Situations or conditions requiring immediate intervention to avoid serious adverse results.

Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient.

The branch of medicine concerned with the evaluation and initial treatment of urgent and emergent medical problems, such as those caused by accidents, trauma, sudden illness, poisoning, or disasters. Emergency medical care can be provided at the hospital or at sites outside the medical facility.

Services specifically designed, staffed, and equipped for the emergency care of patients.

First aid or other immediate intervention for accidents or medical conditions requiring immediate care and treatment before definitive medical and surgical management can be procured.

The specialty or practice of nursing in the care of patients admitted to the emergency department.

Organized services to provide immediate psychiatric care to patients with acute psychological disturbances.

Paramedical personnel trained to provide basic emergency care and life support under the supervision of physicians and/or nurses. These services may be carried out at the site of the emergency, in the ambulance, or in a health care institution.

The use of communication systems, such as telecommunication, to transmit emergency information to appropriate providers of health services.

The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment.

Contraceptive substances to be used after COITUS. These agents include high doses of estrogenic drugs; progesterone-receptor blockers; ANTIMETABOLITES; ALKALOIDS, and PROSTAGLANDINS.

Means of postcoital intervention to avoid pregnancy, such as the administration of POSTCOITAL CONTRACEPTIVES to prevent FERTILIZATION of an egg or implantation of a fertilized egg (OVUM IMPLANTATION).

A vehicle equipped for transporting patients in need of emergency care.

Procedures outlined for the care of casualties and the maintenance of services in disasters.

Damage inflicted on the body as the direct or indirect result of an external force, with or without disruption of structural continuity.

The process of accepting patients. The concept includes patients accepted for medical and nursing care in a hospital or other health care institution.

A way of providing emergency medical care that is guided by a thoughtful integration of the best available scientific knowledge with clinical expertise in EMERGENCY MEDICINE. This approach allows the practitioner to critically assess research data, clinical guidelines, and other information resources in order to correctly identify the clinical problem, apply the most high-quality intervention, and re-evaluate the outcome for future improvement.

Personnel trained to provide the initial services, care, and support in EMERGENCIES or DISASTERS.

Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.

Conveying ill or injured individuals from one place to another.

Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.

Preventive emergency measures and programs designed to protect the individual or community in times of hostile attack.

Fixed-wing aircraft or helicopters equipped for air transport of patients.

Hospitals located in metropolitan areas.

Professional medical personnel approved to provide care to patients in a hospital.

Pressure, burning, or numbness in the chest.

The confinement of a patient in a hospital.

Postcoital contraceptives which owe their effectiveness to hormonal preparations.

Disease having a short and relatively severe course.

Elements of limited time intervals, contributing to particular results or situations.

An excessive number of individuals, human or animal, in relation to available space.

Excessive, under or unnecessary utilization of health services by patients or physicians.

The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide.

The artificial substitution of heart and lung action as indicated for HEART ARREST resulting from electric shock, DROWNING, respiratory arrest, or other causes. The two major components of cardiopulmonary resuscitation are artificial ventilation (RESPIRATION, ARTIFICIAL) and closed-chest CARDIAC MASSAGE.

Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.

Cessation of heart beat or MYOCARDIAL CONTRACTION. If it is treated within a few minutes, heart arrest can be reversed in most cases to normal cardiac rhythm and effective circulation.

Medical care provided after the regular practice schedule of the physicians. Usually it is designed to deliver 24-hour-a-day and 365-day-a-year patient care coverage for emergencies, triage, pediatric care, or hospice care.

An organized procedure carried out through committees to review admissions, duration of stay, professional services furnished, and to evaluate the medical necessity of those services and promote their most efficient use.

Emergency care or treatment given to a person who suddenly becomes ill or injured before full medical services become available.

Interfacility or intrahospital transfer of patients. Intrahospital transfer is usually to obtain a specific kind of care and interfacility transfer is usually for economic reasons as well as for the type of care provided.

A detailed review and evaluation of selected clinical records by qualified professional personnel for evaluating quality of medical care.

Calamities producing great damage, loss of life, and distress. They include results of natural phenomena and man-made phenomena. Normal conditions of existence are disrupted and the level of impact exceeds the capacity of the hazard-affected community.

The period of confinement of a patient to a hospital or other health facility.

Temporary shelter provided in response to a major disaster or emergency.

A province of Canada lying between the provinces of Manitoba and Quebec. Its capital is Toronto. It takes its name from Lake Ontario which is said to represent the Iroquois oniatariio, beautiful lake. (From Webster's New Geographical Dictionary, 1988, p892 & Room, Brewer's Dictionary of Names, 1992, p391)

The capability to perform acceptably those duties directly related to patient care.

