Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2014
Randomized Controlled TrialChest compression with kneeling posture in hospital cardiopulmonary resuscitation: A randomised crossover simulation study.
We suggest an alternative chest compression (CC) in kneeling posture using a 'kneeling stool' on which the performer kneels beside the patient on a bed in-hospital. In kneeling posture, we can maintain high quality cardiopulmonary resuscitation (CPR) without the bed height adjustment, which is necessary and inconvenient in standing posture. ⋯ A kneeling posture with a kneeling stool were preferred by participants, which have shown similar results in CC parameters and VAS with a standing posture on a stepstool with bed height adjustment during in-hospital CPR.
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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
Observational StudyScribes in an Australian private emergency department: A description of physician productivity.
The study aims to determine if trained scribes in an Australian ED can assist emergency physicians (EPs) to work with increased productivity. ⋯ In this pilot study, scribe usage was feasible, and overall improvements in consultations per hour were seen. Overall income improved by AUD104.86 (95% CI AUD38.52, AUD171.21) per scribed hour. Further study is recommended to determine if results are sustained or improved over a longer period.