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Emergency Medicine Australasia: EMA

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https://www.readbyqxmd.com/read/28627014/review-article-paediatric-status-epilepticus-in-the-pre-hospital-setting-an-update
#1
REVIEW
Jeremy Furyk, Kerriane Watt, Theophilus I Emeto, Stuart Dalziel, Daniel Bodnar, Kate Riney, Franz E Babl
Paediatric status epilepticus (SE) is a medical emergency and a common critical condition confronting pre-hospital providers. Management in the pre-hospital environment is challenging but considered extremely important as a potentially modifiable factor on outcome. Recent data from multicentre clinical trials, quality observational studies and consensus documents have influenced management in this area, and is important to both pre-hospital providers and emergency physicians. The objective of this review was to: (i) present an overview of the available evidence relevant to pre-hospital care of paediatric SE; and (ii) assess the current pre-hospital practice guidelines in Australia and New Zealand...
June 18, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28620921/consistency-of-total-body-surface-area-assessment-in-severe-burns-implications-for-practice
#2
Stephen Face, Sarah Dalton
BACKGROUND: Paediatric burn injury is common and often serious. Injuries occur across New South Wales (NSW), with specialised treatment provided in a centralised burns unit. Early management prior to transfer is essential but variation is seen. OBJECTIVES: To determine if differences exist between referring hospital estimates of the total body surface area (TBSA) of burns, and estimates for the same burns by the Burns Unit. To consider if differences in estimations influence initial and ongoing management, and decisions regarding transfer/retrieval...
June 15, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28616868/selection-into-emergency-medicine-specialist-training-a-commentary-on-the-science-of-selection
#3
Simon Chu, Anna Kaider, Lyn Johnson
No abstract text is available yet for this article.
June 14, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28616867/pelvic-trauma-mortality-reduced-by-integrated-trauma-care
#4
Mark Fitzgerald, Max Esser, Matthias Russ, Joseph Mathew, Dinesh Varma, Andrew Wilkinson, Rejith V Mannambeth, Devilliers Smit, Stephen Bernard, Biswadev Mitra
OBJECTIVES: A multidisciplinary approach that emphasised improved triage, early pelvic binder application, early administration of blood and blood products, adherence to algorithmic pathways, screening with focused sonography (FAST), early computed tomography scanning with contrast angiography, angio-embolisation and early operative intervention by specialist pelvic surgeons was implemented in the last decade to improve outcomes after pelvic trauma. The manuscript evaluated the effect of this multi-faceted change over a 12-year period...
June 14, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28609812/selection-into-emergency-medicine-fellowship-training-is-it-a-fair-game
#5
Jessica Forbes, Lisa Brichko
No abstract text is available yet for this article.
June 13, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28608486/point-of-care-ultrasound-averts-catastrophic-iatrogenic-haemorrhage-the-case-of-vascular-aneurysms-masquerading-as-thigh-abscess
#6
Darren Brockie, Grace Balinda, Joseph Niyonzima, Amelia Pousson, Mindi Guptill
No abstract text is available yet for this article.
June 13, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28608370/selection-into-emergency-medicine-specialist-training-the-art-of-selection
#7
Jamie Thomas
No abstract text is available yet for this article.
June 13, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28597966/diurnal-variation-in-outcomes-after-out-of-hospital-cardiac-arrest-in-asian-communities-the-pan-asian-resuscitation-outcomes-study
#8
Yun Jeong Kim, Hyun Wook Ryoo, Sang Do Shin, Kyoung Jun Song, Young Sun Ro, Kyung Won Lee, Matthew Huei-Ming Ma, Patrick Chow-In Ko, Han Nee Gan, Nur Shahidah
OBJECTIVE: The present study aimed to determine whether the time of out-of-hospital cardiac arrest (OHCA) is associated with survival rate and neurological outcome after OHCA, as well as to compare the effect size of time of OHCA across six Asian regions. METHODS: We collected data from the Pan-Asian Resuscitation Outcomes Study registry, six Asian regions (Tokyo, Osaka, Aichi, Seoul, Taipei and Singapore) from 2009 to 2012. Adult OHCA cases were divided depending on the arrest time: I (00...
