Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2012
Capacity building in emergency care: An example from Madang, Papua New Guinea.
Divine Word University (DWU) is an emerging national university of Papua New Guinea (PNG) based in the provincial capital of Madang, providing training for Health Extension Officers (HEOs). HEOs form the backbone of healthcare delivery in PNG as clinicians, public health officers and health centre managers. Both campus-based and clinical teaching at the nearby Modilon Hospital is limited because of significant resource constraints. ⋯ This programme provides positive models of both emergency care capacity building in a resource-constrained setting and training in international EM for Australasian clinicians.
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Emerg Med Australas · Oct 2012
ReviewA primer for clinical researchers in the emergency department: Part IV: Multicentre research.
In this series we address key topics for clinicians who conduct research as part of their work in the ED. Multicentre research is conducted to enrol larger numbers of participants and improve the validity and generalisability of the findings. ⋯ We address the two major categories of multicentre research, collaborative group research based on a group of researchers from a moderate-sized number of EDs and large-scale investigator-led research where a central group of investigators leads a large pool of research sites. Although we focus on clinical trials, the basic principles also apply to multicentre observational studies.
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Emerg Med Australas · Oct 2012
Randomized Controlled TrialRandomised trial of magnesium in the treatment of Irukandji syndrome.
Irukandji syndrome is a distressing condition characterised by pain, hypertension and tachycardia. Some develop cardiac failure and there have been two reported deaths. Magnesium sulphate has become the standard of care despite minimal evidence. The aim of this study was to investigate if magnesium would reduce analgesic requirement and length of stay for patients with Irukandji syndrome. ⋯ Our study did not demonstrate a benefit in the use of magnesium in the treatment of Irukandji syndrome. As such the current use of magnesium needs to be reconsidered until there is good evidence to support its use.
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Emerg Med Australas · Oct 2012
Prevalence of suicidality in asymptomatic adolescents in the paediatric emergency department and utility of a screening tool.
Many authorities recommend screening adolescents for risk of suicide. The ED is a potential setting for such screening. The aim of this study is to explore the use of the Risk of Suicide Questionnaire (RSQ) as a screening tool for suicidality in patients who come to the ED without mental health concerns and without recent mental health history. The Suicide Ideation Questionnaire (SIQ) was the comparison standard. ⋯ The prevalence of suicidal ideation in asymptomatic patients presenting to this paediatric ED is very low. Using this selection method, the RSQ could not be validated, but would be unlikely to be suitable for screening this low-risk population with a high false positive rate.
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Emerg Med Australas · Oct 2012
Unravelling relationships: Hospital occupancy levels, discharge timing and emergency department access block.
To investigate the effect of hospital occupancy levels on inpatient and ED patient flow parameters, and to simulate the impact of shifting discharge timing on occupancy levels. ⋯ Modern hospital systems have the ability to operate efficiently above an often-prescribed 85% occupancy level, with optimal levels varying across hospitals of different size. Operating over these optimal levels leads to performance deterioration defined around occupancy choke points. Understanding these choke points and designing strategies around alleviating these flow bottlenecks would improve capacity management, reduce access block and improve patient outcomes. Effecting early discharge also helps alleviate overcrowding and related stress on the system.