Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2009
Adverse outcomes following emergency department discharge of patients with possible acute coronary syndrome.
To determine the proportion of adverse events in patients discharged after ED assessment for possible acute coronary syndrome. ⋯ In a large Australian ED, less than 1% of patients presenting with symptoms suggestive of coronary syndrome were discharged and subsequently had a 30 day adverse event. Reducing this proportion by admitting patients with traditional risk factors would markedly increase hospital workload. Opportunities exist to improve both the safety and efficiency of chest pain assessment in the ED.
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Emerg Med Australas · Dec 2009
Debriefing critical incidents in the paediatric emergency department: current practice and perceived needs in Australia and New Zealand.
Anecdotally critical incident debriefing (CID) is an important topic for staff in paediatric ED. The present study aimed to determine current baseline CID practices and perceived needs of ED staff. A questionnaire regarding CID practice was circulated to all 13 Paediatric Research in Emergency Departments International Collaborative (PREDICT) sites in Australia and New Zealand (including all tertiary paediatric ED), and completed by 1 senior doctor and 1 senior nurse. ⋯ Almost 90% of those surveyed indicated that they would like a CID programme and guidelines for their department. Debriefing is perceived as important by senior ED clinicians, yet few ED have formalized guidelines or programmes. Best-practice guidelines should be developed.
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Emerg Med Australas · Dec 2009
Clinical TrialThe 10 mL syringe is useful in generating the recommended standard of 40 mmHg intrathoracic pressure for the Valsalva manoeuvre.
The Valsalva manoeuvre (VM) continues to be first-line management for haemodynamically stable supraventricular tachycardia in the acute setting. 40 mmHg of intrathoracic pressure is seen as an essential component of the VM. Anecdotally, blowing into a 10 mL syringe to move the plunger is one method of pressure generation; however, to date its effectiveness has not been tested. The objective of the present study was to assess if blowing into a syringe sufficient to move the plunger could produce the required 40 mmHg of pressure. ⋯ The present study has demonstrated that blowing into a 10 mL Terumo syringe, to move the plunger, generated 40 mmHg intrathoracic pressure, thereby meeting the recommended intrathoracic pressure for optimum VM performance.
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Emerg Med Australas · Dec 2009
Short-term risk of adverse outcome is significantly higher in patients returning an abnormal troponin result when tested in the emergency department.
Describe short-term mortality and hospitalization outcomes in patients undergoing troponin testing in Western Australia tertiary public hospital ED. ⋯ An abnormal ED troponin result appears to be associated with increased risk of subsequent hospitalization and death within 28 days of discharge.