Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2014
Case ReportsAortic dissection presenting an acute onset of neuroradicular syndrome complicated by coeliac and superior mesenteric artery embolism.
Aortic dissection is a catastrophic medical emergency with complex and changeable clinical presentations. We report a case of aortic dissection complicated by coeliac and superior mesenteric artery embolism, which is hardly been reported till date.
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Emerg Med Australas · Dec 2014
Clearing emergency departments and clogging wards: National Emergency Access Target and the law of unintended consequences.
To assess ED length of stay (EDLOS), access block, inpatient length of stay (IPLOS) and waiting times before and after the implementation of the National Emergency Access Target (NEAT). ⋯ At the current institution NEAT success has been guarded, likely secondary to availability of inpatient beds. The implementation of NEAT appears to have reduced emergency waiting times. These early results suggest concurrent a detrimental effect on IPLOS; however, some of this effect may be a result of a large increase in short stay admissions.
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Emerg Med Australas · Dec 2014
Factors influencing ceftriaxone use in community-acquired pneumonia: Emergency doctors' perspectives.
To explore the perceptions of ED doctors regarding the use of ceftriaxone in patients with community-acquired pneumonia (CAP). ⋯ As most cases of CAP are initially diagnosed and treated empirically in the ED, any interventions that aim to decrease inappropriate use of ceftriaxone for CAP should address the factors identified here that influence ED doctors' prescribing decisions.
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Emerg Med Australas · Dec 2014
Sensitivity of proposed clinical decision rules for subarachnoid haemorrhage: An external validation study.
Subarachnoid haemorrhage (SAH) is an uncommon but important cause of sudden-onset headache. Three clinical decision rules (CDRs) for investigation in sudden headache have been proposed, but concerns were raised about the generalisability of some variables. Our aim was to determine what proportion of patients with confirmed SAH has the identified high-risk factors and the sensitivity of the proposed CDR in an Australasian cohort. ⋯ CDR 2, or the refinement of CDRs 1 and 3 with the inclusion of at least one episode of vomiting as a criterion, has very high sensitivity. Although unlikely to reduce CT scan rates for patients in whom there is a clinical suspicion of SAH, they might be useful in guiding which patients require further testing (e.g. lumbar puncture) after a negative CT scan.