Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2023
ReviewReview article: Early steroid administration for traumatic haemorrhagic shock: A systematic review.
Haemorrhagic shock after trauma is a leading cause of death worldwide, particularly in young individuals. Despite advances in trauma systems and resuscitation strategies, mortality from haemorrhagic shock has not declined over the previous two decades. A proportion of shocked trauma patients may experience a deficiency of cortisol relative to the severity of their injury. ⋯ Both studies were at risk of bias. There are no high quality or recent studies in the English literature investigating the use of steroids for haemorrhagic shocked trauma patients. PROSPERO: CRD42021239656.
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Emerg Med Australas · Feb 2023
Epidemiology, outcomes and predictors of mortality in patients transported by ambulance for dyspnoea: A population-based cohort study.
There are currently limited data to inform the management of patients transported by emergency medical services (EMS) with dyspnoea. We aimed to describe the incidence, aetiology and outcomes of patients transported by EMS for dyspnoea using a large population-based sample and to identify factors associated with 30-day mortality. ⋯ Dyspnoea is a common presentation with a broad range of causes and is associated with high rates of hospitalisation and death.
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Emerg Med Australas · Feb 2023
Bandaids are not the fix: Examining the patterns of injury-related emergency department presentations in Australian children.
To provide an epidemiological understanding of the types of injuries treated in ED in Australian children, describe the impact of these injuries in volume and severity, and assess the patterns by demographic and temporal factors. ⋯ This is the first large-scale quantification of paediatric injury-related ED presentation patterns in Australia since the conclusion of the National Injury Surveillance and Prevention Program about 30 years ago. It provides valuable information to inform paediatric ED resourcing decisions as well as important evidence for injury prevention practitioners.
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Emerg Med Australas · Feb 2023
Observational StudyDedicated nursing care pathway improved management of opioid-poisoned patients in the emergency department: A before-after observational study.
Opioid overdose is increasing and accounts for two-thirds of poisoning deaths. Opioid induced respiratory depression is life-threatening and can be under-recognised even in the hospital setting. We aimed to evaluate the effect of a care pathway on the management of opioid-poisoned patients. ⋯ Following the introduction of a dedicated opioid poisoning nursing care pathway, naloxone delivery and observation documentation increased. A care pathway may improve ED management of opioid poisoning.
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Emerg Med Australas · Feb 2023
Cervical spine immobilisation is only required in drowning patients at high risk of axial loading of the spine.
Wave forced impacts are known to result in cervical spine injuries (CSI) and approximately 20% of drownings in Australia occur at the beach. The most common mechanism of injury in studies examining the frequency of CSI in drowning patients is shallow water diving. The aim of the present study was to determine what proportion of CSIs occurring in bodies of water experienced a concomitant drowning injury in a location where wave forced impacts are likely to be an additional risk factor. ⋯ The combination of CSI and drowning is uncommon. Cervical spine precautions are only required in drowning patients with signs or a history, or at high risk of, axial loading of the spine. This paper supports the move away from routine cervical spine precautions even in a high-risk population.