Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2025
Randomized Controlled TrialSuperior efficacy of intramuscular diclofenac compared to intravenous tramadol for acute renal colic in northern Thai patients: A randomised double-blind, sham-controlled trial.
The present study aimed to compare time to effective pain relief between diclofenac 75 mg intramuscular (IM) and tramadol 50 mg intravenous (IV) for ED patients with acute renal colic. ⋯ Diclofenac 75 mg IM provides faster effective pain relief compared with tramadol 50 mg IV.
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Improved understanding of the deteriorating patient in the pre-hospital setting may result in earlier recognition and response. Considering the effects of undetected deterioration are profound, it is fundamental to report the prevalence of pre-hospital clinical deterioration to advance our understanding. The present study investigated the prevalence of pre-hospital clinical deterioration and adverse events (AEs) within 3 days of the pre-hospital episode of care. ⋯ The present study found the prevalence of pre-hospital clinical deterioration and AEs subsequent to pre-hospital episodes of care to be low. Future research should prioritise using standardised criteria to define pre-hospital clinical deterioration and evaluate the performance of early warning scores.
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Emerg Med Australas · Feb 2025
Supporting clinicians post exposure to potentially traumatic events: Emergency department peer support program evaluation.
Workers in EDs are regularly exposed to potentially traumatic events. Since the COVID-19 pandemic, there has been exponential interest in peer support programs (PSPs) in a range of settings. We describe a PSP implemented in 2017 at University Hospital Geelong (UHG) ED together with results of a survey. ⋯ ED Doctors place high value on the PSP.
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Emerg Med Australas · Feb 2025
Comparative StudyComparison of mechanical restraint use in a metropolitan ED after system change: A before and after analysis.
Prior to 2020, Nepean ED had high rates of restraint of mental health (MH) patients compared to peer hospitals. Restraint can cause emotional and physical trauma to patients and staff and should be used as seldom as possible. The ED undertook a project to reduce the number and duration of restraint episodes, involving telepsychiatry, culture change, staff education, increasing use of sedation and bedside engagement in de-escalation techniques. ⋯ After a year of change implementation, there was a reduction in the use of restraints and an increase in the use of sedation in 2021 when compared to 2019.
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Emerg Med Australas · Feb 2025
Trauma system management of adults with severe burns in Victoria, Australia.
The aim of the present study was to examine the profile, management and outcomes of adult patients with severe burns within the Victorian State Trauma System (VSTS). ⋯ Severe burns are uncommon injuries with high mortality. There is a high rate of adherence to VSTS guidelines for managing patients with severe burns, and a decrease in patients requiring transfer associated with an increase in acceptable time to a trauma-receiving hospital. The VSTS operates to deliver almost all patients with severe burns to the definitive burns service efficiently.