Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2023
Randomized Controlled TrialSOFTLY: Comparison of outcomes of rigid versus soft collar during emergency department investigation for potential cervical spine injury in low-risk blunt trauma patients - A pilot study.
Blunt trauma patients with potential cervical spine injury are traditionally immobilised in rigid collars. Recently, this has been challenged. The present study's objective was comparison of the rate of patient-oriented adverse events in stable, alert, low-risk patients with potential cervical spine injuries immobilised in rigid versus soft collars. ⋯ Use of soft rather than rigid collar immobilisation for low-risk blunt trauma patients with potential cervical spine injury is significantly less painful for patients and results in less agitation. A larger study is needed to determine the safety of this approach or whether collars are required at all.
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Emerg Med Australas · Aug 2023
24 hours - Life in the E.R.: A state-wide data linkage analysis of in-patients with prolonged emergency department length of stay in New South Wales, Australia.
Describe the characteristics and predictors of mortality for patients who spend more than 24 h in the ED waiting for an in-patient bed and compare baseline clinical and demographic characteristics between tertiary and non-tertiary hospitals. ⋯ Interventions and models of care to address ED access block need to focus on mental health patients, older patients particularly those with cardiorespiratory illness and oncology and haematology patients for whom risk of mortality is disproportionately higher.
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Emerg Med Australas · Aug 2023
Intentional Paediatric Poisoning Presentations to Emergency Departments During the COVID-19 Pandemic.
To characterise paediatric poisoning presentations to EDs and determine if the advent of the COVID-19 pandemic was associated with increased intentional paediatric poisoning presentations. ⋯ Intentional paediatric poisoning presentations increased during the COVID-19 pandemic in our study population. These results may support an emerging body of evidence that the psychological strain of COVID-19 disproportionately impacts adolescent females.
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Emerg Med Australas · Aug 2023
Evolution in the choice of therapies used to treat latrodectism: Redback spider antivenom or standard analgesic medications. Nothing to rave about.
Redback spider (RBS) antivenom (RBSAV) use appears to have decreased since the results of the RAVE-2 antivenom efficacy study were released. The aims of this study were to assess change in RBSAV use over time and compare responses to treatment for antivenom and other analgesics. ⋯ Antivenom use fell over the study period. There was no difference in pain relief between RBSAV and analgesia-only groups. RBSAV, regardless of route of administration, was no better than standard analgesics in pain reduction in the present study.
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Emerg Med Australas · Aug 2023
Comment Observational StudyImpact of time of intensive care unit transfer and outcomes in patients with septic shock: An observational study.
To evaluate the association between time from ED presentation to intensive care unit (ICU) transfer on mortality in patients presenting with septic shock. ⋯ In patients presenting to the ED with septic shock, ED-to-ICU time less than 4 h was not associated with altered 90-day mortality, although this should be interpreted with caution due to study limitations.