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Emergency Medicine Australasia: EMA

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https://www.readbyqxmd.com/read/28201852/the-probability-of-probability-and-research-truths
#1
Daniel M Fatovich, Michael Phillips
The foundation of much medical research rests on the statistical significance of the P-value, but we have fallen prey to the seductive certainty of significance. Other scientific disciplines work to a different standard. This may partly explain why medical reversal is an increasing phenomenon, whereby new studies (based on the 0.05 standard) overturn previous significant findings. This has generated a crisis in the rigour of evidence-based medicine, as many people erroneously believe that a P < 0.05 means the treatment effect is clinically important...
February 15, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28125855/predictors-and-outcomes-of-acute-pancreatitis-in-critically-ill-patients-presenting-to-the-emergency-department-of-a-tertiary-referral-centre-in-australia
#2
Krishnaswamy Sundararajan, Tom Schoeman, Lara Hughes, Suzanne Edwards, Benjamin Reddi
OBJECTIVE: To provide a current review of the clinical characteristics, predictors and outcomes in critically ill patients presenting to the ED with acute pancreatitis and subsequently admitted to an intensive care unit (ICU) of a tertiary referral centre in Australia. METHODS: A retrospective single-centre study of adult patients admitted with pancreatitis. Severe acute pancreatitis defined by Bedside Index of Severity in Acute Pancreatitis (BISAP) score ≥2. RESULTS: Eighty-seven patients fulfilled criteria for inclusion during the study period, representing 0...
January 26, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28122419/factors-influencing-choice-of-pre-hospital-transportation-of-patients-with-potential-acute-coronary-syndrome-an-observational-study
#3
Tim Lavery, Jaimi H Greenslade, William A Parsonage, Tracey Hawkins, Emily Dalton, Christopher Hammett, Louise Cullen
OBJECTIVE: To determine factors associated with ambulance use in patients with confirmed and potential acute coronary syndrome presenting to the ED. METHODS: A convenience sample of patients (n = 247) presenting to the ED from April 2014 to January 2015 with suspected acute coronary syndrome were included in the study. Data on mode of transport and patient demographics were collected from the Emergency Department Information System database. Clinical data were collected from chart records and information systems...
January 25, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28118693/case-control-study-to-investigate-variables-associated-with-incidents-and-adverse-events-in-the-emergency-department
#4
Jamie Hendrie, Michael Yeoh, Jo Richardson, Andrew Blunt, Peter Davey, David Taylor, Antony Ugoni
OBJECTIVE: To detect and analyse incidents (Is) and adverse events (AEs) in the ED. We hypothesised that I/AE are associated with patient load. METHODS: We undertook a case-control study in a tertiary level hospital ED (from 1 April 2012 to 31 March 2013). Three percent of patients were randomly selected and screened for I/AEs. I/AEs were adjudicated by consensus of four FACEMs. Controls were matched to cases 2:1. Logistic regression was used to analyse the data...
January 24, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28118692/intercollegiate-conversations-australian-and-new-zealand-college-of-anaesthetists
#5
Victor Lee, Ian S Graham
In the first of a series of online interviews with other Australian and New Zealand Specialty Colleges about the developments and shared challenges with implementing competency-based medical education, I spoke with the current Dean of Education at the Australian and New Zealand College of Anaesthetists, Dr Ian Graham. Dr Graham is not an anaesthetist. He is a Fellow of the Royal Australasian College of Medical Administrators, educator and consultant in health management. He was appointed into the role of part-time Dean of Education at the Australian and New Zealand College of Anaesthetists in August 2014...
January 24, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28111931/transfer-of-care-and-overstay-in-the-management-of-cellulitis-in-the-emergency-short-stay-unit-a-retrospective-cohort-study
#6
Jeremy W Abetz, Nicholas G Adams, Harvey Newnham, De Villiers Smit, Biswadev Mitra
OBJECTIVE: This study aimed to quantify the rate of transfer of care or overstay from cellulitis management in the emergency short stay unit (ESSU) and to identify risk factors during initial assessment associated with transfer of care or overstay. METHODS: A retrospective cohort study was conducted including cellulitis patients diagnosed with and admitted to the ESSU at a metropolitan adult tertiary referral centre. Data abstracted included patient demographics, comorbidities, initial investigations and initial vital signs...
