Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2004
The potential role of procalcitonin in the emergency department management of febrile young adults during a sustained meningococcal epidemic.
To prospectively investigate the diagnostic characteristics of procalcitonin as an aid in the diagnosis of meningococcal disease in febrile young adults presenting to the Waikato Hospital emergency department during a sustained meningococcal epidemic. ⋯ The finding of a procalcitonin level > or = 0.5 ng/mL in young adults with undifferentiated fever indicates an increased chance that the presenting illness may be meningococcal disease. In New Zealand's continuing meningococcal epidemic empirical antibiotics should be strongly considered in those with elevated procalcitonin levels in the hope of reducing meningococcal disease deaths due to delays in antibiotic administration.
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Emerg Med Australas · Apr 2004
Mental health and alcohol and other drug training for emergency department workers: one solution to help manage increasing demand.
To evaluate a training course for ED staff aiming to improve knowledge and skills in working with mental health and drug/alcohol patients attending EDs. ⋯ The course has led to staff feeling more confident and competent to help mental health or drug/alcohol patients who attend the ED.
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To investigate the incidence and describe the nature of non-motorized scooter related injuries in children presenting to the ED. ⋯ There has been no significant change in scooter injury presentations over the two summer periods of 2000 and 2001. Children presenting to the ED with a scooter related injury tend to be primary school aged, which may have implications on scooter design, age recommendations and safety guidelines.
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The object of this review is to discuss the recognition and treatment of septic shock in children based on principles of resuscitation, antibiotic use and recent therapeutic advances. ⋯ Septic shock remains a leading cause of morbidity and mortality in children. Early administration of empirical antibiotic therapy reduces mortality. The keystone of resuscitation is aggressive volume replacement. Adjunctive therapies to modulate the inflammatory response may further enhance outcome, but do not replace principles of resuscitation.
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Emerg Med Australas · Apr 2004
Clinical TrialA pilot trial of BIS monitoring for procedural sedation in the emergency department.
Procedural sedation is common in the ED. However, there is no objective physiologic parameter available to monitor a patient's conscious state. The Bispectral Index (BIS) monitor has been validated as an objective measure of depth of anaesthesia. We studied the BIS monitor for this role in procedural sedation. ⋯ BIS monitoring is feasible in the ED. Our small study suggests that there is a poor correlation between BIS values and the OAAS scale. Larger studies are required to further explore this relationship. Further developments in brain monitoring technology are also needed before this form of monitoring becomes clinically useful for procedural sedation.