Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2020
Domestic and family violence, non-lethal strangulation and social work intervention in the emergency department.
To review domestic and family violence (DFV) and non-lethal strangulation (NLS) presentations to an ED with 24-h social work. ⋯ Social work referral for DFV is regularly missed despite 24-h access. Assessment of NLS in ED requires improvement and standardised national guidelines.
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Lung ultrasound (LUS) plays a critical role in the SARS-CoV-2 pandemic. Evidence is mounting on its utility to diagnose, assess the severity and as a triage tool in the ED. ⋯ In this article, we have described a step-by-step approach to LUS in COVID patients and the CLUE (COVID-19 LUS in the ED) protocol, which involves an anatomical parameter, the severity of lung changes, objectively scored using the validated LUS scoring system and a physiological parameter, oxygen requirement. We believe this CLUE protocol can help risk-stratify patients presenting to ED with suspected COVID-19 and aid clinicians in making appropriate disposition decisions.
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Emerg Med Australas · Aug 2020
Predictors and in-hospital mortality associated with prolonged emergency department length of stay in New South Wales tertiary hospitals from 2017 to 2018.
To determine specific patient, clinical and service factors associated with increased ED length of stay and investigate whether prolonged ED length of stay, as measured by emergency treatment performance (ETP) non-compliance, is an independent predictor of all cause 30-day mortality for patients presenting to, and admitted from ED. ⋯ Patients with complex and multiple medical comorbidities, and those admitted under certain service-related groups such as psychiatry, surgery and oncology were found to have poorer ETP performance. Overall, failure to meet ETP was associated with increased mortality after adjusting for age, case-mix, comorbidities and acuity.
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Emerg Med Australas · Aug 2020
Randomized Controlled TrialPropofol for migraine in the emergency department: A pilot randomised controlled trial.
To test the administration of intravenous (i.v.) propofol at a procedural sedation dose compared to standard therapy for initial management of migraine in the ED. ⋯ Initial management of migraine with i.v. propofol at procedural sedation doses significantly reduced TTD compared to standard therapy. We did not detect any significant safety concerns although the study was not adequately powered to detect safety of the intervention and requires validation.