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.
-
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
Review Comparative StudyThe role of physician staffing of helicopter emergency medical services in prehospital trauma response.
The crewing of Helicopter Emergency Medical Service (HEMS) for scene response to trauma patients is generally considered to be controversial, particularly regarding the role of physicians. This is reflected in HEMS in Australia with some services utilizing physician crewing for all prehospital missions. Others however, use physicians for selected missions only whilst others do not use physicians at all. ⋯ Studies were excluded if they compared physician teams with basic life support teams (BLS) teams rather than paramedics. Ambulance officers were considered to be paramedics where they were able to administer intravenous fluids and use a method of airway management beyond bag-valve-mask ventilation. Studies were excluded if the skill set of the ambulance team was not defined, the level of staffing of the helicopter service was not stated, team composition varied without reporting outcomes for each team type, patient outcome data were not reported, or the majority of the transports were interhospital rather than prehospital transports.