72-569: Calderdale is a metropolitan borough of West Yorkshire , England, which had a population of 211,439. It takes its name from the River Calder , and dale , a word for valley. The name Calderdale usually refers to the borough through which the upper river flows, while the actual landform is known as the Calder Valley . Several small valleys contain tributaries of the River Calder. The main towns of
144-419: A play therapist whose job is to put children at ease to reduce the anxiety caused by visiting the emergency department, as well as provide distraction therapy for simple procedures. Many hospitals have a separate area for evaluation of psychiatric problems . These are often staffed by psychiatrists and mental health nurses and social workers . There is typically at least one room for people who are actively
216-753: A central library in Halifax, and also offer a home library service and digital library service. In 2014, construction began on a new central library and archive building in Halifax, adjacent to the Piece Hall and the Square Chapel . The new Central Library and Archive officially opened in September 2017. Calderdale has seven operational railway stations: Brighouse , Halifax , Hebden Bridge , Mythomroyd , Sowerby Bridge , Todmorden , Walsden . A new Elland railway station received planning permission in 2023 and construction
288-532: A common feature in municipal arms. The lion supporters are taken from the arms of Halifax and also for England . A lion also featured on the shield of the arms of Brighouse . The black crescents, also from the arms of Brighouse, are featured on the arms of the Brighouse family. The blue wave around each lion's collar is from the arms of Todmorden and represents the Calder again. The motto, Industria arte prundentia ,
360-481: A complaint of mental illness. In many jurisdictions (including many U.S. states), patients who appear to be mentally ill and to present a danger to themselves or others may be brought against their will to an emergency department by law enforcement officers for psychiatric examination. The emergency department conducts medical clearance rather than treats acute behavioral disorders. From the emergency department, patients with significant mental illness will be transferred to
432-718: A day, 7 days a week, 365 days a year; and Type B, the rest, which are not. Many US emergency departments are exceedingly busy. A study found that in 2009, there were an estimated 128,885,040 ED encounters in US hospitals. Approximately one-fifth of ED visits in 2010 were for patients under the age of 18 years. In 2009–2010, a total of 19.6 million emergency department visits in the United States were made by persons aged 65 and over. Most encounters (82.8 percent) resulted in treatment and release; 17.2 percent were admitted to inpatient care. The 1986 Emergency Medical Treatment and Active Labor Act
504-578: A day, although staffing levels may be varied in an attempt to reflect patient volume. Accident services were provided by workmen's compensation plans, railway companies, and municipalities in Europe and the United States by the late mid-nineteenth century, but the world's first specialized trauma care center was opened in 1911 in the United States at the University of Louisville Hospital in Louisville, Kentucky . It
576-423: A dedicated area for this process to take place and may have staff dedicated to performing nothing but a triage role. In most departments, this role is fulfilled by a triage nurse , although dependent on training levels in the country and area, other health care professionals may perform the triage sorting, including paramedics and physicians . Triage is typically conducted face-to-face when the patient presents, or
648-495: A form of triage may be conducted via radio with an ambulance crew; in this method, the paramedics will call the hospital's triage center with a short update about an incoming patient, who will then be triaged to the appropriate level of care. Most patients will be initially assessed at triage and then passed to another area of the department, or another area of the hospital, with their waiting time determined by their clinical need. However, some patients may complete their treatment at
720-400: A healthcare professional. Patients arriving at the emergency department with a myocardial infarction (heart attack) are likely to be triaged to the resuscitation area. They will receive oxygen and monitoring and have an early ECG ; aspirin will be given if not contraindicated or not already administered by the ambulance team; morphine or diamorphine will be given for pain; sub lingual (under
792-416: A key part of the operation of an emergency department is the prioritization of cases based on clinical need. This process is called triage . Triage is normally the first stage the patient passes through, and consists of a brief assessment, including a set of vital signs , and the assignment of a "chief complaint" (e.g. chest pain, abdominal pain, difficulty breathing, etc.). Most emergency departments have
