Emergency medicine Australasia : EMA
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Debate around medical futility has produced a vast literature that continues to grow. Largely absent from the broader literature is the role of emergency medicine in either starting measures that prove to be futile, withholding treatment or starting the end of life communication process with patients and families. ⋯ We conclude that emergency physicians have the clinical ability and the legal and moral standing to resist providing futile treatment. In these situations they can take a different path that focuses on comfort care thereby initiating the process of the much sought after 'good death'.
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Emerg Med Australas · Oct 2011
Case ReportsSubclavian artery laceration: A serious complication of needle decompression.
A 31-year-old woman presented with spontaneous tension pneumothorax. This was initially treated with needle decompression, which led to massive haemothorax. Treatment and methods to reduce the likelihood of this complication are discussed.
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To describe in-hospital resuscitation outcomes and factors associated with survival at Auckland City Hospital, New Zealand. ⋯ Survival from cardiac arrest in our hospital compared well to similar centres and good neurological outcome was higher than reported previously. Reduced survival during the 'After-Hours' period is cause for concern, and further research into the factors underlying this is required.
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Emerg Med Australas · Oct 2011
Case ReportsA case of phlegmesia cerulea dolens after dialysis catheter insertion.
Phlegmesia cerulea dolens (PCD) is a rare complication of deep vein thrombosis characterized by massive venous thrombosis leading to arterial compromise and tissue ischaemia. PCD carries high morbidity and mortality and is an often times overlooked cause of acute limb ischaemia that must be recognized and treated promptly. Early referral for percutaneous catheter directed thrombectomy offers an alternative to thrombolysis in patients who present with venous gangrene or fail anticoagulation therapy. A case of PCD is presented in a 71-year-old woman with end-stage renal disease 3 days after right femoral dialysis catheter placement.
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Emerg Med Australas · Oct 2011
Australasian College for Emergency Medicine examiner peer review process: Development and implementation.
In 2005, the Australasian College for Emergency Medicine set out to refine the selection, training and development of examiners. Part of this included development of an examiner peer review process. ⋯ The present article describes the development of a list of optimal examiner attributes, followed by implementation of an examiner peer review process. The authors recommend examiner peer review for high-stakes examinations.