Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2012
Comparative StudyComparison of early biomarker strategies with the Heart Foundation of Australia/Cardiac Society of Australia and New Zealand guidelines for risk stratification of emergency department patients with chest pain.
To compare cardiac risk stratification using a 0 and 2 h point-of-care (POC) cardiac troponin (cTn), 0 and 2 h POC multi-biomarkers against the 0 and 6 h laboratory cTn reference standard. ⋯ Using a 2 h POC cTn-only biomarker strategy with the HF-A/CS-ANZ guidelines accurately identified a population at intermediate risk of 30-day events in whom further objective testing might be accelerated, allowing subsequent early discharge of the majority of this cohort. Within 2 h of presentation a high risk population could be identified in whom early management, including admission, was required.
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Emerg Med Australas · Dec 2012
Improving the attractiveness of an emergency medicine career to medical students: An exploratory study.
To describe perceptions of medical students and emergency doctors towards careers in emergency medicine (EM), and to identify influences on career choice. ⋯ Increasing the attractiveness of a career in EM requires changing student perceptions of lifestyle and satisfaction benefits, access to EM subspecialties, increasing ED research, information about job security, and improved work conditions.
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Emerg Med Australas · Dec 2012
Earthquake-related crush fractures and non-earthquake-related fractures of the extremities: a comparative radiological study.
To determine the features that differentiate earthquake-related crush extremity fractures from non-earthquake-related extremity fractures by using digital radiography (DR) and multidetector row computed tomography (MDCT). ⋯ Earthquake-related crush fractures of extremities are more likely than non-earthquake-related extremity fractures to involve multiple extremities, multiple bones and to be comminuted. The lower extremities, predominantly the tibia and fibula, are more likely to be involved. This has implications for emergency and disaster planning in earthquake-prone regions.
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The first extended care paramedic (ECP) model of care in New Zealand was introduced in the Kapiti region, north of Wellington in 2009. The ECP model aimed to increase the proportion of patients presenting to the ambulance service who could be treated in the community. This study evaluated the first 1000 patients seen by ECPs. ⋯ We observed that ECPs have significant potential to reduce hospital ED attendances by treating more patients in the community, and this is associated with a low rate of subsequent ED presentations. Prioritisation of dispatch of ECPs to particular types of patients might be useful in maximising this reduction.
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Children undergo many diagnostic and therapeutic procedures in the ED. Although emergency staff can often intervene to reduce physical pain through topical anaesthesia, analgesia and sedation, much procedural distress can be addressed by better preparing patients and families for the procedures. ⋯ We present a practical language guide for procedures and equipment for use by clinicians in the ED before, during and after procedures. The language tables might be most usefully placed in the procedure rooms for easy reference or incorporated into clinical practice guidelines.