The restoration to life or consciousness of one apparently dead. (Dorland, 27th ed)

Laboratory and other services provided to patients at the bedside. These include diagnostic and laboratory testing using automated information entry.

Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.

Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.

A bracelet or necklace worn by an individual that alerts emergency personnel of medical information for that individual which could affect their condition or treatment.

Specialized hospital facilities which provide diagnostic and therapeutic services for trauma patients.

The degree to which individuals are inhibited or facilitated in their ability to gain entry to and to receive care and services from the health care system. Factors influencing this ability include geographic, architectural, transportational, and financial considerations, among others.

A procedure involving placement of a tube into the trachea through the mouth or nose in order to provide a patient with oxygen and anesthesia.

The administrative process of discharging the patient, alive or dead, from hospitals or other health facilities.

Incorrect diagnoses after clinical examination or technical diagnostic procedures.

A medical specialty concerned with maintaining health and providing medical care to children from birth to adolescence.

Systems for assessing, classifying, and coding injuries. These systems are used in medical records, surveillance systems, and state and national registries to aid in the collection and reporting of trauma.

Assistance, such as money, food, or shelter, given to the needy, aged, or victims of disaster. It is usually granted on a temporary basis. (From The American Heritage Dictionary, 2d college ed)

Traumatic injuries involving the cranium and intracranial structures (i.e., BRAIN; CRANIAL NERVES; MENINGES; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage.

Hospitals maintained by a university for the teaching of medical students, postgraduate training programs, and clinical research.

Special hospitals which provide care for ill children.

Health care workers specially trained and licensed to assist and support the work of health professionals. Often used synonymously with paramedical personnel, the term generally refers to all health care workers who perform tasks which must otherwise be performed by a physician or other health professional.

The interactions between representatives of institutional departments.

Hospitals engaged in educational and research programs, as well as providing medical care to the patients.

A clinical syndrome with acute abdominal pain that is severe, localized, and rapid in onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases.

Tomography using x-ray transmission and a computer algorithm to reconstruct the image.

Hospitals located in a rural area.

Large hospitals with a resident medical staff which provides continuous care to maternity, surgical and medical patients.

An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.

Directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.

Postcoital contraceptives which owe their effectiveness to synthetic preparations.

Accidents on streets, roads, and highways involving drivers, passengers, pedestrians, or vehicles. Traffic accidents refer to AUTOMOBILES (passenger cars, buses, and trucks), BICYCLING, and MOTORCYCLES but not OFF-ROAD MOTOR VEHICLES; RAILROADS nor snowmobiles.

The use or threatened use of force or violence against persons or property in violation of criminal laws for purposes of intimidation, coercion, or ransom, in support of political or social objectives.

A form of bronchial disorder with three distinct components: airway hyper-responsiveness (RESPIRATORY HYPERSENSITIVITY), airway INFLAMMATION, and intermittent AIRWAY OBSTRUCTION. It is characterized by spasmodic contraction of airway smooth muscle, WHEEZING, and dyspnea (DYSPNEA, PAROXYSMAL).

An infant during the first month after birth.

Injuries caused by impact with a blunt object where there is no penetration of the skin.

Any materials used in providing care specifically in the hospital.

Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient.

The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)

A condition or physical state produced by the ingestion, injection, inhalation of or exposure to a deleterious agent.

Accidental or deliberate use of a medication or street drug in excess of normal dosage.

A vital statistic measuring or recording the rate of death from any cause in hospitalized populations.

Cardiac electrical stimulators that apply brief high-voltage electroshocks to the HEART. These stimulators are used to restore normal rhythm and contractile function in hearts of patients who are experiencing VENTRICULAR FIBRILLATION or ventricular tachycardia (TACHYCARDIA, VENTRICULAR) that is not accompanied by a palpable PULSE. Some defibrillators may also be used to correct certain noncritical dysrhythmias (called synchronized defibrillation or CARDIOVERSION), using relatively low-level discharges synchronized to the patient's ECG waveform. (UMDNS, 2003)

Events that overwhelm the resources of local HOSPITALS and health care providers. They are likely to impose a sustained demand for HEALTH SERVICES rather than the short, intense peak customary with smaller scale disasters.

The use of biological agents in TERRORISM. This includes the malevolent use of BACTERIA; VIRUSES; or other BIOLOGICAL TOXINS against people, ANIMALS; or PLANTS.

Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.

The observation and analysis of movements in a task with an emphasis on the amount of time required to perform the task.

Conformity in fulfilling or following official, recognized, or institutional requirements, guidelines, recommendations, protocols, pathways, or other standards.

Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.

Health care provided to a critically ill patient during a medical emergency or crisis.

