Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2013
ReviewReview article: Evacuating hospitals in Australia: What lessons can we learn from the world literature?
The creation of hospitals safe from disaster is an area of increasing public policy. The vulnerability of hospitals to damage and destruction during an event has profound implications for the health of a community. Although hospital evacuations do occur in Australia, their prevalence is unknown and what leads to a successful evacuation is poorly understood. ⋯ Most critically, all hospitals must have a practised, detailed hospital evacuation plan existing before an impending threat. There are also areas for improvement in the areas of assessing the risk to the facility, communications, leadership, logistics, staffing and planning. These lessons should be included into comprehensive, detailed evacuation plans for all Australian hospitals, supported by a national framework that standardises planning and response.
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The aims of this research were to characterise the injury patterns associated with nail guns, highlight their potential complications and review treatment options. ⋯ The present study characterises the injury patterns caused by nail guns. Treatment of these injuries should be based on clinical findings; however, the majority of cases should undergo surgical treatment. The required operation is a short and safe treatment modality that might allow a thorough assessment of the injury, removal of embedded material, repair of structural damage and a sterile washout to be performed.
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Emerg Med Australas · Dec 2013
Sensitivity and specificity of three-point compression ultrasonography performed by emergency physicians for proximal lower extremity deep venous thrombosis.
The present study aims to quantify the sensitivity and specificity of three-point compression ultrasonography for diagnosing proximal lower extremity deep venous thrombosis when performed by Australian consultant emergency physicians with limited specific training. Secondary aims included quantifying rapidity, technical adequacy, predictability of equivocal results and relationships between emergency physician experience and proficiency. ⋯ Abbreviated ultrasonography performed by emergency physicians for proximal lower extremity deep venous thrombosis could be valuable. However, more precise estimates for sensitivity and greater understanding of relationships between emergency physician experience and proficiency are required.
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Emerg Med Australas · Dec 2013
Design and roll out of standardised approach to paediatric procedural sedation in Victorian emergency departments.
Children sometimes require minor procedures in the ED for which sedation is needed. Information from Victorian EDs indicated that processes for paediatric procedural sedation were variable, both within and between health services. The aims of this project were to improve safety and reduce variation in practice with respect to paediatric procedural sedation in EDs by rolling out a standardised paediatric sedation programme in Victorian EDs. ⋯ This multi-modal implementation strategy has achieved clinical practice improvement across organisational boundaries.
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Emerg Med Australas · Dec 2013
Evaluation and outcomes of patients admitted to a tertiary medical assessment unit with acute chest pain of possible coronary origin.
The study aims to (i) profile clinical characteristics, risk estimates of acute coronary syndrome (ACS), use and yield of non-invasive cardiac testing, discharge diagnosis and 30-day outcomes among patients admitted with acute chest pain of possible coronary origin; and (ii) construct a risk stratification algorithm that informs management decisions. ⋯ In patients with indeterminate chest pain, clinical features and risk scores identify most with myocardial ischaemia. An algorithm is presented that might inform triaging, early discharge, choice of testing and need for telemetry.