Quality in emergency departments: a study on 3,285,440 admissions.

INTRODUCTION: A multi-centre study has been conducted, during 2005, by means of a questionnaire posted on the Italian Society of Emergency Medicine (SIMEU) web page. Our intention was to carry out an organisational and functional analysis of Italian Emergency Departments (ED) in order to pick out some macro-indicators of the activities performed. Participation was good, in that 69 ED (3,285,440 admissions to emergency services) responded to the questionnaire. METHODS: The study was based on 18 questions: 3 regarding the personnel of the ED, 2 regarding organisational and functional aspects, 5 on the activity of the ED, 7 on triage and 1 on the assessment of the quality perceived by the users of the ED. RESULTS AND CONCLUSION: The replies revealed that 91.30% of the ED were equipped with data-processing software, which, in 96.83% of cases, tracked the entire itinerary of the patient. About 48,000 patients/year used the ED: 76.72% were discharged and 18.31% were hospitalised. Observation Units were active in 81.16% of the ED examined. Triage programmes were in place in 92.75% of ED: in 75.81% of these, triage was performed throughout the entire itinerary of the patient; in 16.13% it was performed only symptom-based, and in 8.06% only on-call. Of the patients arriving at the ED, 24.19% were assigned a non-urgent triage code, 60.01% a urgent code, 14.30% a emergent code and 1.49% a life-threatening code. Waiting times were: 52.39 min for non-urgent patients, 40.26 min for urgent, 12.08 for emergent, and 1.19 for life-threatening patients.

[Factors that can affect the breeding and maintenance of infected snails and the production of Schistosoma mansoni cercariae]. / Fatores que podem afetar a criação e manutenção de caramujos infectados e a produção de cercárias de Schistosoma mansoni.

Mass production of Schistosoma mansoni cercariae was affected by biological and chemical agents. Rotifers and ostracods, snail predators, were identified in our colony. Rotifers were easily eradicated by washing the aquaria and lettuce with diluted solution of acetic acid. On the other hand, ostracods were difficult to eradicate and led to a high level mortality of infected snails (50-60%). Snails maintained in an incubator at constant temperature and total darkness produced maximum shedding when submitted to brightness and high temperature (about 30 degrees C). The number of cercariae shed was practically the same between pH 5-7. Contaminants such as Cu and Pb added to glass distilled water decreased the cercariae production. In conclusion, laboratory maintenance of large number of infected snails for mass production of cercariae is much simpler and more efficient than the conventional technique with running tap water although a high rate of mortality is observed in the snail colony.