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#1732837776687864-609: A large proportion of A* to C grades at GCSE level. In 2005 the Crossley Heath School was the highest ranking co-educational school in the north of England. Calderdale College is a local further education college on Francis Street, in Halifax. In December 2006 it was announced that Calderdale College, in partnership with Leeds Metropolitan University , would open a new higher education institution in January 2007 called University Centre Calderdale. In terms of television, Calderdale
936-426: A more appropriate procedure. (Information is for England; details may vary in different countries.) Cardiac arrest is a sudden (in most cases, unexpected) loss of heart function, breathing, and consciousness. This emergency usually results from an electrical disturbance in the heart that disrupts its pumping action, stopping blood flow to the rest of the body. It is different from a heart attack, where blood flow to
1008-526: A part of the heart is blocked. Cardiac arrest may occur in the ED/A&;E or a patient may be transported by ambulance to the emergency department already in this state. Treatment is basic life support , Automated External Defibrillator (AED), and advanced life support as taught in advanced life support and advanced cardiac life support courses. Cardiac arrest is not a condition that can be self-diagnosed. It requires immediate medical attention and diagnosis by
1080-405: A psychiatric unit (in many cases involuntarily). In recent years, EmPATH units have been developed to relieve pressure on hospital emergency departments and improve the treatment of psychiatric emergencies. Emergency departments are often the first point of contact with healthcare for people who self-harm . As such they are crucial in supporting them and can play a role in preventing suicide. At
1152-556: A red background across the world, which indicates the location of the emergency department, or a hospital with such facilities. Signs on emergency departments may contain additional information. In some American states, there is close regulation of the design and content of such signs. For example, California requires wording such as "Comprehensive Emergency Medical Service" and "Physician On Duty", to prevent persons in need of critical care from presenting to facilities that are not fully equipped and staffed. In some countries, including
1224-506: A rise of just 3% in A&;E visits, and this trend looks set to continue. Other influential factors identified by the report included temperature (with both hotter and colder weather pushing up A&E visits), staffing and inpatient bed numbers. A&E services in the UK are often the focus of a great deal of media and political interest, and data on A&E performance is published weekly. However, this
1296-409: A risk to themselves or others (e.g. suicidal ). Fast decisions on life-and-death cases are critical in hospital emergency departments. As a result, doctors face great pressures to overtest and overtreat. The fear of missing something often leads to extra blood tests and imaging scans for what may be harmless chest pains, run-of-the-mill head bumps, and non-threatening stomach aches, with a high cost on
1368-417: A very large number of conditions. However, if a patient presents to a free-standing clinic with a condition requiring hospital admission, he or she must be transferred to an actual hospital, as these facilities do not have the capability to provide inpatient care. The Centers for Medicare and Medicaid Services (CMS) classified emergency departments into two types: Type A, the majority, which are open 24 hours
1440-807: Is Latin for 'Industry, skill, and foresight'. The following people and military units have received the Freedom of the Borough of Calderdale. 53°43′N 1°58′W / 53.72°N 1.97°W / 53.72; -1.97 Metropolitan borough A metropolitan borough (or metropolitan district ) is a type of local government district in England. Created in 1974 by the Local Government Act 1972 , metropolitan boroughs are defined in English law as metropolitan districts within metropolitan counties . All of
1512-508: Is a key area in most departments. The most seriously ill or injured patients will be dealt with in this area, as it contains the equipment and staff required for dealing with immediately life-threatening illnesses and injuries. In such situations, the time in which the patient is treated is crucial. Typical resuscitation staffing involves at least one attending physician, and at least one and usually two nurses with trauma and Advanced Cardiac Life Support training. These personnel may be assigned to
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#17328377766871584-699: Is a medical treatment facility specializing in emergency medicine , the acute care of patients who present without prior appointment; either by their own means or by that of an ambulance . The emergency department is usually found in a hospital or other primary care center. Due to the unplanned nature of patient attendance, the department must provide initial treatment for a broad spectrum of illnesses and injuries, some of which may be life-threatening and require immediate attention. In some countries, emergency departments have become important entry points for those without other means of access to medical care. The emergency departments of most hospitals operate 24 hours
