Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2025
ReviewReview article: Somatization Disorders in emergency department: A critical overview of current challenges and future directions.
Individuals with Somatization Disorders present frequently to the ED with non-cardiac chest pain, non-specific abdominal pain, headaches and a range of other non-specific symptoms. Somatization Disorder presentations are ubiquitous within the healthcare system. ⋯ The current review explores the scope of the problem and, the challenges inherent in diagnosing and treating these disorders in ED environments. Based on available evidence and the essential character of these disorders, future directions are suggested for more effective emergency management and possible referral from ED.
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Emerg Med Australas · Feb 2025
ReviewReview article: Efficacy of cyproheptadine in the management of serotonin toxicity following deliberate self-poisoning - A systematic review.
Serotonin toxicity is a potentially fatal condition caused by increased serotonergic activity in the central nervous system. Cyproheptadine, a serotonergic antagonist, is recommended for treatment; however, there is a lack of evidence to support its use. The present study aimed to evaluate the evidence for the use of cyproheptadine in the management of serotonin toxicity following deliberate self-poisoning. ⋯ Few reports commented on clinical resolution and therefore efficacy was not established. All studies were graded as being of very low evidence and at high risk of bias. There is a lack of evidence to support the efficacy of cyproheptadine or its recommendation in clinical guidelines pertaining to the management of serotonin toxicity.
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Emerg Med Australas · Feb 2025
ReviewReview article: Evaluating the effectiveness of arterial pressure point techniques as a first aid method for external haemorrhage control: A systematic review.
The current ANZCOR guidelines for first aid management of life-threatening bleeding from a limb, where bleeding cannot be controlled with direct pressure, recommends the use of an arterial tourniquet. However, tourniquets required specialised training and equipment, which may not be accessible in all emergencies. This systematic review evaluated the effectiveness of arterial pressure point techniques (APPT) as a first aid measure for controlling life-threatening, non-compressible bleeding from limbs and anatomical junctions. ⋯ Additional research with higher levels of evidence, standardised protocols and larger sample sizes is needed. Investigation in real-world scenarios is crucial to compare methods like tourniquets. Future research will determine APPT's effectiveness and its potential role as a bridging technique before tourniquet application or medical assistance.