Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2018
Evaluation of the trauma triage accuracy in a Level 1 Australian trauma centre.
To assess the rate of undertriage of major trauma patients and to assess factors contributing to undertriage in a modern Australian Level 1 trauma centre. ⋯ In this cohort of major trauma, a 6.1% undertriage performance of the triage tool was observed. Sub-analysis of the data showed that elderly patients were more likely to be undertriaged.
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A number of new time critical medical interventions are highly specialised. As such, they are not available in many hospitals and EDs. This necessitates transfer to another facility, which is often associated with some degree of delay. Processes to facilitate timely access to these interventions should aim to replicate or improve on that which would have been available should the patient have been in the community, and responded to, primarily, by an emergency medical service.
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Emerg Med Australas · Oct 2018
ReviewReview article: Best practice management of closed hand and wrist injuries in the emergency department (part 5 of the musculoskeletal injuries rapid review series).
Acute hand and wrist injuries are a common presentation to the ED and are associated with large individual and societal costs. Appropriate management of these injuries in the ED is crucial given that optimal hand function is essential for daily activities and quality of life. This rapid review investigated best practice for the assessment and management of common closed hand and wrist injuries in the ED. ⋯ This rapid review provides clinicians who manage common closed fractures and soft tissue injuries of the hand and wrist in the ED, a summary of the best available evidence to enhance the quality of care for optimal patient outcomes. There is evidence to support taking a thorough history and physical examination with consideration of occupational and functional factors, restoring alignment and immobilising when necessary and referring onwards. Key points regarding the diagnosis and management of these injuries are provided.