Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2023
Randomized Controlled TrialDroperidol versus ondansetron for nausea treatment within the emergency department.
A randomised single-blind trial was undertaken in an adult ED population, comparing the effectiveness of droperidol 2.5 mg IV with ondansetron 8 mg IV for the treatment of nausea and vomiting. ⋯ There was no statistically significant difference in the primary outcome of symptom improvement between droperidol and ondansetron. Secondary outcomes which favour droperidol warrant further exploration.
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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
Introduction of an emergency medicine pharmacist-led sepsis alert response system in the emergency department: A cohort study.
To determine effects of implementing a sepsis alert response system in the ED that included early intervention by emergency medicine (EM) pharmacists. ⋯ Implementation of a sepsis alert response that included early involvement of the EM pharmacist was associated with improvement in time to antimicrobials and other components of the sepsis bundle. An upfront, multidisciplinary approach to patients presenting to the ED with suspected sepsis should be considered more broadly.
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Emerg Med Australas · Aug 2023
Case ReportsFeasibility of a rapid diagnosis discussion tool for reducing misdiagnosis of patients presenting to emergency departments with abdominal pain.
Providing accurate and timely diagnoses is challenging in ED settings. We evaluated the feasibility and effectiveness of a short, structured rapid diagnosis discussion (RaDD) between a patient's initial doctor and a second doctor for patients presenting to ED with abdominal pain. ⋯ RaDD encouraged clinicians to take a more cautious, risk-averse approach to care and improved confidence in their diagnostic decisions. However, cost effectiveness of these outcomes and possible implementation barriers need to be further considered in subsequent studies.
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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.