Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2023
ReviewClosing the miscommunication gap: A user guide to developing picture-based communication tools for Aboriginal and Torres Strait Islander peoples in emergency departments.
To document an illustration-based methodology for culturally safe communication between Indigenous patients and clinicians in an urban ED. ⋯ Co-design methodologies can guide improvements in culturally safe clinical communication with First Nations patients in EDs.
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To assess Australian and New Zealand emergency clinicians' attitudes towards the use of artificial intelligence (AI) in emergency medicine. ⋯ Emergency clinicians interviewed were generally optimistic about the use of AI in emergency medicine, so long as it is used as a decision support tool and they maintain the ability to override its recommendations.
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Emerg Med Australas · Apr 2024
Nine recommendations for the emergency department for patients presenting with low back pain based on management and post-discharge outcomes in an Australian, tertiary emergency department.
To ascertain and develop recommendations for analgesic management, discharge planning and further healthcare utilisation of adults presenting to an Australian tertiary ED with radicular or low back pain (LBP). ⋯ ED presentations for LBP were more often treated pharmacologically than non-pharmacologically, with opioids commonly prescribed and NSAIDs potentially under-utilised. Post-discharge, additional investigations/referrals, discharge analgesia reductions and maintenance of non-pharmacological management were common. Opioid initiation as a result of LBP presentations, signifies a potential 'gateway' towards unintentional long-term use. Key study findings form our nine recommendations to inform ED LBP pain management.
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Emerg Med Australas · Oct 2023
ReviewReview article: Accuracy of emergency physician performed point-of-care ultrasound of the thoracic aorta: A systematic review and narrative synthesis of the literature.
Point-of-care ultrasound (POCUS) is becoming ubiquitous in emergency medicine. POCUS for abdominal aortic aneurysm is well established in practice. The thoracic aorta can also be assessed by POCUS for dissection and aneurysm and transthoracic echocardiography is endorsed by international guidelines as an initial test for thoracic aortic pathologies. ⋯ We suggest that detection of thoracic aorta dilation >40 mm by POCUS at any site increases the suspicion of serious aortic pathology. Studies incorporating algorithmic use of POCUS, Aortic Dissection Detection Risk Score and D-dimer as decision tools are promising and may improve current ED practices. Further research is warranted in this rapidly evolving field.
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Emerg Med Australas · Feb 2024
Appraisal of Australian and New Zealand paediatric sepsis guidelines.
Clinical practice guidelines (CPGs) are an important tool for the management of children with sepsis. The quality, consistency and concordance of Australian and New Zealand (ANZ) childhood sepsis CPGs with the Australian Commission on Safety and Quality in Healthcare (ACSQHC) sepsis clinical care standards and international sepsis guidelines is unclear. ⋯ Childhood sepsis CPGs in current use in ANZ are of variable quality and lack consistency with key treatment recommendations. CPGs are concordant with the ACSQHC care standard, but not with international sepsis guidelines. A bi-national sepsis CPG may reduce unnecessary variation in care.