Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2016
Review Meta AnalysisReview article: Why is there still a debate regarding the safety and efficacy of intravenous thrombolysis in the management of presumed acute ischaemic stroke? A systematic review and meta-analysis.
The objective of the present study is to independently and systematically assess the harms and benefits of intravenous thrombolysis for patients with presumed acute schaemic stroke. ⋯ There is clear evidence of increased early mortality, increased rates of symptomatic intracranial haemorrhage and also of improved functional outcomes for patients with presumed acute ischaemic stroke treated with thrombolysis. The available data are unlikely to resolve the controversy regarding the use of intravenous thrombolysis in this population, and further randomised controlled trials are urgently required.
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This perspective article summarises the experience of conducting a multicentre research project. We describe expected and unexpected hurdles we experienced as well as suggesting possible solutions for researchers embarking on multicentre studies.
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Emerg Med Australas · Oct 2016
ReviewPotential role for psychological skills training in emergency medicine: Part 1 - Introduction and background.
Psychological skills training (PST) is the systematic acquisition and practice of different psychological techniques to improve cognitive and technical performance. This training consists of three phases: education, skills acquisition and practice. Some of the psychological skills developed in this training include relaxation techniques, focusing and concentration skills, positive 'self-suggestion' and visualisation exercises. ⋯ Despite the benefits realised in other professions, medicine has only recently begun to explore certain elements of PST. The present paper reviews the history and evidence behind the concept of PST. In addition, it presents some aspects of PST that have already been incorporated into medical training as well as implications for developing more comprehensive programmes to improve delivery of emergency medical care.
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Emerg Med Australas · Oct 2016
Observational StudyFluid bolus therapy in emergency department patients: Indications and physiological changes.
The aim of the present paper is to study the indications for fluid bolus therapy (FBT) and its associated physiological changes in ED patients. ⋯ In ED, FBT is used mostly in patients without shock. However, after an immediate haemodynamic effect, FBT is associated with absent or limited physiological changes at 1 or 2 h. Even in shocked patients, the changes in MAP at 1 or 2 h after FBT are small.
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Emerg Med Australas · Oct 2016
Impact of population ageing on growing demand for emergency transportation to emergency departments in Western Australia, 2005-2020.
The aim of the present paper is to quantify the impact of population ageing on demand for emergency transportation (ET) to EDs in Western Australia (WA). ⋯ There has been a continuous rise in ET demand in WA, particularly in older people who have a higher urgency and requirement for admission.