Major administrative divisions of the hospital.

Government-controlled hospitals which represent the major health facility for a designated geographic area.

The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.

Health care services provided to patients on an ambulatory basis, rather than by admission to a hospital or other health care facility. The services may be a part of a hospital, augmenting its inpatient services, or may be provided at a free-standing facility.

Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.

Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure).

Evaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically.

The largest country in North America, comprising 10 provinces and three territories. Its capital is Ottawa.

The medical specialty which deals with WOUNDS and INJURIES as well as resulting disability and disorders from physical traumas.

The seeking and acceptance by patients of health service.

The integration of epidemiologic, sociological, economic, and other analytic sciences in the study of health services. Health services research is usually concerned with relationships between need, demand, supply, use, and outcome of health services. The aim of the research is evaluation, particularly in terms of structure, process, output, and outcome. (From Last, Dictionary of Epidemiology, 2d ed)

Sensation of discomfort, distress, or agony in the abdominal region.

The capacity of an organization, institution, or business to produce desired results with a minimum expenditure of energy, time, money, personnel, materiel, etc.

Precise and detailed plans for the study of a medical or biomedical problem and/or plans for a regimen of therapy.

Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.

Subsequent admissions of a patient to a hospital or other health care institution for treatment.

Ongoing scrutiny of a population (general population, study population, target population, etc.), generally using methods distinguished by their practicability, uniformity, and frequently their rapidity, rather than by complete accuracy.

Health services required by a population or community as well as the health services that the population or community is able and willing to pay for.

Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.

Multiple physical insults or injuries occurring simultaneously.

Hospital department which administers all departmental functions and the provision of surgical diagnostic and therapeutic services.

NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).

Individuals licensed to practice medicine.

Inanimate objects that become enclosed in the body.

Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.

Bleeding in any segment of the GASTROINTESTINAL TRACT from ESOPHAGUS to RECTUM.

Operations carried out for the correction of deformities and defects, repair of injuries, and diagnosis and cure of certain diseases. (Taber, 18th ed.)

Diagnostic, therapeutic, and investigative procedures prescribed and performed by health professionals, the results of which do not justify the benefits or hazards and costs to the patient.

Institutions with permanent facilities and organized medical staff which provide the full range of hospital services primarily to a neighborhood area.

Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed)

The frequency of different ages or age groups in a given population. The distribution may refer to either how many or what proportion of the group. The population is usually patients with a specific disease but the concept is not restricted to humans and is not restricted to medicine.

A synthetic progestational hormone with actions similar to those of PROGESTERONE and about twice as potent as its racemic or (+-)-isomer (NORGESTREL). It is used for contraception, control of menstrual disorders, and treatment of endometriosis.

Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data.

The inhabitants of a city or town, including metropolitan areas and suburban areas.

Torn, ragged, mangled wounds.

Falls due to slipping or tripping which may result in injury.

Evaluation, planning, and use of a range of procedures and airway devices for the maintenance or restoration of a patient's ventilation.

General or unspecified injuries to the chest area.

Medical complexes consisting of medical school, hospitals, clinics, libraries, administrative facilities, etc.

Surgery which could be postponed or not done at all without danger to the patient. Elective surgery includes procedures to correct non-life-threatening medical problems as well as to alleviate conditions causing psychological stress or other potential risk to patients, e.g., cosmetic or contraceptive surgery.

Medical procedure involving the emptying of contents in the stomach through the use of a tube inserted through the nose or mouth. It is performed to remove poisons or relieve pressure due to intestinal blockages or during surgery.

General or unspecified injuries involving organs in the abdominal cavity.

On the job training programs for personnel carried out within an institution or agency. It includes orientation programs.

The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases, new or old, in the population at a given time.

Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.

A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.

Acute inflammation of the APPENDIX. Acute appendicitis is classified as simple, gangrenous, or perforated.

Unforeseen occurrences, especially injuries in the course of work-related activities.

Coordination of activities and programs among health care institutions within defined geographic areas for the purpose of improving delivery and quality of medical care to the patients. These programs are mandated under U.S. Public Law 89-239.

In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.

Recording of pertinent information concerning patient's illness or illnesses.

Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL).

The total amount of work to be performed by an individual, a department, or other group of workers in a period of time.

The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.

Brief therapeutic approach which is ameliorative rather than curative of acute psychiatric emergencies. Used in contexts such as emergency rooms of psychiatric or general hospitals, or in the home or place of crisis occurrence, this treatment approach focuses on interpersonal and intrapsychic factors and environmental modification. (APA Thesaurus of Psychological Index Terms, 7th ed)

Any impairment, arrest, or reversal of the normal flow of INTESTINAL CONTENTS toward the ANAL CANAL.

