Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2012
Pain management in Australian emergency departments: current practice, enablers, barriers and future directions.
To explore current pain management practice in Australian EDs and identify enablers and barriers for best-practice pain management. ⋯ Effective and sustainable system change requires a strategy that is initiated within the ED, targets opinion leaders, is supported by evidence, and engages all levels of ED staff.
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Emerg Med Australas · Apr 2012
Prosthetic hip dislocations: is relocation in the emergency department by emergency medicine staff better?
Prosthetic hip dislocation is common. This study compares prosthetic hip relocations attempted within the ED by emergency doctors and those under orthopaedic care in the ED or operating theatre (OT). ⋯ There was no difference between EM and orthopaedics in the proportion of hips successfully relocated or complications in the ED; however, EM patients were discharged much sooner, with important resource implications. Procedures carried out in the OT were more successful than in the ED but resulted in prolonged hospital stays and were associated with more complications.
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Emerg Med Australas · Apr 2012
Cardiac troponin I does not independently predict mortality in critically ill patients with severe sepsis.
Patients with sepsis often have elevated cardiac troponin I even in the absence of coronary artery disease. The prognostic value of cardiac troponins in critically ill patients with sepsis remains debatable. Our objective was to evaluate the prognostic value of cardiac troponin I in critically ill patients with severe sepsis. ⋯ Critically ill patients with severe sepsis who had elevated troponin had increased hospital and intensive care mortality. However, cardiac troponin I did not independently predict hospital mortality.
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Twenty-five years on from the first fellowship examination of the College, it is timely to reflect on the issue of clinical longevity. The pressures of the emergency medicine workplace are relatively unique among the medical specialties, and might require unique solutions if emergency physicians are to continue clinical practice in the latter stages of their careers.