June 9, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28597505/renal-effects-of-an-emergency-department-chloride-restrictive-intravenous-fluid-strategy-in-patients-admitted-to-hospital-for-more-than-48-hours
#9
Nor'azim Mohd Yunos, Rinaldo Bellomo, David McD Taylor, Simon Judkins, Fergus Kerr, Harvey Sutcliffe, Colin Hegarty, Michael Bailey
OBJECTIVE: Patients commonly receive i.v. fluids in the ED. It is still unclear whether the choice of i.v. fluids in this setting influences renal or patient outcomes. We aimed to assess the effects of restricting i.v. chloride administration in the ED on the incidence of acute kidney injury (AKI). METHODS: We conducted a before-and-after trial with 5008 consecutive ED-treated hospital admissions in the control period and 5146 consecutive admissions in the intervention period...
June 8, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28589691/medical-scribes-have-no-impact-on-the-patient-experience-of-an-emergency-department
#10
William Dunlop, Lachlan Hegarty, Margaret Staples, Michele Levinson, Michael Ben-Meir, Katherine Walker
OBJECTIVE: We aimed to evaluate patient perceptions of medical scribes in the ED and to test for scribe impacts on ED Net Promoter Scores, Press Ganey Surveys and other patient-centred topics. METHODS: Exploratory semi-structured interviews were conducted in the ED during wait times after scribed consultations. Interview results were used to derive topics relating to scribes. Items addressing these topics from validated surveys were combined with items from widely used patient satisfaction questionnaires...
June 6, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28582801/emergency-airway-management-in-australian-and-new-zealand-emergency-departments-a-multicentre-descriptive-study-of-3710-emergency-intubations
#11
Hatem Alkhouri, John Vassiliadis, Matthew Murray, John Mackenzie, Alex Tzannes, Sally McCarthy, Toby Fogg
OBJECTIVE: The aim of this study was to describe the practice of endotracheal intubation across a range of Australasian EDs. METHODS: We established a multicentre airway registry (The Australian and New Zealand Emergency Department Airway Registry [ANZEDAR]) prospectively capturing intubations from 43 Australian and New Zealand EDs over 24 months using the ANZEDAR form. Information recorded included patient demographics, intubation indications, predicted difficulty, rapid sequence induction and endotracheal intubation preparation technique, induction drugs, airway adjuncts and complications...
June 5, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28574204/rational-clinical-evaluation-of-suspected-acute-coronary-syndromes-the-value-of-more-information
#12
David G Hancock, Ming-Yu Anthony Chuang, Rebecca Bystrom, Amera Halabi, Rachel Jones, Matthew Horsfall, Louise Cullen, William A Parsonage, Derek P Chew
OBJECTIVE: Many meta-analyses have provided synthesised likelihood ratio data to aid clinical decision-making. However, much less has been published on how to safely combine clinical information in practice. We aimed to explore the benefits and risks of pooling clinical information during the ED assessment of suspected acute coronary syndrome. METHODS: Clinical information on 1776 patients was collected within a randomised trial conducted across five South Australian EDs between July 2011 and March 2013...
June 2, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28571117/do-all-adult-orthopaedic-injuries-seen-in-emergency-departments-need-to-attend-fracture-clinic-a-queensland-multicentred-review
#13
Aidan Cleary, Robert Zeller, Chris Maguire, Shyan Goh, Nick Shortt
OBJECTIVE: Musculoskeletal injuries account for a significant proportion of ED presentations annually, with a large percentage being referred to the fracture clinic (FC). A literature review found that many referrals could be safely managed outside the traditional model of care. The present study aims to review all adult presentations to FCs at two Queensland metropolitan hospitals, finding low-risk injuries that can safely and appropriately be managed by their general practitioner (GP) or allied health professionals (AHPs), potentially affording significant savings to the health system...
June 1, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28571105/visualising-emergency-department-capacity-in-an-emergency-department-capacity-clock-a-novel-tool-to-assess-and-communicate-overcrowding-and-access-block
#14
Ohad Dar, Jacques Loubser
Hospital-wide engagement is required to alleviate the problem of ED crowding and its associated adverse effects. To this end, the article describes a novel visualisation termed 'the ED Capacity Clock', which can be formatted using business intelligence software. This radial diagram represents ED capacity and its consumption in a format that can be understood intuitively and at a glance. The ED Capacity Clock is designed to promote common understanding and discussion between relevant hospital services and also acts as an auditing tool to monitor processes implemented to alleviate ED crowding...
