Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2005
Factors associated with walkout of patients from New South Wales hospital emergency departments, Australia.
To explore the association between daily patient numbers, sociodemographic, clinical and system characteristics and walkout rates of patients from New South Wales (NSW) public hospital ED (without seeing a medical officer). ⋯ After adjusting for triage category (urgency of presentation) and triage time, patients from lower socioeconomic backgrounds and those without private health insurance coverage were more likely to leave ED without treatment. These results have important implications for Health Services. Future strategies aimed at minimizing walkouts from public hospital ED should prioritize and target factors identified in the present study.
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Emerg Med Australas · Oct 2005
Case ReportsDefinitive management of acute cardiac tamponade secondary to blunt trauma.
Blunt cardiac injuries are a leading cause of fatalities following motor-vehicle accidents. Injury to the heart is involved in 20% of road traffic deaths. Structural cardiac injuries (i.e. chamber rupture or perforation) carry a high mortality rate and patients rarely survive long enough to reach hospital. ⋯ The presence of normal clinical signs or normal ECG studies does not exclude tamponade. In recent years the widespread availability and use of ultrasound for the initial assessment of severely injured patients has facilitated the early diagnosis of cardiac tamponade and associated cardiac injuries. Two cases of survival from blunt traumatic cardiac trauma are described in the present paper to demonstrate survivability in the context of rapid assessment and intervention.
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Emerg Med Australas · Oct 2005
Case ReportsUnusual cause of sudden onset headache: spontaneous intracranial hypotension.
Spontaneous intracranial hypotension is a very distinctive but unusual cause of acute headache. The postural nature of the headache can be easily overlooked in the celerity to exclude subarachnoid haemorrhage. We describe the clinical and radiological features of a case that emphasizes some of the diagnostic difficulties. An approach to management and treatment for this condition is outlined.
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Emerg Med Australas · Oct 2005
Comparative StudyImpact on patients triage distribution utilizing the Australasian Triage Scale compared with its predecessor the National Triage Scale.
To assess the impact of the change from the National Triage Scale (NTS) to the Australasian Triage Scale (ATS) within a hospital ED. ⋯ The revision of the ATS has had a significant impact on the triage distribution of patients who present to ED. The change of distribution might have implications for meeting performance criteria and assessing casemix.
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Emerg Med Australas · Oct 2005
Self-reported antibiotic compliance: emergency department to general practitioner follow up.
General practitioner (GP) follow up is important in the management of patients who are discharged from an ED. ⋯ The majority of patients who were seen and discharged from the ED with an antibiotic prescription were able to nominate a GP and this was associated with improved follow-up compliance and antibiotic compliance. Improving follow-up compliance and thus the quality of patient care would involve identifying those patients who present to the ED who are unable to nominate a GP.