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Emergency Medicine Australasia: EMA

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https://www.readbyqxmd.com/read/29148184/windsock-in-the-heart
#1
Anthony Wald, Andrew Cochrane, Gabriel Blecher, Nitesh Nerlekar
No abstract text is available yet for this article.
November 17, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29148174/prehospital-transfusion-of-red-cell-concentrates-in-a-paramedic-staffed-helicopter-emergency-medical-service
#2
Stefan Heschl, Emily Andrew, Anthony de Wit, Stephen Bernard, Marcus Kennedy, Karen Smith
OBJECTIVE: The optimal volume and type of intravenous fluid for the treatment of blood loss in the prehospital setting is controversial. The use of red cell concentrates (RCCs) may be associated with improved outcomes; however, the administration of blood products is limited to physicians in many jurisdictions. We sought to describe the characteristics of RCC transfusions in a paramedic-staffed helicopter emergency medical system in Victoria, Australia. METHODS: We performed a retrospective analysis of all cases where paramedics consulted the responsible physician for approval of RCC transfusion between July 2011 and December 2015 in Victoria, Australia...
November 17, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29145711/timing-of-antibiotics-in-the-management-of-community-acquired-sepsis-can-a-randomised-controlled-trial-of-prehospital-therapy-provide-answers
#3
Andrew A Udy, Karen Smith, Stephen Bernard
Significant tension surrounds the application of antibiotics in suspected infection. Guidelines stress the importance of early empirical broad-spectrum therapy, with select observational data suggesting inferior outcomes when this is delayed. In contrast, microbiological resistance is an ever increasing global problem, with many advocating for a more restricted, culture-driven approach to antibiotic prescription. Controlled trial data are urgently needed, although many clinicians would find withholding of antibiotic therapy unethical...
November 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29145708/managing-non-serious-low-back-pain-in-the-emergency-department-time-for-a-change
#4
Gustavo C Machado, Eileen Rogan, Chris G Maher
Low back pain is a common condition seen in the ED. However, its management in this setting has received relatively little attention and there have been few efforts to develop strategies to improve emergency care of low back pain. In order to ensure that care is appropriately delivered for low back pain patients in the ED, emergency physicians must understand issues of providing low-value care and consider potential solutions to the problem. In this paper, we describe the usual emergency care provided for non-serious low back pain and present possible strategies for restructuring ED practice and approaches for changing physician and patient behaviour...
November 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29145705/review-article-critical-care-airway-management-elearning-modules
#5
REVIEW
Deepak Doshi, Sally McCarthy, Elizabeth Mowatt, Angela Cahill, Bronwyn Peirce, Geoff Hawking, Ruth Osborne, Belinda Hibble, Katharine Ebbs
The Australasian College for Emergency Medicine (ACEM) has recently launched the Critical Care Airway Management eLearning modules to support emergency medicine trainees in developing their airway management skills in the ED. A team of emergency physicians and trainees worked collaboratively to develop the eLearning resources ensuring extensive stakeholder consultation. A comprehensive resource manual was written to provide learners with knowledge that underpins the modules. ACEM provided project coordination as well as administrative and technical team support to the production...
November 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29143448/prospective-observational-study-of-predicted-usage-of-intravenous-cannulas-inserted-in-a-tertiary-paediatric-emergency-department
#6
William Hollaway, Carsten Broeze, Meredith L Borland
OBJECTIVES: To determine the proportion of unused peripheral intravenous cannulas (PIVCs) inserted in a paediatric emergency department (PED) and to assess clinicians' abilities to predict future usage of PIVC. METHODS: Prospective concealed observational study in a tertiary PED. Healthcare workers (HCWs) completed questionnaires upon insertion and removal of PIVC with review of patient notes if required. The primary outcome was the number of unused, unnecessary PIVCs...
