Emergency medicine Australasia : EMA
-
Emerg Med Australas · Aug 2004
ReviewFamily member presence during resuscitation in the emergency department: An Australian perspective.
The practice of family member presence during resuscitation in the ED has attracted widespread attention over the last few decades. Despite the recommendations of international organizations, clinical staff remain reluctant to engage in this practice in many EDs. This paper separates the evidence from opinion to determine the current state of knowledge about this practice. ⋯ Although critics point to the lack of rigour in this body of literature, the current state of knowledge suggests merit in pursuing future research to examine and measure effects of family member presence during resuscitation on patients, family members and healthcare providers.
-
Emerg Med Australas · Aug 2004
Multicenter StudyIncorrect instruction in the use of the Valsalva manoeuvre for paroxysmal supra-ventricular tachycardia is common.
Success rates for the Valsalva manoeuvre (VM) in treatment of paroxysmal supraventricular tachycardia (SVT) vary with performance technique. This study aimed to assess whether ED doctors instruct their patients to perform the recommended VM technique (supine position for 15 s). ⋯ Few ED doctors correctly instruct their patients in the VM technique recommended for management of SVT. Hence, maximal vagal tone and SVT conversion rates may not be achieved in many cases. The use of the recommended VM technique is encouraged.
-
To identify the difficulties encountered with the emergency management of morbidly obese patients and formulate recommendations to streamline care. ⋯ Very obese patients present a variety of logistical and medical challenges for EDs. A series of recommendations are made based on available data. Further studies in this area would be desirable to more specifically address ED issues.
-
Emerg Med Australas · Aug 2004
ReviewDrotrecogin alfa: a role in emergency department treatment of severe sepsis?
Human protein C is a serine protease that circulates in the blood as an inactive zymogen. It is converted to its active form by interaction with thrombomodulin on the endothelial wall. ⋯ This review describes the physiology of the protein C pathway and its importance in sepsis. It will also focus on the use of drotrecogin alfa in sepsis, and its use in the ED.
-
Emerg Med Australas · Aug 2004
Comparative Study Clinical TrialDoes potassium concentration measured on blood gas analysis agree with serum potassium in patients with diabetic ketoacidosis?
The aims of this study were to define the maximum clinically acceptable difference between potassium concentrations on different samples and to determine the degree of agreement between potassium concentration measured on blood gas analysis and serum for patients with diabetic ketoacidosis (DKA). ⋯ This study suggests that potassium concentration derived from blood gas analysis may not be an acceptable substitute for serum potassium concentration in patients with diabetic ketoacidosis, particularly at higher serum glucose concentrations.