Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2025
ReviewReview article: Primer for clinical researchers on innovative trial designs for emergency medicine.
Randomised trials have long been recognised as the gold standard research tool for evidence-based medicine. The past decade has seen the emergence of several innovative trial designs that are revolutionising how trials are conducted. ⋯ We describe the main features of each design, outline their pros and cons, and describe when they may or may not be useful. We also provide examples of these innovative designs in contexts that are relevant to emergency medicine.
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Emerg Med Australas · Feb 2025
Observational StudyEvaluation of older patients with minor blunt head trauma to identify those who do not have clinically important traumatic brain injury and can be safely managed without cranial computed tomography.
Our primary aim was to identify a low-risk subgroup of older adults (aged 65 and older) presenting to ED with minor head trauma which can be safely managed without a cranial CT (cCT). ⋯ Alert, haemodynamically stable, older ED adults with suspected head trauma had a low incidence of ciTBI in the present study. Abnormal physical examination findings were consistently present in patients with ciTBI. Shared decision-making prior to cCT may be the pragmatic way ahead in the management of this patient cohort, especially among those from RACFs.
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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.
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Emerg Med Australas · Feb 2025
Effectiveness of a Disability Liaison Officer service in a metropolitan emergency department.
To identify the influence of a Disability Liaison Officer (DLO) service in the ED setting on people with disability (PWD). For this project, PWD included adults with communication disability, intellectual disability or autism spectrum disorder. ⋯ The DLO service was associated with a reduction in ED LOS for PWD. Further assessment of the service using patient- and carer-reported outcome measures and cost-effectiveness studies are indicated.