Emergency medicine Australasia : EMA
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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.
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Emerg Med Australas · Aug 2005
Comparative StudyAssessment of cricoid pressure application by emergency department staff.
To assess the accuracy of cricoid force applied by ED staff working in two hospitals based on the New South Wales central coast. ⋯ The application of cricoid force by ED staff participating in the present study is unreliable, often providing inadequate protection against regurgitation. Training using a model integrating the concept of force is recommended. The role of cricoid pressure in rapid sequence induction needs to be further investigated.
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Thyrotoxic, hypokalaemic periodic paralysis is an uncommon, potentially life-threatening endocrine emergency. Because of the acute onset of neurological symptoms patients often initially present to hospital ED. To reduce patient morbidity and costs of unnecessary investigations, early recognition and appropriate treatment is required. The case of a young man of Singaporean origin is presented to highlight current treatment, management and pathophysiology of this condition.
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To evaluate the precipitants, subject characteristics, nature and outcomes of unarmed threats in the ED. ⋯ Acutely agitated subjects pose a threat to themselves and the staff caring for them. The reason for the agitation is multifactorial and the majority arrive in a behaviourally disturbed state requiring early intervention. The times most likely to result in a Code Grey coincide with least available resources: ED and hospital risk management policies must account for this. A coherent approach by ED to this population is required to optimize patient and staff outcomes.