January 22, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28097829/barriers-to-conducting-research-a-survey-of-trainees-in-emergency-medicine
#7
Alexander Olaussen, Paul A Jennings, Gerard O'Reilly, Biswadev Mitra, Peter A Cameron
OBJECTIVE: Research underpins evidence-based practice, but there are significant barriers to conducting research relevant to each clinical discipline. Understanding these barriers could allow strategies to reduce their impact. The present study was undertaken to understand specific barriers to research for emergency medicine (EM) trainees. METHODS: EM trainees attending research short courses were surveyed. Free-text responses were classified into themes and a list of pre-specified potential barriers was used for ranking purposes...
January 17, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28093870/acute-management-of-autoimmune-toxicity-in-cancer-patients-on-immunotherapy-common-toxicities-and-the-approach-for-the-emergency-physician
#8
Anna J Lomax, Catriona McNeil
When a patient receiving anti-cancer treatment presents acutely unwell, an understanding of associated side effects of their therapy is critical. This review will discuss the approach to patients receiving anti-cancer treatment with immunotherapy presenting with autoimmune toxicities in the emergency setting. These toxicities are commonly referred to as immune-related adverse events (irAE). IrAE might consist of, but are not limited to, dermatologic, gastrointestinal (diarrhoea, colitis), hepatic, endocrine (thyroid dysfunction, hypophysitis, adrenal crisis), renal, ocular and pulmonary toxicity...
January 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28093867/paramedic-resuscitation-competency-a-survey-of-australian-and-new-zealand-emergency-medical-services
#9
Kylie Dyson, Janet E Bray, Karen Smith, Stephen Bernard, Lahn Straney, Judith Finn
OBJECTIVE: We have previously established that paramedic exposure to out-of-hospital cardiac arrest (OHCA) is relatively rare, therefore clinical exposure cannot be relied on to maintain resuscitation competency. We aimed to identify the current practices within emergency medical services (EMS) for developing and maintaining paramedic resuscitation competency. METHODS: We developed and conducted an online cross-sectional survey of Australian and New Zealand EMS in 2015...
January 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28087894/public-cardiopulmonary-resuscitation-training-rates-and-awareness-of-hands-only-cardiopulmonary-resuscitation-a-cross-sectional-survey-of-victorians
#10
Janet E Bray, Karen Smith, Rosalind Case, Susie Cartledge, Lahn Straney, Judith Finn
OBJECTIVES: To provide contemporary Australian data on the public's training in cardiopulmonary resuscitation (CPR) and awareness of hands-only CPR. METHODS: A cross-sectional telephone survey in April 2016 of adult residents of the Australian state of Victoria was conducted. Primary outcomes were rates of CPR training and awareness of hands-only CPR. RESULTS: Of the 404 adults surveyed (mean age 55 ± 17 years, 59% female, 73% metropolitan residents), 274 (68%) had undergone CPR training...
January 13, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28087889/national-audit-of-the-quality-of-pain-relief-provided-in-emergency-departments-in-aotearoa-new-zealand-the-prized-1-study
#11
(no author information available yet)
OBJECTIVE: Pain is a common feature of ED presentations and the timely provision of adequate analgesia is important for patient care. However, there is currently no New Zealand data with respect to this indicator of care quality. The present study aimed to provide a baseline for the quality of care with respect to the provision of timely and adequate analgesia in New Zealand EDs. METHODS: The present study is a secondary analysis of data initially collected for the Shorter Stays in Emergency Department Study, using a retrospective chart review of 1685 randomly selected ED presentations (2006-2012) from 26 New Zealand public hospital EDs...
January 13, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28009102/feeling-the-heat-using-hourly-emergency-activity-tracking-to-demonstrate-a-novel-method-of-describing-activity-and-patient-flow
#12
Kendall J Bein, Saartje Berendsen Russell, David Muscatello, Dane Chalkley, Rebecca Ivers, Michael M Dinh
OBJECTIVE: The objective of the present study is to demonstrate a novel method of mapping ED activity to analyse patterns presentations, occupancy and performance trends. METHODS: This was a retrospective, descriptive analysis of de-identified and linked ED presentations across NSW, Australia, over five calendar years, 2010-2014. It was undertaken as part of the Demand for Emergency Services Trend in Years 2010-2014 (DESTINY) study. The DESTINY project analysed 10...