1656-596: Is a separate (surgical) specialty from emergency medicine (which is itself a medical specialty, and has certifications in the United States from the American Board of Emergency Medicine). Trauma is treated by a trauma team who have been trained using the principles taught in the internationally recognized Advanced Trauma Life Support (ATLS) course of the American College of Surgeons . Some other international training bodies have started to run similar courses based on
1728-563: Is also still in use in Hong Kong. Earlier terms such as 'casualty' or 'casualty department' were previously used officially and continue to be used informally. The same applies to 'emergency room', 'emerg', or 'ER' in North America, originating when emergency facilities were provided in a single room of the hospital by the department of surgery. Regardless of naming convention, there is a widespread usage of directional signage in white text on
1800-631: Is an act of the United States Congress , that requires emergency departments, if the associated hospital receives payments from Medicare , to provide appropriate medical examination and emergency treatment to all individuals seeking treatment for a medical condition, regardless of citizenship, legal status, or ability to pay. Like an unfunded mandate , there are no reimbursement provisions. Rates of ED visits rose between 2006 and 2011 for almost every patient characteristic and location. The total rate of ED visits increased 4.5% in that time. However,
1872-477: Is at Halifax police station. Other police stations are located in Todmorden and at Brighouse, which reopened in 2009. West Yorkshire Fire & Rescue covers Calderdale and it has five fire stations in the borough. These are located at Rastrick (Since 2015), King Cross (Halifax Fire Station), Mytholmroyd, Illingworth, and Todmorden. Calderdale Libraries provides services through 22 local library branches, including
1944-433: Is claimed to have reduced aggression against hospital staff in the departments by 50 per cent. A system of environmental signage provides location-specific information for patients. Screens provide live information about how many cases are being handled and the current status of the A&E department. Waiting times for patients to be seen at A&E were rising in the years leading up to 2020, and were hugely worsened during
2016-455: Is commonly known as the " golden hour ". Some emergency departments in smaller hospitals are located near a helipad which is used by helicopters to transport a patient to a trauma centre. This inter-hospital transfer is often done when a patient requires advanced medical care unavailable at the local facility. In such cases the emergency department can only stabilize the patient for transport. Some patients arrive at an emergency department for
2088-823: Is expected to begin in 2024 for a potential opening date of December 2025. The train operators in the borough are Northern and Grand Central . Destinations for services include Bradford Interchange , Huddersfield , Leeds , York , Manchester Victoria , Blackpool North , Wigan North Western , Chester , Warrington Bank Quay , Hull , Preston , Burnley Manchester Road and London King's Cross . Two selective schools in Calderdale jointly administer an 11+ admissions exam: The Crossley Heath School , in Savile Park and North Halifax Grammar School in Illingworth. Both schools achieve excellent GCSE and A-level results, achieving
2160-696: Is free of charge only to all who are "ordinarily resident" in Britain; residency rather than citizenship is the criterion (details on charges vary from country to country). In England departments are divided into three categories: Historically, waits for assessment in A&E were very long in some areas of the UK. In October 2002, the Department of Health introduced a four-hour target in emergency departments that required departments in England to assess and treat patients within four hours of arrival, with referral and assessment by other departments if deemed necessary. It
2232-462: Is normally elected on a first past the post basis for a four-year period which is staggered with the other councillors of that ward so that only one councillor per ward is up for election at any one time. Exceptions to this include by-elections and ward boundary changes. The largest ethnic group within Calderdale at the 2011 census was White British at 86.7%, down from 90.8% in 2001. The next largest ethnic group are Pakistanis, comprising 6.8% of
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2304-660: Is not a life-threatening situation. Urgent care services include a phone consultation through the NHS111 Clinical Assessment Service, pharmacy advice, out-of-hours GP appointments, and/or referral to an urgent treatment centre (UTC) . As part of the response, walk-in Urgent Treatment Centres (UTC) were created. People potentially needing A&E treatment are recommended to phone the NHS111 line, which will either book an arrival time for A&E, or recommend