Health services, public or private, in urban areas. The services include the promotion of health and the delivery of health care.

A measure of inpatient health facility use based upon the average number or proportion of beds occupied for a given period of time.

A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.

Regulations to assure protection of property and equipment.

Wounds caused by objects penetrating the skin.

The use of sophisticated methods and equipment to treat cardiopulmonary arrest. Advanced Cardiac Life Support (ACLS) includes the use of specialized equipment to maintain the airway, early defibrillation and pharmacological therapy.

Penetrating wounds caused by a pointed object.

Health services, public or private, in rural areas. The services include the promotion of health and the delivery of health care.

Programs of training in medicine and medical specialties offered by hospitals for graduates of medicine to meet the requirements established by accrediting authorities.

Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.

A range of values for a variable of interest, e.g., a rate, constructed so that this range has a specified probability of including the true value of the variable.

Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work.

Individual or group aggressive behavior which is socially non-acceptable, turbulent, and often destructive. It is precipitated by frustrations, hostility, prejudices, etc.

A system of medical care regulated, controlled and financed by the government, in which the government assumes responsibility for the health needs of the population.

Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY.

Management of public health organizations or agencies.

Schedules of medical and nursing procedures, including diagnostic tests, medications, and consultations designed to effect an efficient, coordinated program of treatment. (From Mosby's Medical, Nursing & Allied Health Dictionary, 4th ed)

Organized services to provide health care to expectant and nursing mothers.

Medical problems associated with OBSTETRIC LABOR, such as BREECH PRESENTATION; PREMATURE OBSTETRIC LABOR; HEMORRHAGE; or others. These complications can affect the well-being of the mother, the FETUS, or both.

Individuals referred to for expert or professional advice or services.

The systematic application of information and computer sciences to public health practice, research, and learning.

A direct communication system, usually telephone, established for instant contact. It is designed to provide special information and assistance through trained personnel and is used for counseling, referrals, and emergencies such as poisonings and threatened suicides.

Occurrence of heart arrest in an individual when there is no immediate access to medical personnel or equipment.

Damage or trauma inflicted to the eye by external means. The concept includes both surface injuries and intraocular injuries.

A province of western Canada, lying between the provinces of British Columbia and Saskatchewan. Its capital is Edmonton. It was named in honor of Princess Louise Caroline Alberta, the fourth daughter of Queen Victoria. (From Webster's New Geographical Dictionary, 1988, p26 & Room, Brewer's Dictionary of Names, 1992, p12)

Injuries of tissue other than bone. The concept is usually general and does not customarily refer to internal organs or viscera. It is meaningful with reference to regions or organs where soft tissue (muscle, fat, skin) should be differentiated from bones or bone tissue, as "soft tissue injuries of the hand".

Sudden increase in the incidence of a disease. The concept includes EPIDEMICS and PANDEMICS.

Institutional night care of patients.

Opening or penetration through the wall of the INTESTINES.

The number of males and females in a given population. The distribution may refer to how many men or women or what proportion of either in the group. The population is usually patients with a specific disease but the concept is not restricted to humans and is not restricted to medicine.

Tear or break of an organ, vessel or other soft part of the body, occurring in the absence of external force.

The expenses incurred by a hospital in providing care. The hospital costs attributed to a particular patient care episode include the direct costs plus an appropriate proportion of the overhead for administration, personnel, building maintenance, equipment, etc. Hospital costs are one of the factors which determine HOSPITAL CHARGES (the price the hospital sets for its services).

Death resulting from the presence of a disease in an individual, as shown by a single case report or a limited number of patients. This should be differentiated from DEATH, the physiological cessation of life and from MORTALITY, an epidemiological or statistical concept.

Services for the diagnosis and treatment of disease and the maintenance of health.

A state in southeastern Australia, the southernmost state. Its capital is Melbourne. It was discovered in 1770 by Captain Cook and first settled by immigrants from Tasmania. In 1851 it was separated from New South Wales as a separate colony. Self-government was introduced in 1851; it became a state in 1901. It was named for Queen Victoria in 1851. (From Webster's New Geographical Dictionary, 1988, p1295 & Room, Brewer's Dictionary of Names, p574)

Pregnancy, usually accidental, that is not desired by the parent or parents.

Educational programs for medical graduates entering a specialty. They include formal specialty training as well as academic work in the clinical and basic medical sciences, and may lead to board certification or an advanced medical degree.

Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.

Activities devoted to freeing persons or animals from danger to life or well-being in accidents, fires, bombings, floods, earthquakes, other disasters and life-threatening conditions. While usually performed by team efforts, rescue work is not restricted to organized services.

Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps.

Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192)