The use and efficacy of child restraint devices — The Tennessee experience, 1982 and 1983: Decker MD, Dewey MJ, Hutcheson RH, et al JAMA 252:2571–2575 Nov 1984
✍ Scribed by James E Gruber
- Book ID
- 104313402
- Publisher
- Elsevier Science
- Year
- 1985
- Tongue
- English
- Weight
- 209 KB
- Volume
- 14
- Category
- Article
- ISSN
- 1097-6760
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✦ Synopsis
stances. The authors describe an approach they have used in managing these "difficult" patients in the emergency department at Beth Israel Hospital in Boston. Consistency is emphasized in their approach in order to facilitate setting limits for the patient and providing appropriate care. An attempt is made to have these patients develop an ongoing relationship with a primary care physician outside of the emergency department, and as much of the patient's medical care as possible is moved to this outpatient setting. A file, separate from the patient's medical records, is kept on "difficult" patients. In the file, information concerning the patient's past complaints and treatment plans is documented. Patient-specific treatment protocols are used to guide all staff in providing consistent care from one visit to the next. Clear limits on the patient's behavior are set forth and explained to the patient. In addition to these measures, the authors have found that frequent and open communication among staff regarding these patients' care is helpful. These patients are discussed at weekly rounds involving the ED nurses and social care workers. The psychological problems of the patient's techniques facilitating their care and relevant community resources available to help them are reviewed.