2376-449: Is only one part of a complex urgent and emergency care system. Reducing A&E waiting times therefore requires a comprehensive, coordinated strategy across a range of related services. Many A&E departments are crowded and confusing. Many of those attending are understandably anxious, and some are mentally ill, and especially at night are under the influence of alcohol or other substances. Pearson Lloyd's redesign – 'A Better A&E' –
2448-795: Is served by BBC Yorkshire and ITV Yorkshire broadcasting from the Emley Moor transmitter. Radio stations for the area: There are three current swimming pools in Calderdale. These are located in Todmorden , Brighouse and Sowerby Bridge . Halifax is currently in the phase of getting a new swimming pool after the old pool shut in 2021. Other sports facilities include North Bridge Leisure Centre (Halifax, Currently Closed), Sowerby Bridge Swimming Pool, Brighouse Leisure Centre and Pool, Todmorden Swimming Pool, The Shay Stadium ( Halifax Towns Football Pitch) and Spring Hall (Halifax, Track and field). There are eight civil parishes in Calderdale, covering
2520-731: Is the Calderdale Royal Hospital , located on the main route to Huddersfield in Salterhebble . It has specialist departments: Calderdale's A&E department and the Calderdale Birth Centre. The hospital was built and opened in 2001 on the site of the original Halifax General Hospital . After the new hospital opened, the Royal Halifax Infirmary closed and all services were transferred, as were services from Northowram Hospital . NHS Ambulance services are provided by
2592-507: The Local Government Act 1972 . It covered the area of eight former districts and part of a ninth, which were all abolished at the same time: In 2022, Yorkshire Water built an emergency water pipeline from Calderdale to Ponden Reservoir in Haworth as Yorkshire experienced its driest period on record. The borough is divided into 17 wards and each is represented on Calderdale Metropolitan Borough Council by three councillors. Each councillor
2664-522: The United States and Canada, a smaller facility that may provide assistance in medical emergencies is known as a clinic . Larger communities often have walk-in clinics where people with medical problems that would not be considered serious enough to warrant an emergency department visit can be seen. These clinics often do not operate on a 24-hour basis. Very large clinics may operate as "free-standing emergency centres", which are open 24 hours and can manage
2736-571: The Yorkshire Ambulance Service from stations in Halifax, Brighouse and Todmorden. Overgate Hospice provides specialist palliative care for adults in Calderdale. Elland Hospital , Calderdale's only private hospital, is located by the Calderdale Way . Formerly BUPA Elland Independent Hospital, it is now owned and operated by Classic Hospitals . Calderdale is served by West Yorkshire Police ; whose Calderdale Division headquarters
2808-458: The Baptist , the patron saint of wool workers. It was shown on the former arms of Halifax . The green and blue wavy line of the shield symbolises the River Calder and Calder Valley. The white rose is for Yorkshire . The crest shows a rose bush with nine white flowers representing the nine former authorities that now comprise the Calderdale district. The bush is shown growing out of a mural crown,
2880-702: The COVID-19 pandemic that started in 2020. In response to the year-on-year increasing pressure on A&E units, followed by the unprecedented effects of the COVID-19 pandemic, the NHS in late 2020 proposed a radical change to handling of urgent and emergency care, separating "emergency" and "urgent". Emergencies are life-threatening illnesses or accidents which require immediate, intensive treatment. Services that should be accessed in an emergency include ambulance (via 999) and emergency departments . Urgent requirements are for an illness or injury that requires urgent attention but
2952-565: The ED could not safely accommodate any more patients. This controversial practice was banned in Massachusetts (except for major incidents, such as a fire in the ED), effective 1 January 2009; in response, hospitals have devoted more staff to the ED at peak times and moved some elective procedures to non-peak times. In 2009, there were 1,800 EDs in the country. In 2011, about 421 out of every 1,000 people in
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3024-704: The ED has reduced the requirement for tracheal intubation in many cases of severe exacerbations of COPD. An ED requires different equipment and different approaches than most other hospital divisions. Patients frequently arrive with unstable conditions, and so must be treated quickly. They may be unconscious, and information such as their medical history, allergies, and blood type may be unavailable. ED staff are trained to work quickly and effectively even with minimal information. ED staff must also interact efficiently with pre-hospital care providers such as EMTs , paramedics , and others who are occasionally based in an ED. The pre-hospital providers may use equipment unfamiliar to
