unable to validate the predictive ability of a previously described mneumonic (SAD PERSONS score, SPS) for determining the need for hospitalization of patients who have expressed suicidal ideation or behavior. After reviewing published studies on the subject, we arrived at a modification of this scale (MSPS). The MSPS obtained by nonpsychiatric and psychiatric house staff was compared and correlated with patient disposition for 100 consecutive adult patients presenting to the Harbor-UCLA Medical Center emergency department for the assessment of suicidal behavior. We were unable to correlate the MSPS with patient disposition. However, four criteria were found to correlate with the need for hospitalization (P less than .001). After weighting the MSPS, giving two points for each of these four criteria, and one point for each of the other six, we found that a score of greater than or equal to 6 had a sensitivity of 94% and a specificity of 71% in identifying need for hospitalization. A score of less than or equal to 5 had a negative predictive value for hospitalization of 95%. When two nonsuicidal patients, admitted for situational reasons only, were eliminated, a score of greater than or equal to 6 had a 100% sensitivity and a score of less than or equal to 5 had a 100% negative predictive value in identifying patients requiring hospitalization. Subsequent use of the weighted MSPS for an additional 82 patients confirmed these results. Follow-up of 97.5% (116/119) of all patients discharged from the emergency department at 6 to 12 months found no mortalities. Using a weighted MSPS, nonpsychiatrists can quickly and easily obtain the objective information necessary to make an initial assessment of suicidality.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