Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2023
Observational StudyToxicology presentations to a tertiary unit in New South Wales during the COVID-19 pandemic first wave: A retrospective comparison study.
To compare presentation numbers, class of exposure, poison severity score (PSS) and drugs ingested by patients in a tertiary toxicology service during the first wave of the COVID-19 pandemic to the corresponding time periods in 2018 and 2019. ⋯ There was a relative increase in toxicology presentations during the COVID-19 pandemic compared to an overall decrease in presentations to ED. Recreational drug use increased significantly during the pandemic compared to 2018.
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Emerg Med Australas · Feb 2023
Observational StudyClinical Characteristics and Predictors for Hospitalisation During the Initial Phases of the Delta Variant Covid-19 Outbreak Sydney, Australia.
The COVID-19 Delta variant of concern continues to pose significant challenges to health systems globally, with increased transmissibility and different patient populations affected. In Sydney, a virtual model of care was implemented in response to the COVID-19 pandemic and Special Health Accommodation (SHA) was made available for community patients with COVID-19 who could not isolate at home or needed health support. ⋯ Initial symptoms and vital signs were just as predictive for short-term deterioration as age and pre-existing comorbidities and should be included in future risk prediction models for COVID-19. Based on this, we derive a proposed risk prediction score that incorporates these predictors with further validation required.
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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.
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Emerg Med Australas · Feb 2023
Observational StudyLonger times in computed tomography for trauma patients result in a decrease in body temperature.
To determine if lower ambient temperatures in computed tomography (CT) rooms contribute to accidental hypothermia (≤35°C) in trauma patients. ⋯ Increasing time spent in CT leads to a decrease in body temperature in trauma patients. Clinicians should actively reduce time spent in the CT room and take active warming measures.