3096-445: The EDs operating at an average of 116% of capacity (meaning there were more patients than available treatment spaces) with insufficient beds to accommodate victims of a terrorist attack the size of the 2004 Madrid train bombings . Three of the five Level I trauma centres were on "diversion", meaning ambulances with all but the most severely injured patients were being directed elsewhere because
3168-506: The QualityWatch research programme published in-depth analysis which tracked 41 million A&E attendances from 2010 to 2013. This showed that the number of patients in a department at any one time was closely linked to waiting times, and that crowding in A&E had increased as a result of a growing and ageing population, compounded by the freezing or reduction of A&E capacity. Between 2010/11 and 2012/13 crowding increased by 8%, despite
3240-563: The United Kingdom are financed and managed publicly by the National Health Service (NHS of each constituent country: England , Scotland , Wales and Northern Ireland ). The term "A&E" is widely recognised and used rather than the full name; it is used on road signs, official documentation, etc. A&E services are provided to all, without charge. Other NHS medical care, including hospital treatment following an emergency,
3312-475: The United States visited the emergency department; five times as many were discharged as were admitted. Rural areas are the highest rate of ED visits (502 per 1,000 population) and large metro counties had the lowest (319 visits per 1,000 population). By region, the Midwest had the highest rate of ED visits (460 per 1,000 population) and Western States had the lowest (321 visits per 1,000 population). In addition to
3384-600: The average physician, but ED physicians must be expert in using (and safely removing) specialized equipment, since devices such as military anti-shock trousers ("MAST") and traction splints require special procedures. Among other reasons, given that they must be able to handle specialized equipment, physicians can now specialize in emergency medicine, and EDs employ many such specialists. ED staff have much in common with ambulance and fire crews, combat medics , search and rescue teams, and disaster response teams. Often, joint training and practice drills are organized to improve
3456-670: The borough are Brighouse , Elland , Halifax , Hebden Bridge , Sowerby Bridge and Todmorden . Calderdale covers part of the South Pennines , and the Calder Valley is the southernmost of the Yorkshire Dales , though it is not part of the Yorkshire Dales National Park . The borough was formed in 1974 by the merger of nine local government districts. Halifax is the commercial, cultural and administrative centre of
3528-470: The borough. Calderdale is served by Calderdale Council , which is headquartered in Halifax, with some functions based in Todmorden. The Roman settlement of Cambodunum was probably located within Calderdale. A Roman fort has been excavated in Slack , which is in the neighbouring borough of Kirklees , but its identity is not yet certain. The metropolitan district of Calderdale was created on 1 April 1974 under
3600-429: The coordination of this complex response system. Busy EDs exchange a great deal of equipment with ambulance crews, and both must provide for replacing, returning, or reimbursing for costly items. Cardiac arrest and major trauma are relatively common in EDs, so defibrillators , automatic ventilation and CPR machines, and bleeding control dressings are used heavily. Survival in such cases is greatly enhanced by shortening
3672-430: The health care system. Emergency department became commonly used when emergency medicine was recognized as a medical specialty, and hospitals and medical centres developed departments of emergency medicine to provide services. Other common variations include 'emergency ward', 'emergency centre' or 'emergency unit'. Accident and emergency (A&E) is deprecated in the United Kingdom but still in common parlance. It
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#17328377766873744-596: The largest operator, Adeptus Health , declared bankruptcy. Patients may visit the emergency room for non-emergencies , which typically costs the patient and the managed care insurance company more, and therefore the insurance company may apply utilization management to deny coverage. In 2004, a study found that emergency room visits were the most common reason for appealing disputes over coverage after receiving service. In 2017, Anthem expanded this denial coverage more broadly, provoking public policy reactions. All accident and emergency (A&E) departments throughout
3816-616: The latter having a directly elected metropolitan mayor . The term "metropolitan borough" was first used for administrative subdivisions of the County of London between 1900 and 1965. There were 28 of these metropolitan boroughs, which were replaced by a new system of larger London boroughs in 1965, when the County of London was replaced by Greater London . The current metropolitan boroughs originated as metropolitan districts created in 1974 as subdivisions of new metropolitan counties, created to cover
