Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2020
Randomized Controlled Trial Multicenter StudyImplementation study reporting diagnostic accuracy, outcomes and costs in a multicentre randomised controlled trial of non-expert lung ultrasound to detect pulmonary oedema.
Lung ultrasound experts claim that 'B line' artefacts herald pulmonary oedema, but links between early recognition and improved outcome are unconfirmed, particularly for non-expert clinicians. ⋯ Non-expert LUS augmenting dyspnoea workup may improve diagnostic accuracy, but did not significantly alter costs or outcomes in the ED or the hospital.
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Emerg Med Australas · Jun 2019
Randomized Controlled TrialUltrasound-guided femoral nerve blocks are not superior to ultrasound-guided fascia iliaca blocks for fractured neck of femur.
To determine if an ultrasound-guided femoral nerve block (FNB) is superior to an ultrasound-guided fascia iliaca compartment block (FICB) in providing pain relief to patients with a neck of femur or proximal femoral fracture. ⋯ Ultrasound-guided FNB is not superior to ultrasound-guided FICB, with both facilitating an equivalent analgesia effect in patients with a neck of femur or proximal femur fracture.
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Emerg Med Australas · Jun 2018
Randomized Controlled Trial Multicenter StudyMedication use in infants admitted with bronchiolitis.
There are no medications known that improve the outcome of infants with bronchiolitis. Studies have shown the management of bronchiolitis to be varied. ⋯ Medication was used for infants with bronchiolitis frequently and variably in Australia and New Zealand. Medication use increased with age. Better strategies for translating evidence into practice are needed.
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Emerg Med Australas · Apr 2018
Randomized Controlled Trial Observational StudyTiming of antibiotics in the management of community-acquired sepsis: Can a randomised controlled trial of prehospital therapy provide answers?
Significant tension surrounds the application of antibiotics in suspected infection. Guidelines stress the importance of early empirical broad-spectrum therapy, with select observational data suggesting inferior outcomes when this is delayed. ⋯ Controlled trial data are urgently needed, although many clinicians would find withholding of antibiotic therapy unethical. A trial of prehospital antibiotic administration (by paramedics) in patients with suspected sepsis would therefore provide crucial data, and go a long way to determining whether earlier empirical therapy does actually improve outcomes.
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Emerg Med Australas · Oct 2017
Randomized Controlled TrialControlled clinical trial exploring the impact of a brief intervention for prevention of falls in an emergency department.
To establish the effectiveness of a brief intervention to prevent falls in older patients presenting to the ED post-discharge. ⋯ A brief intervention was associated with maintenance of function in fallers and reduced hospital admissions, without preventing falls post-discharge.