Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2025
SAFE: Safety of procedural sedation and analgesia administration in the fast-track area of the emergency department.
To determine whether undertaking procedural sedation in the low-acuity fast-track area is safe and effective in improving patient flow. ⋯ The sedation of patients outside a high-acuity area is safe and significantly improves patient flow.
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Emerg Med Australas · Feb 2025
Review Meta AnalysisReview article: Electronic screening and brief intervention for alcohol-related trauma: A systematic review and meta-analysis.
This systematic review and meta-analysis aimed to evaluate the effectiveness of Electronic Screening and Brief Intervention (e-SBI) in changing or reducing alcohol consumption and/or related risk behaviours among trauma patients compared to standard of care. Following Cochrane Collaboration's guidelines and PRISMA recommendations, a search of electronic databases (MEDLINE via PubMed, CINAHL, Scopus and Web of Science) and grey literature (Google Scholar) was conducted. Randomised controlled trials (RCTs) from 1995 to 2023 were included, focusing on e-SBI for alcohol misuse in trauma patients. ⋯ However, uncertainties and methodological variations highlight the need for standardised outcome measurements, consistent reporting and further exploration of e-SBI's long-term impact. Relevance to health promotion: Understanding the effectiveness of e-SBI in managing alcohol-related issues among trauma patients is crucial for health promotion. Despite uncertainties, the findings underscore the potential of e-SBI as a scalable and accessible intervention. e-SBI in the setting of the present study, emphasises the importance of tailored approaches in public health strategies.
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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
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
Comparative StudyRethinking the pan scan in stable trauma: A comparison of whole-body computed tomography and selective imaging in clinically stable blunt force trauma.
To compare the frequency of clinically significant missed injuries in clinically stable trauma patients undergoing initial whole-body computed tomography (WBCT) versus selective imaging. Secondary objectives include comparisons of radiation exposure, incidental findings, ED length of stay (LOS), hospital LOS and mortality. ⋯ Missed injuries were rare and without major complications in this clinically stable cohort. The liberal use of WBCT, despite low rates of missed injuries, morbidity and mortality, suggests over-utilisation of WBCT for 'mechanism only' traumas.