Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2022
Observational StudyHigher quality of care in emergency departments with physiotherapy service models.
To investigate the quality of care provided by EDs with physiotherapy services compared to those without, using established musculoskeletal process and outcome quality indicators (QIs). ⋯ EDs with physiotherapists provide at least equivalent or higher quality of care for patients with musculoskeletal injuries than those EDs with limited access to physiotherapists. This may be because of their specialised training in musculoskeletal diagnosis and treatment, as well as the impact of teaching and mentoring for other ED clinicians.
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Emerg Med Australas · Apr 2022
Chlorhexidine skin cleaning to reduce clean-catch urine contamination in infants: A pilot study.
Clean-catch urine (CCU) samples are frequently contaminated. Our aim was to determine if cleaning with 0.1% chlorhexidine before CCU is a safe and feasible method to reduce contamination. ⋯ Cleaning with chlorhexidine solution before CCU is safe and feasible.
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Emerg Med Australas · Apr 2022
Neonatal emergency transport teams and general emergency departments: Who will intubate the neonate?
Confidence treating critically ill infants presenting to general ED may be limited by inexperience, with procedures deferred until specialised transport teams arrive. ⋯ Referring ED physicians perform the majority of critical procedures where infants require inter-hospital transfer by neonatal emergency transport service.
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Emerg Med Australas · Apr 2022
Observational StudyMapping haemodynamic changes with rapid sequence induction agents in the emergency department.
Patients intubated in the ED are at an increased risk of post-intubation hypotension. However, evidence regarding the most appropriate induction agent is lacking. The present study aims to describe and compare the haemodynamic effect of propofol, ketamine and thiopentone during rapid sequence induction. ⋯ Propofol was associated with post-intubation hypotension and it is recommended clinicians consider using the lowest effective dose to reduce this risk. Reflecting its perceived haemodynamic stability, patients who received ketamine were more likely to have a higher shock index; however, there was also an association with post-intubation hypotension.
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Emerg Med Australas · Apr 2022
Management of patients presenting with low back pain to a private hospital emergency department in Melbourne, Australia.
Recent studies suggest many patients with non-specific low back pain presenting to public hospital EDs receive low-value care. The primary aim was to describe management of patients presenting with low back pain to the ED of a private hospital in Melbourne, Australia, and received a final ED diagnosis of non-specific low back pain. We also determined predictors of hospital admission. ⋯ We observed high rates of imaging, pathology tests and hospital admissions compared with previous public hospital studies, while medication use was similar. Implementation of strategies to optimise evidence-based ED care is needed to reduce low-value care and improve patient outcomes.