Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2015
Resident transfers from aged care facilities to emergency departments: Can they be avoided?
Residents from aged care facilities make up a considerable proportion of ED presentations. There is evidence that many residents transferred from aged care facilities to EDs could be managed by primary care services. The present study aimed to describe the characteristics of residents transferred from residential aged care facilities to EDs, and to evaluate the appropriateness and cost of these presentations. ⋯ Many resident transfers might have been avoided with better primary care services in place. Future strategies to improve resident care might include aged care staff skill mix and the availability of outreach or primary care services.
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Emerg Med Australas · Oct 2015
Observational StudyOff-label and unlicenced medicine administration to paediatric emergency department patients.
To determine the prevalence and nature of off-label and unlicenced (off-label/unlicenced) medicine administration to paediatric ED patients. ⋯ Off-label/unlicenced medicine administration is common. A registry of commonly used off-label medicines is recommended in which the safety and efficacy of their off-label use have been demonstrated by published evidence.
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Emerg Med Australas · Oct 2015
Use of a high-sensitivity troponin T assay in the assessment and disposition of patients attending a tertiary Australian emergency department: A cross-sectional pilot study.
We examined the disposition and outcomes of patients presenting to the ED with symptoms suggestive of acute coronary syndrome undergoing measurement of troponin T using a highly sensitive assay. ⋯ Despite high-sensitivity TnT assay having a high sensitivity and specificity for myocardial necrosis, the majority of unselected consecutive patients attending ED in whom TnT levels were elevated did not have an acute coronary syndrome. Our pilot study suggests that a larger study is needed to provide evidence to modify management algorithms.
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Emerg Med Australas · Oct 2015
Assessing the damage control resuscitation: Development, drivers and direction.
Damage control resuscitation (DCR) has become a more widely adopted acute management strategy over the past decade. A cornerstone of this strategy is the performance of an initial limited surgical intervention for the control of active bleeding and contamination. ⋯ This damage control surgery itself is completed judiciously to allow a period of resuscitative stabilisation before later definitive surgical solutions. This discussion describes the three further principles of DCR and then explores the rationale and drivers behind the development of this approach.
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Emerg Med Australas · Oct 2015
Tyranny of distance and rural prehospital care: Is there potential for a national rural responder network?
Critical illness intersects with the workload of rural doctors in Australia, mostly via their on-call responsibilities to rural hospitals. A significant proportion of these are prehospital incidents - vehicle crashes, farming injuries, bushfire etc. ⋯ Ambulance services in rural areas are often volunteer based, and with increasing remoteness via the 'tyranny of distance' comes the likelihood of increased delay in arrival of specialist retrieval services. Potential exists to utilise rural clinicians to respond to prehospital incidents in certain defined circumstances, as suggested by a recent survey of rural doctors.