Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2010
Emergency physician credentialing for resuscitative thoracotomy for trauma.
A low case incidence and variable skill level prompted the development of a credentialing programme and specific surgical training in resuscitative thoracotomy for emergency physicians at The Alfred, a Level 1 Adult Victorian Major Trauma Service. ⋯ Emergency physicians working in high-volume Trauma Centres are expected to diagnose cardiac tamponade and on occasion decompress the pericardium. Specific training in the procedure should be undertaken.
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Emerg Med Australas · Aug 2010
Obesity significantly increases the difficulty of patient management in the emergency department.
To determine which aspects of ED management are adversely affected by patient obesity, to determine the level of obesity above which management is made more difficult and to make recommendations on how these effects might be mitigated. ⋯ Patient obesity significantly increases the difficulty of ED patient management. Staff recommendations to mitigate these effects were few but may inform changes in ED practice.
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Emerg Med Australas · Aug 2010
Case ReportsAcute coronary syndrome mimicked by acute cholecystitis.
Various aetiologies have been reported that cause severe trauma segment and T-wave abnormalities that are not related to acute coronary syndromes. However, the reports of transient ECG abnormalities associated with acute cholecystitis are limited in the literature. We describe a 42-year-old man presented with abdominal pain and hypertensive episode that developed dynamic ECG changes mimicking acute coronary syndrome and was diagnosed acute cholecystitis eventually. Emergency physicians should keep in mind dynamic T-wave changes mimicking acute myocardial ischaemia in patients with acute cholecystitis.