November 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29143446/realism-in-paediatric-emergency-simulations-a-prospective-comparison-of-in-situ-low-fidelity-and-centre-based-high-fidelity-scenarios
#7
Fenton O'Leary, Ioannis Pegiazoglou, Kathryn McGarvey, Ruza Novakov, Ingrid Wolfsberger, Jennifer Peat
OBJECTIVE: To measure scenario participant and faculty self-reported realism, engagement and learning for the low fidelity, in situ simulations and compare this to high fidelity, centre-based simulations. METHODS: A prospective survey of scenario participants and faculty completing in situ and centre-based paediatric simulations. RESULTS: There were 382 responses, 276 from scenario participants and 106 from faculty with 241 responses from in situ and 141 from centre-based simulations...
November 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29131536/non-invasive-ventilation-use-in-status-asthmaticus-16%C3%A2-years-of-experience-in-a-tertiary-intensive-care
#8
Kirsten Rl Bond, Carl Ae Horsley, Anthony B Williams
OBJECTIVE: To describe the use of non-invasive ventilation (NIV) in adults presenting with status asthmaticus to Middlemore Hospital Critical Care Complex (CCC, South Auckland, New Zealand) from 2000 to 2015. METHOD: Retrospective review of all adult asthma admissions to the Hospital CCC between 2000 and 2015. Demographic, physiological, treatment data and blood gas results were recorded. RESULTS: There were 265 asthma admissions to Middlemore Hospital CCC during the study period...
November 12, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29130627/temporal-trends-2002-2014-of-incidence-and-shockable-status-of-adult-emergency-medical-service-attended-out-of-hospital-cardiac-arrest-of-presumed-cardiac-aetiology-in-queensland
#9
Katherine Pemberton, Emma Bosley
OBJECTIVE: To describe trends in incidence and shockable status of adult out-of-hospital cardiac arrest (OHCA) of presumed cardiac aetiology attended by Queensland Ambulance Service (QAS) paramedics between 2002 and 2014. METHODS: The QAS cardiac arrest registry was used to collect data. Analyses included age-standardised rates by gender for all adults and older adults only (65 years+); age-specific incidence rates of young adults (18-49), middle age adults (50-64) and five groups of older adults (65-69, 70-74, 75-79, 80-84 and 85+); and proportions of shockable versus non-shockable initial rhythm together and by age group (young, middle age and older adults)...
November 12, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29117641/increasing-workplace-violence-in-an-australian-adult-emergency-department
#10
Shradha Nikathil, Alexander Olaussen, Evan Symons, Robert Gocentas, Gerard O'Reilly, Biswadev Mitra
OBJECTIVE: Workplace violence (WPV) is an increasingly concerning occupational hazard within the ED. The aim of the present study was to evaluate the incidence and characteristics of WPV in an adult ED. METHODS: A retrospective cohort study was conducted to identify the incidence of ED WPV in an adult metropolitan ED. Data were obtained from the activity records of security staff from 1 January 2013 to 31 December 2015 for all incidents of patient-perpetrated violence...
November 8, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29115723/patterns-of-paediatric-emergency-presentations-to-a-tertiary-referral-centre-in-the-northern-territory
#11
Davina Buntsma, Anna Lithgow, Evan O'Neill, Didier Palmer, Peter Morris, Jason Acworth, Franz E Babl
OBJECTIVE: To describe epidemiological data concerning paediatric attendances at the ED of Royal Darwin Hospital (RDH). METHODS: We conducted a retrospective cohort study of paediatric emergency presentations to the RDH ED during 2004 and 2013. Epidemiological data, including demographics, admission rates and diagnostic grouping, were analysed using descriptive and comparative statistical methods. We compared data with findings from a baseline epidemiological study by the Paediatric Research in Emergency Departments International Collaborative (PREDICT) conducted in 2004...
November 8, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29113021/trauma-case-review-a-quality-and-safety-feature-of-the-victorian-state-trauma-system
#12
Carolyn Pinto, Peter A Cameron, Belinda Gabbe, Susan McLellan, Tony Walker
The aim of the present study was to describe the trauma case review process and its role in a regionalised trauma system. Victoria has a population of 5.9 million people, accounting for 26% of Australia's population. Victoria has been serviced by an inclusive, organised trauma system since 2000 comprising 138 health services with trauma designations and three major trauma services. Pre- and interhospital guidelines prescribe the timely transport of patients to the appropriate level of trauma service. A review of the role and contribution of 10 years of operation of the trauma case review group (CRG) was undertaken to describe the aims, processes and governance surrounding the implementation of an individual case review for specified major trauma patients...