December 23, 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28004506/impact-of-an-education-session-on-clinical-handover-between-medical-shifts-in-an-emergency-department-a-pilot-study
#13
Caroline Blyth, Nerolie Bost, Sue Shiels
OBJECTIVE: To evaluate the impact of a medical education session on the implementation of a new change of shift medical clinical handover format in an urban hospital ED. METHODS: This pilot study used a pre- and post-intervention design. The intervention consisted of a 1 h education session to teach a new handover format, SBARM (Situation, Background, Assessment, Recommendation, Medication). Data were collected through observations of doctors performing clinical handover and individual interviews with participants...
December 22, 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28004493/economic-evaluation-of-nasogastric-versus-intravenous-hydration-in-infants-with-bronchiolitis
#14
Ed Oakley, Rob Carter, Bridie Murphy, Meredith Borland, Jocelyn Neutze, Jason Acworth, David Krieser, Stuart Dalziel, Andrew Davidson, Susan Donath, Kim Jachno, Mike South, Franz E Babl
OBJECTIVE: Bronchiolitis is the most common lower respiratory tract infection in infants and the leading cause of hospitalisation. We aimed to assess whether intravenous hydration (IVH) was more cost-effective than nasogastric hydration (NGH) as a planned secondary economic analysis of a randomised trial involving 759 infants (aged 2-12 months) admitted to hospital with a clinical diagnosis of bronchiolitis and requiring non-oral hydration. No Australian cost data exist to aid clinicians in decision-making around interventions in bronchiolitis...
December 22, 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28147465/sharing-research-data
#15
EDITORIAL
Geoff Hughes
No abstract text is available yet for this article.
February 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28147464/acute-appendicitis-in-adults-diagnostic-accuracy-of-emergency-doctors-in-a-university-hospital-in-hong-kong
#16
Yuk-Ki Leung, Cangel Py Chan, Colin A Graham, Timothy H Rainer
OBJECTIVE: The aim of this study was to assess the diagnostic accuracy of ED doctors with variable training levels in detecting acute appendicitis, without access to advanced imaging in admitted patients with acute abdominal pain in a university hospital of Hong Kong. METHODS: A retrospective analysis was performed on data collected from prospectively identified patients presenting to the ED with acute abdominal pain and admitted to either a surgical or emergency medical ward between December 2011 and October 2012...
February 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28147462/in-this-february-issue
#17
EDITORIAL
Geoff Hughes
No abstract text is available yet for this article.
February 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28078762/competence-in-the-use-of-supraglottic-airways-by-australian-surf-lifesavers-for-cardiac-arrest-ventilation-in-a-manikin
#18
Lachlan Holbery-Morgan, Cara Angel, Michelle Murphy, James Carew, Finn Douglas, Robert Murphy, Natalie Hood, Andrew Rechtman, Christopher Scarff, Nicholas Simpson, Andrew Stewardson, Daniel Steinfort, Sam Radford, Ned Douglas, Douglas Johnson
OBJECTIVES: Lifesavers in Australia are taught to use pocket mask (PM) rescue breathing and bag valve mask (BVM) ventilation, despite evidence that first responders might struggle with these devices. Novices have successfully used the Laryngeal Mask Airway (LMA) Supreme and iGel devices previously, but there has been no previous comparison of the ability to train lifesavers to use the supraglottic airways compared to standard techniques for cardiac arrest ventilation. METHODS: The study is a prospective educational intervention whereby 113 lifesavers were trained to use the LMA and iGel supraglottic airways...
February 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28078686/making-the-transition-to-specialist-practice-as-a-new-facem
#19
Sara MacKenzie, Michael Jr Edmonds
No abstract text is available yet for this article.
February 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28073168/how-clean-is-your-stethoscope
#20
LETTER
Brittany Scott-Rimington, Sharon Klim, Anne-Maree Kelly
No abstract text is available yet for this article.
February 2017: Emergency Medicine Australasia: EMA
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