Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2005
Occult pneumothorax in trauma patients: should this be sought in the focused assessment with sonography for trauma examination?
At present, CT scan is the gold standard for detecting occult traumatic pneumothorax not apparent on supine chest X-ray radiograph. Recently there were suggestions to expand focused assessment with sonography for trauma (FAST) to include thoracic ultrasound for detecting pneumothorax. The aim of the present study is to determine the incidence of occult pneumothorax (as shown by CT) in the subgroup of trauma patients undergoing FAST. ⋯ The incidence of occult pneumothorax in the subgroup of trauma patients undergoing FAST is low. It implies that routine screening for its presence by adding thoracic ultrasound to FAST is unnecessary. Identifying those at risk of occult pneumothorax for further investigation appeared feasible.
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Emerg Med Australas · Oct 2005
Difference in trauma team activation criteria between hospitals within the same region.
The present study was conducted to establish the current criteria for trauma team activation (TTA) in hospitals in the Metropolitan Sydney area, and examine the rationale behind their use. ⋯ The criteria for TTA differ between hospitals within the same region. The criteria currently used will result in over-triage of trauma patients, but this might be of benefit in training the trauma team in centres that do not see a large volume of trauma patients. There are several advantages in standardization of criteria including optimization of patient care, training, research and audit. Further work is needed to validate existing criteria for use throughout the region.
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Emerg Med Australas · Aug 2005
Comparative StudyHelicopter primary retrieval: tasking who should do it?
Cairns Base Hospital utilizes a helicopter retrieval system, which until 2001 had been tasked and staffed by emergency physicians. Since 2001, the ambulance service has assumed the role of both tasking and staffing the helicopter with intensive care paramedics. The present study examines whether the change has resulted in different activation patterns and patient outcomes. ⋯ The similarities in outcomes for admitted patients support the view that both groups have similar tasking criteria for high-acuity patients and suggest that paramedics are as efficacious as physicians in delivering prehospital care in this group of patients. However, for lower-acuity patients, there is a statistically significant higher rate of clinically unnecessary taskings by the ambulance group. Given the recent fatal aeromedical accidents in Queensland (Thursday Island 1998, Rockhampton 1999 and Mackay 2003), it would seem prudent to reduce clinically unnecessary retrievals through clinical coordination with appropriately qualified emergency physicians.