November 7, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29113019/diving-into-research-a-practical-guide-for-emergency-medicine-trainees
#13
Louise Cullen, Nathan Brown
No abstract text is available yet for this article.
November 7, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29113010/comparison-of-four-methods-of-endotracheal-tube-passage-in-simulated-airways-there-is-room-for-improved-techniques
#14
Kirsten Kingma, Ross Hofmeyr, Irene Suilan Zeng, Christin Coomarasamy, Andrew Brainard
OBJECTIVE: Endotracheal intubation requires laryngoscopy followed by passage of the endotracheal tube (ETT). Tube passage can be difficult, but there is little evidence to support which adjunct for tube passage is most effective. METHODS: The four tube passage adjuncts tested were the naked ETT, stylet ETT, railroaded bougie and preloaded bougie. Participants completed pre- and post-test surveys identifying demographics, experience and method preference. After instruction, participants completed eight intubations on manikins with 'easy' and 'difficult' airways...
November 7, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29105321/evidence-based-medicine-the-significance-of-research-literacy-in-emergency-medicine-training
#15
Lisa Brichko, Jessica Forbes, Kimberly Humphrey
No abstract text is available yet for this article.
November 3, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29105280/the-acem-trainee-research-requirement-is-no-longer-relevant-yes
#16
Khoury Mykkanen, Viet Tran
No abstract text is available yet for this article.
November 3, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29094474/review-article-sepsis-in-the-emergency-department-part-1-definitions-and-outcomes
#17
REVIEW
Stephen Pj Macdonald, Julian M Williams, Amith Shetty, Rinaldo Bellomo, Simon Finfer, Nathan Shapiro, Gerben Keijzers
Sepsis has recently been redefined as acute organ dysfunction due to infection. The ED plays a critical role in identifying patients with sepsis. This is challenging due to the heterogeneity of the syndrome, and the lack of an objective standard diagnostic test. While overall mortality rates from sepsis appear to be falling, there is an increasing burden of morbidity among survivors. This largely reflects the growing proportion of older patients with comorbid illnesses among those treated for sepsis.
November 2, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29094472/serum-mast-cell-tryptase-measurements-sensitivity-and-specificity-for-a-diagnosis-of-anaphylaxis-in-emergency-department-patients-with-shock-or-hypoxaemia
#18
Abbie Francis, Daniel M Fatovich, Glenn Arendts, Stephen Pj Macdonald, Erika Bosio, Yusuf Nagree, Hugh Ma Mitenko, Simon Ga Brown
OBJECTIVE: Clinical diagnosis of anaphylaxis is principally based on symptoms and signs. However, particularly for patients with atypical symptoms, laboratory confirmation of anaphylaxis would be useful. This study investigated the utility of mast cell tryptase, an available clinical biomarker, for differentiating anaphylaxis from other causes of critical illness, which can also involve mast cell activation. METHODS: Tryptase was measured (ImmunoCAP) in serum from patients with anaphylaxis and non-anaphylactic critical illness (controls) at ED arrival, and after 1-2, 3-4 and 12-24 h...
November 2, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29090530/no-need-to-strain-a-practical-approach-to-paediatric-constipation
#19
Ben Lawton, Tessa Davis, Henry Goldstein, Andrew Tagg
No abstract text is available yet for this article.
October 31, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29090519/why-change-the-name-of-the-college-from-australasian-to-australian-and-new-zealand
#20
EDITORIAL
Michael Ardagh
Australasian is the adjectival version of the name of a geographical region. The region is defined differently by different people. It includes islands other than Australia and New Zealand and variably includes or excludes New Guinea. It has nothing to do with Asia. The adjective is often misunderstood, it leaves New Zealand invisible to many readers and it is an incorrect description of who we are as a college. Australian and New Zealand describes who we are - fellows from two sovereign nations - Australia and New Zealand...
October 31, 2017: Emergency Medicine Australasia: EMA
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