Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2017
Patterns of paediatric emergency presentations to a tertiary referral centre in the Northern Territory.
To describe epidemiological data concerning paediatric attendances at the ED of Royal Darwin Hospital (RDH). ⋯ This study provides important information regarding paediatric presentations to a major referral hospital in the Northern Territory. Overall, there was a disproportionate rate of presentation and admission among Indigenous children. Other key findings were higher proportions of cellulitis, head injury and adolescent presentations. These findings can assist in service planning and in directing future research specific to children in the Northern Territory.
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Emerg Med Australas · Dec 2017
Letter Review Case ReportsTraumatic dislocation of the first rib: A case report and review of the literature.
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Emerg Med Australas · Dec 2017
Multicenter StudyDo all adult orthopaedic injuries seen in emergency departments need to attend fracture clinic? A Queensland multicentred review.
Musculoskeletal injuries account for a significant proportion of ED presentations annually, with a large percentage being referred to the fracture clinic (FC). A literature review found that many referrals could be safely managed outside the traditional model of care. The present study aims to review all adult presentations to FCs at two Queensland metropolitan hospitals, finding low-risk injuries that can safely and appropriately be managed by their general practitioner (GP) or allied health professionals (AHPs), potentially affording significant savings to the health system. ⋯ Adopting the PCP could potentially reduce fracture clinic referrals by 40%. Having a structured pathway has the potential to empower primary health professionals, which could result in a more streamlined process that aids in significant time and financial savings and maintains good patient satisfaction and outcomes.
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Emerg Med Australas · Dec 2017
Do antiemetic drugs benefit adult emergency department patients with nausea? The literature says no, but is it right?
Nausea is a common problem in ED patients. Antiemetic drugs have been used in the ED for decades, but a recent Cochrane review found no convincing evidence for the benefit of antiemetic drugs over placebo. This was largely based on three placebo-controlled trials, which found mean Visual Analog Scale (VAS) changes for various drugs and placebo, to be similar. ⋯ Use of a VAS cut-off level indicative of clinically significant symptom improvement would allow comparison of numbers of patients with improved nausea ratings. This is proposed as the best option currently available. Preliminary testing of this outcome measure suggests that the conclusions of past studies may be misleading, and that the question of antiemetic efficacy for ED patients is not yet answered.