Emergency medicine Australasia : EMA
-
Emerg Med Australas · Oct 2023
Drug and alcohol intoxication in major trauma: Associations, trends and outcomes over a decade.
Drug and alcohol intoxication is common among injured patients altering trauma presentation and characteristics. However, uncertainty exists regarding the effect of intoxication on injury severity, as well as outcomes. The present study aims to provide an update on substance-use patterns and their association with traumatic presentation and outcome within a contemporary Australian context. ⋯ Within this contemporary Australian population, we demonstrate escalating rates of drug intoxication and declining rates of alcohol intoxication prior to trauma. Intoxication was associated with more frequent violent and non-accidental injury, and despite no difference in severity, it was associated with worse outcomes.
-
Emerg Med Australas · Oct 2023
Pathology testing in non-trauma patients presenting to the emergency department with recurrent seizures.
Excessive pathology testing is associated with ED congestion, increased healthcare costs and adverse patient health outcomes. This study aimed to determine the frequency, yield and influence of pathology tests among patients presenting to the ED with atraumatic recurrent seizures. ⋯ Most patients presenting to the ED with atraumatic recurrent seizures underwent pathology tests. Abnormalities were frequently detected but were uncommonly associated with change in management. Abnormal pathology test results were associated with changes in antiepileptic drug management although rarely led to acute changes in patient management. This study suggests that pathology tests may be excessively requested in this population.
-
Emerg Med Australas · Oct 2023
Choosing Wisely audit: Blood gas ordering in the emergency department.
Our aim was to reduce unnecessary blood gases to improve patient flow, reduce false positives and reduce unnecessary treatments. ⋯ We have found that many blood gases are ordered for patients who are not critically unwell, and whose disposition was not affected by their result.
-
Emerg Med Australas · Oct 2023
Twenty-year perspective on blunt traumatic diaphragmatic injury in level 1 trauma centre: Early versus delayed diagnosis injury patterns and outcomes.
Blunt traumatic diaphragmatic injury (TDI) is typically associated with severe trauma and concomitant injuries. It is a diagnostic challenge in the setting of blunt trauma and can be easily overlooked especially in the acute phase often dominated by concurrent injuries. ⋯ The diagnosis of TDI is challenging. Without frank signs of herniation of abdominal contents on CXR or CT, the diagnosis is often not made on initial imaging. In patients with the evidence of blunt traumatic injury in the lower-chest/upper-abdomen, a high degree of clinical suspicion should be held and follow-up CXRs/CTs arranged.