Emergency medicine Australasia : EMA
-
Emerg Med Australas · Dec 2015
Femoral nerve blocks for fractured neck of femur patients: A 'feel good solution' but a 'short-term fix'?
Femoral nerve blocks (FNBs) are commonly administered to patients with a fractured neck of femur (NOF). FNBs reduce complications associated with opioids and are effective for up to 24 h. However, the recognised 'gold standard' time to definitive treatment (surgery) in the patient with a fractured NOF is within 48 h. This leaves a significant period of time in which the patient has no effective analgesia, and might require opioids to alleviate pain. The present study explored the number of NOF patients who received a FNB: their wait for definitive treatment (surgery) and how much opioid analgesia was administered in the preoperative phase. ⋯ Even when patients' time to surgery was within the 'gold standard', patients received increasing doses of opioids 20 h after the administration of the FNB. While patients continue to wait extended periods for surgery, the practice of administering a single injection FNB needs to be challenged. ED clinicians might consider FNB infusions rather than single injection FNBs for patients with a fractured NOF.
-
Emerg Med Australas · Dec 2015
ReviewReview article: Very serious and non-ignorable problem: Crisis in emergency medical response in catastrophic event.
The crisis of medical response caused by catastrophic events might significantly affect emergency response, and might even initiate more serious social crisis. Therefore, early identification and timely blocking the formation of crisis in the early phase after a major disaster will improve the efficiency of medical response in a major disaster and avoid serious consequences. In the present paper, we described the emergency strategy to crisis management of medical response after a major disaster. ⋯ First, all relevant society forces led by the government and military should be linkages. Second, a powerful medical response system must be based on a strong support system. Third, countermeasures of medical surge should be applied flexibly to the special and specific disaster environment, to promote the effective medical response force.
-
Emerg Med Australas · Dec 2015
Randomised control trial of humidified high flow nasal cannulae versus standard oxygen in the emergency department.
The aim of the study was to determine if oxygen delivered through humidified high flow nasal cannulae (HHFNC) reduced the need for escalation in ventilation management and work of breathing in the ED patients presenting with acute undifferentiated shortness of breath compared with standard oxygen therapy. ⋯ The use of high flow nasal cannula oxygenation was associated with improved respiratory state in selected patients presenting to the ED with acute undifferentiated shortness of breath.
-
Emerg Med Australas · Dec 2015
Use of a telenursing triage service by Victorian parents attending the emergency department for their child's lower urgency condition.
The Victorian Nurse-On-Call (NOC) service has been in use for over 8 years, though little research has been conducted investigating the service. The present study aimed to explore whether parents in Victoria presenting with their child to the ED for lower urgency conditions use the NOC before ED arrival and whether the advice given impacts their decision to attend the ED. ⋯ The findings of our study show that use and awareness of NOC is low in parents attending the ED for their child's lower urgency condition. The success of NOC in the goal of deferring non-urgent conditions from presenting to the ED appears limited. Telenursing triage services in Australia should consider assessment of their algorithms to increase the likelihood that where appropriate, lower urgency conditions are directed to primary care services rather than the ED.
-
Emerg Med Australas · Dec 2015
ReviewReview article: Potential of medical scribes to allay the burden of documentation and enhance efficiency in Australian emergency departments.
The increasing burden of documentation experienced by doctors threatens the efficiency in EDs and increases the likelihood of documentation errors. Medical scribes afford the opportunity to allay this burden by removing a large component of the doctors' documentation task. Scribes have been embedded successfully in US EDs, and the effects have been mostly advantageous. The present paper provides a brief overview of the function of scribes and their potential contribution to Australian EDs.