Emergency medicine Australasia : EMA
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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.
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Emerg Med Australas · Dec 2014
Prehospital paediatric burn care: New priorities in paramedic reporting.
The present study evaluates the prehospital care of paediatric burn patients in Queensland (QLD). As first aid (FA) treatment has been shown to affect burn progression and outcome, the FA treatment and the risk of associated hypothermia in paediatric patients were specifically examined in the context of paramedic management of burn patients. ⋯ Despite FA and patient temperatures being important prognostic factors for burn patients, paramedic documentation of these was often incomplete, and there was no consistent use of burns dressings.
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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.