June 1, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28571104/a-review-of-the-burns-caseload-of-a-physician-based-helicopter-emergency-medical-service
#15
Karina Hall, Brian Burns
OBJECTIVES: The aim of this study was to describe patient demographics, injuries, physiology and interventions performed by retrieval physicians in the care of burns patients in both a pre-hospital and interhospital setting. METHODS: A retrospective review of patient records from a large Australian Helicopter Emergency Medical Service was conducted. Demographics, injury, burn type, physiology and intervention data were extracted into a database for statistical analysis...
June 1, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28571103/epidemiology-and-outcomes-of-missing-admission-medication-history-in-severe-trauma-a-retrospective-study
#16
Matthew Miller, Richard Morris, Nicoletta Fisicaro, Kate Curtis
OBJECTIVE: Anticoagulant and antiplatelet (ACAP) drugs are associated with increased mortality in trauma patients, therefore medication history on admission is important. Whether these medications are recorded on trauma admission has not been investigated, nor if absence of a medication history is associated with worse patient outcomes. METHODS: We conducted a retrospective database review combining demographic and outcome data from the St George Hospital (Sydney) trauma registry with admission medication history in the electronic record...
June 1, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28569051/the-chances-that-an-emergency-physician-will-demonstrate-three-abdominal-aortic-aneurysms-by-ultrasound-in-the-emergency-department-for-credentialing-a-statistician-s-view
#17
Kevin H Chu, Anita Pelecanos, Nathan J Brown, Anthony Ft Brown
The Australasian College for Emergency Medicine requires 15 proctored examinations of the aorta for credentialing in ultrasonography for abdominal aortic aneurysm (AAA). Furthermore, at least three examinations need to be positive for an aneurysm. In the ED where AAA presentations are sporadic, what are the chances that an emergency physician (EP) will have the opportunity to demonstrate three AAAs in the next 12 months? The probability of an event occurring within a given time-frame can be modelled by the Poisson distribution...
May 31, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28568968/effect-of-known-history-of-heart-disease-on-survival-outcomes-after-out-of-hospital-cardiac-arrests
#18
Magdalene Hm Lee, Stephanie Fook-Chong, Win Wah, Sang Do Shin, Tatsuya Nishiuchi, Patrick Chow-In Ko, Ghulam Yasin Naroo, Kwanhathai Darin Wong, Ling Tiah, Apichaya Monsomboon, Fahad J Siddiqui, Marcus Eh Ong
OBJECTIVE: We aimed to investigate the effect of known heart disease on post-out-of-hospital cardiac arrest (OHCA) survival outcomes, and its association with factors influencing survival. METHODS: This was an observational, retrospective study involving an OHCA database from seven Asian countries in 2009-2012. Heart disease was defined as a documented diagnosis of coronary artery disease or congenital heart disease. Patients with non-traumatic arrests for whom resuscitation was attempted and with known medical histories were included...
May 31, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28568241/team-structure-skill-mix-and-clinical-outcomes
#19
Eamon Merrick, Margaret Fry, Janie Busby Grant
The majority of presentations to Australian EDs are for semi-urgent and non-urgent complaints in the older adult. For these patient's treatment and care is typically delivered by loosely organised teams of professionals. While substantial research has examined the clearly defined, hierarchical team structures used during resuscitation events, little is known about the composition and functioning of teams involved in non-urgent patient care in ED. Investigation of these team dynamics can identify personal and professional factors involved in the delivery of this care and enable the design of teams that enhance patient outcomes...
May 31, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28544642/evaluation-of-a-targeted-prescriber-education-intervention-on-emergency-department-discharge-oxycodone-prescribing
#20
Síne R Donaldson, Andrew M Harding, Simone E Taylor, Hassan Vally, Shaun L Greene
OBJECTIVES: The objective of this study was to evaluate the impact of an educational intervention on ED discharge opioid analgesic (OA) prescribing. METHODS: A brief, one-on-one, educational intervention was delivered to ED OA prescribers by an ED clinical champion. The percentage of patients receiving (i) written advice regarding appropriate oxycodone use, (ii) written or verbal advice regarding appropriate post-discharge follow up and (iii) written general practitioner notification that oxycodone had been prescribed were determined pre- and post-intervention, through review of electronic patient records and structured patient telephone interviews conducted 3-7 days after ED attendance...
May 24, 2017: Emergency Medicine Australasia: EMA
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