Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2022
ReviewReview article: Ankle intra-articular haematoma block for reduction of unstable ankle fractures in the emergency department: An integrative review.
A review was conducted to assess the efficacy and safety of the intra-articular haematoma block (IAHB) for manipulation of ankle fractures in ED. Any study investigating the success of IAHB for ankle fracture reduction published in English was sought. Seven databases were searched. ⋯ Findings suggest that IAHB might be safe and effective but the evidence is very limited. High-quality research is required before IAHB can be considered a routine alternative. However, IAHB could be considered in situations where the risk of procedural sedation outweighs the likely very low risk of chondrolysis.
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Emerg Med Australas · Oct 2022
ReviewReview article: A primer for clinical researchers in the emergency department: Part XII. Sustainability of improvements in care: An introduction.
Despite an increased focus on ways to improve implementation of evidence and de-implementation of practices with no known benefit, there is limited guidance on how to sustain these improvements. This review provides an introduction to sustainability of improvements in care and sustainability research, discussing how to support sustainability in practice and detailing a sustainability research agenda for the emergency medicine setting.
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Emerg Med Australas · Oct 2022
ReviewReview article: Roles of activities of daily living and frailty assessments for residents of residential aged care services in emergency department transfers: A scoping review.
Residents from residential aged care services (RACS) (i.e. nursing homes) many of whom are frail or disabled, are frequently transferred to ED for treatment of acute episodes of illness or injury. This review scoped the research related to the ways in which frailty or activities of daily living (ADL) measures are used for clinical purposes, either prior to the transfer of patients to ED or in ED themselves. A search for original studies up to June 2021 that included participants aged 65 years or over was conducted across four databases. ⋯ No results were found that associated the assessment of ADL or frailty with decisions related to treatment in the ED. A single ED study involved specialist emergency nursing in an ED as an intervention which included frailty assessment and led to decreased hospitalisation. This scoping review confirms an opportunity for further research into the ways frailty and ADL assessments are used for decision making in relation to the transfer of frail older people to ED, including how these assessments influence their treatment.
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Emerg Med Australas · Aug 2022
ReviewReview article: Clinical manifestations and outcomes of chronic nitrous oxide misuse: A systematic review.
Recreational nitrous oxide (N2 O) use is widespread, and complications associated with its use are increasingly common. We sought to identify risk factors, clinical features and outcomes in individuals presenting with effects of chronic N2 O abuse to develop an approach to clinical assessment and management. A systemic literature review was completed with searches conducted across EMBASE, MEDLINE, PSYCINFO and Cochrane databases. ⋯ As B12 is often normal, homocysteine and methylmalonic acid are important biomarkers of disease. An approach to diagnosis is offered but requires validation in prospective studies. Research exploring B12 and methionine therapy is required to refine management.
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Emerg Med Australas · Aug 2022
ReviewReview article: Clinical manifestations and outcomes of chronic nitrous oxide misuse: A systematic review.
Recreational nitrous oxide (N2 O) use is widespread, and complications associated with its use are increasingly common. We sought to identify risk factors, clinical features and outcomes in individuals presenting with effects of chronic N2 O abuse to develop an approach to clinical assessment and management. A systemic literature review was completed with searches conducted across EMBASE, MEDLINE, PSYCINFO and Cochrane databases. ⋯ As B12 is often normal, homocysteine and methylmalonic acid are important biomarkers of disease. An approach to diagnosis is offered but requires validation in prospective studies. Research exploring B12 and methionine therapy is required to refine management.