Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2020
Use of computed tomography and magnetic resonance imaging for occult neck of femur fractures: A single-centre study.
Neck of femur (NOF) fractures are common and serious injuries in the elderly. When a NOF fracture is suspected but is not clearly visible on radiographs, guidelines recommend magnetic resonance imaging (MRI), or computed tomography (CT) if MRI is not available/contraindicated. The aim of our study was to review the use of CT and subsequent MRI for suspected NOF fractures in patients with negative or equivocal radiographs. ⋯ Access to CT for evaluation of suspected occult NOF fractures is much quicker compared to MRI. When CT results are negative with on-going clinical suspicion of an occult fracture, MRI should be performed in a time efficient manner.
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Emerg Med Australas · Dec 2020
Examining the association between triage streamed treatment location and time to appropriate antibiotics in emergency department patients with septic shock.
Early recognition and treatment for sepsis is critical in improving patient outcomes. The present study sought to examine whether triage location was associated with time to appropriate antibiotics in a cohort of ED patients with septic shock. ⋯ We identified a sub-group of septic shock patients triaged to a lower acuity treatment location who received significant delays to antibiotics. This research area deserves closer examination to potentially recognise septic shock earlier in the continuum.
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Emerg Med Australas · Dec 2020
Observational StudyOxycodone prescribing in the emergency department during the opioid crisis.
Misuse of prescription opioids is a significant public health issue in Australia. There has been a rapid rise in prescription opioid use, with an associated increase in overdose and death. The over-prescribing of oral opioids, especially oxycodone, in the ED has been identified as a contributor to this problem overseas. It is unclear if similar practice occurs in the Australian ED. The primary aim of our study was to identify the incidence of oral oxycodone administration to patients within the ED. The secondary outcome was to identify the incidence of oxycodone prescribed to patients on discharge from the ED into the community. ⋯ There is a higher incidence of oxycodone prescribing in the Australian ED than previously recognised. An overuse of oxycodone may be contributing to adverse patient outcomes and a public health crisis. Hospitals should consider appropriate steps to reduce the incidence of opioid prescribing and the supply of these medications into the community.
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Emerg Med Australas · Dec 2020
Management of patients with low back pain in the emergency department: Is it feasible to follow evidence-based recommendations?
Low back pain is frequently seen in patients visiting the ED, but many patients receive medical care with no demonstrable benefits. We studied the clinical characteristics of patients visiting two EDs in Santiago, Chile, and their management to evaluate how it adheres to evidence-based recommendations. ⋯ Older age, the presence of red flags and pain intensity influenced the management of patients with low back pain in the ED. Future strategies should emphasise avoiding costly and ineffective management in these patients.
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Emerg Med Australas · Dec 2020
Observational StudyImpact of COVID-19 State of Emergency restrictions on presentations to two Victorian emergency departments.
To determine if COVID-19 State of Emergency (SOE) restrictions were associated with a reduction in presentations to two urban EDs in Melbourne, Victoria. ⋯ SOE restrictions were associated with a significant reduction in ED presentations across a range of triage categories and diagnoses. Public health messaging should emphasise the importance of timely ED attendance for acute illness and injury.