3888-557: The metropolitan districts have been granted or regranted royal charters giving them borough status (and in some cases, they also have city status ). Metropolitan boroughs have been effectively unitary authority areas since the abolition of metropolitan county councils by the Local Government Act 1985 . Metropolitan boroughs pool much of their authority in joint boards and other arrangements that cover whole metropolitan counties, such as Local enterprise partnerships and Combined authorities and combined county authorities , with most of
3960-496: The mortality of myocardial infarction. Many centers are now moving to the use of PTCA as it is somewhat more effective than thrombolysis if it can be administered early. This may involve transfer to a nearby facility with facilities for angioplasty . Major trauma, the term for patients with multiple injuries, often from a motor vehicle crash or a major fall, is initially handled in the Emergency Department. However, trauma
4032-543: The normal hospital based emergency departments a trend has developed in some states (including Texas and Colorado) of emergency departments not attached to hospitals. These new emergency departments are referred to as free standing emergency departments. The rationale for these operations is the ability to operate outside of hospital policies that may lead to increased wait times and reduced patient satisfaction. These departments have attracted controversy due to consumer confusion around their prices and insurance coverage. In 2017,
4104-689: The patient's condition will also be given. Depending on underlying causes of the patient's chief complaint, he or she may be discharged home from this area or admitted to the hospital for further treatment. Patients whose condition is not immediately life-threatening will be sent to an area suitable to deal with them, and these areas might typically be termed as a prompt care or minors area. Such patients may still have been found to have significant problems, including fractures , dislocations , and lacerations requiring suturing . Children can present particular challenges in treatment. Some departments have dedicated pediatrics areas, and some departments employ
4176-586: The population (4.9% in 2001). In 2011, Christians comprised 60.6% of the borough's population. This was followed by those of no religion (30.2%) and Muslims (7.8%). The 2021 census showed further changes in the borough, with the White British population declining slightly to 82.7% and the proportion of residents of Pakistani heritage increasing to 8.5%. Younger residents showed a higher level of ethnic diversity with 74.7% of Calderdale's population aged under 16 identifying as White British compared with 93.5% of
4248-778: The population over 65. Those holding no religion had risen to 42.0% of the population, now comprising a slightly higher proportion of residents than Christians (41.5%) and the Muslim population remaining relatively stable increasing to 9.5%. The large majority of Calderdale residents were born in England - falling slightly from 90.6% to 89.7% between 2011 and 2021. Calderdale is part of the Calderdale Primary Care Trust , South West Yorkshire NHS Foundation Trust and Calderdale & Huddersfield NHS Foundation Trust . The borough has two hospitals and one hospice . The main hospital (part of Calderdale & Huddersfield NHS Foundation Trust)
4320-555: The rate of visits for patients under one year of age declined 8.3%. A survey of New York area doctors in February 2007 found that injuries and even deaths have been caused by excessive waits for hospital beds by ED patients. A 2005 patient survey found an average ED wait time from 2.3 hours in Iowa to 5.0 hours in Arizona. One inspection of Los Angeles area hospitals by Congressional staff found
4392-468: The responsibility of county councils . Many metropolitan districts were boroughs from their establishment on 1 April 1974; others gained borough status later. In 1986 the metropolitan county councils were abolished under the Local Government Act 1985 and most of their functions were devolved to the metropolitan boroughs, making them, to a large extent, unitary authorities in all but name. At
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#17328377766874464-453: The resuscitation area for the entirety of the shift or may be "on call" for resuscitation coverage (i.e. if a critical case presents via walk-in triage or ambulance, the team will be paged to the resuscitation area to deal with the case immediately). Resuscitation cases may also be attended by residents , radiographers , ambulance personnel , respiratory therapists , hospital pharmacists and students of any of these professions depending upon
4536-437: The same principles. The services that are provided in an emergency department can range from x-rays and the setting of broken bones to those of a full-scale trauma centre . A patient's chance of survival is greatly improved if the patient receives definitive treatment (i.e. surgery or reperfusion) within one hour of an accident (such as a car accident) or onset of acute illness (such as a heart attack). This critical time frame
