Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2020
Shetty test in ankle and foot trauma: An emergency department pilot study assessing specificity and sensitivity.
To assess the potential impact of the Shetty test over Ottawa ankle foot rules (OAFR) on plain imaging utilisation in the ED. ⋯ Shetty test may safely reduce unneeded radiographs in ED. Further research is warranted.
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Major trauma is associated with blood loss and hypothermia. It is common to replace lost fluid with red cells stored at 2-6°C, and/or colloid/crystalloid fluid stored at ambient temperature, thus increasing hypothermia risk. At trauma and medical retrieval sites, mains electricity powered fluid warmers cannot be generally used. Latent heat provides an alternate practical method of portable temperature-controlled intravenous fluid warming. This work investigates the safety and efficacy of a fluid warmer powered by latent heat. ⋯ The latent heat fluid warmer was shown to safely warm transfused blood in a controlled clinical setting.
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Emerg Med Australas · Aug 2020
Incidence and outcomes of aortic dissection for emergency departments in New South Wales, Australia 2017-2018: A data linkage study.
The aims of the present study were to describe the age-specific incidence and 30-day mortality of aortic dissection patients presenting to the EDs in New South Wales (NSW). ⋯ The present study found the incidence of aortic dissection within the NSW population to be 3.4 per 100 000. The incidence of aortic dissection in our population increased from 8.6 per 100 000 for people aged between 60 and 80 years to 32 per 100 000 for those aged over 80 years.
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An unconscious patient with an extra-dural haematoma may not survive transfer to a neurosurgical centre for definitive care. This article describes a simple approach to a decompressive craniotomy which may be life-saving in these patients when a neurosurgeon is not available.
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Emerg Med Australas · Aug 2020
Directors of emergency medicine's beliefs about, barriers to, and enablers of solutions to emergency department crowding and access block.
To identify opportunities for directors of emergency medicine (DEMs) to lead change efforts to address ED crowding and access block. ⋯ Addressing the political and cultural forces that sustain ED crowding and access block are key adaptive challenges requiring DEM leadership.