4608-737: The same time some of the functions of the abolished metropolitan county councils were taken over by joint bodies such as passenger transport authorities , and joint fire , police and waste disposal authorities. The metropolitan districts are administered by metropolitan district councils. They are the principal local authorities in the six metropolitan counties and are responsible for running most local services, such as schools, social services, waste collection, and roads. The 36 metropolitan boroughs are: Accident and Emergency An emergency department ( ED ), also known as an accident and emergency department ( A&E ), emergency room ( ER ), emergency ward ( EW ) or casualty department ,
4680-670: The same time, according to a study conducted in England, people who self-harm often experience that they do not receive meaningful care at the emergency department. Higher ambient temperature may also increase mental illness related emergency department presentations, particularly in females. Acute exacerbations of chronic respiratory diseases, mainly asthma and chronic obstructive pulmonary disease (COPD), are assessed as emergencies and treated with oxygen therapy , bronchodilators , steroids or theophylline , have an urgent chest X-ray and arterial blood gases and are referred for intensive care if necessary. Noninvasive ventilation in
4752-627: The six largest urban areas in England outside Greater London. The new districts replaced the previous system of county boroughs , municipal boroughs , and urban and rural districts . Metropolitan districts were originally parts of a two-tier structure of local government, and shared power with metropolitan county councils. They differed from non-metropolitan districts in the division of powers between district and county councils. Metropolitan districts were local education authorities , and were also responsible for social services and libraries . In non-metropolitan counties these services were (and are)
4824-633: The skill mix needed for any given case and whether or not the hospital provides teaching services. Patients who exhibit signs of being seriously ill but are not in immediate danger of life or limb will be triaged to "acute care" or "majors", where they will be seen by a physician and receive a more thorough assessment and treatment. Examples of "majors" include chest pain, difficulty breathing, abdominal pain and neurological complaints. Advanced diagnostic testing may be conducted at this stage, including laboratory testing of blood and/or urine, ultrasonography , CT or MRI scanning. Medications appropriate to manage
4896-551: The tongue) or buccal (between cheek and upper gum) glyceryl trinitrate ( nitroglycerin ) (GTN or NTG) will be given, unless contraindicated by the presence of other drugs. An ECG that reveals ST segment elevation suggests complete blockage of one of the main coronary arteries. These patients require immediate reperfusion (re-opening) of the occluded vessel. This can be achieved in two ways: thrombolysis (clot-busting medication) or percutaneous transluminal coronary angioplasty (PTCA). Both of these are effective in reducing significantly
4968-442: The triage stage, for instance, if the condition is very minor and can be treated quickly, if only advice is required, or if the emergency department is not a suitable point of care for the patient. Conversely, patients with evidently serious conditions, such as cardiac arrest, will bypass triage altogether and move straight to the appropriate part of the department. The resuscitation area, commonly referred to as "Trauma" or "Resus",
5040-415: The western part of the borough. The eastern part of the borough, covering Brighouse, Elland, Halifax, Shelf and Sowerby Bridge, is an unparished area . The two parish councils of Hebden Royd and Todmorden take the style "town council". The borough contains numerous settlements, including: Calderdale Metropolitan Borough Council was granted a coat of arms in 1977. The Paschal lamb is the emblem of John
5112-635: Was expected that the patients would have physically left the department within the four hours. Present policy is that 95% of all patient cases do not "breach" this four-hour wait. The busiest departments in the UK outside London include University Hospital of Wales in Cardiff, The North Wales Regional Hospital in Wrexham, the Royal Infirmary of Edinburgh and Queen Alexandra Hospital in Portsmouth. In July 2014,
5184-409: Was further developed in the 1930s by surgeon Arnold Griswold, who also equipped police and fire vehicles with medical supplies and trained officers to give emergency care while en route to the hospital. Today, a typical hospital has its emergency department in its own section of the ground floor of the grounds, with its own dedicated entrance. As patients can arrive at any time and with any complaint,
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