Emergency medicine (Fremantle, W.A.)
-
Emerg Med (Fremantle) · Jun 2001
Reliability of modern microwave ovens to safely heat intravenous fluids for resuscitation.
To determine if intravenous fluid heated in modern microwave ovens is warmed to a consistently safe temperature, as has been advocated in a number of texts and journals. ⋯ The increased output power of modern microwave ovens can lead to overheating of resuscitation fluids, if the simple algorithm currently recommended is followed, leading to potentially serious complications. Microwave heating of intravenous fluid could be a safe, simple, cheap and effective means of heating intravenous fluids for resuscitation, but care needs to be taken to calibrate individual machines to ensure a safe temperature is reached.
-
Emerg Med (Fremantle) · Jun 2001
Review Case ReportsFatal pneumococcal Waterhouse-Friderichsen syndrome.
There have only been six deaths reported in the English literature due to disseminated intravascular coagulation and Waterhouse-Friderichsen syndrome complicating pneumococcemia in otherwise healthy persons with normal spleens. Four of these deaths occurred in children and two in adults. ⋯ The case is typical of the course of fulminant pneumococcal sepsis and highlights some of the difficulties experienced by rural general practitioners and rural retrieval services. Mechanisms by which Pneumococcus can elicit fulminant sepsis are discussed, although there is no explanation as to why this may occur in the setting of normal splenic function.
-
To characterize the prerequisite experience and training undertaken by nurses for the role of triage in emergency departments in Australasia. ⋯ In Australasia, there is wide variability in required training and experience before triage duties are performed. Strategies to set suggested minimum standards in these areas and to make training activities more accessible are recommended.
-
Emerg Med (Fremantle) · Jun 2001
Comparative StudyEmergency Medical Services Fellowship in the United States of America.
Travelling outside Australia to undertake further training in an area of subspecialty interest is both interesting and beneficial to the advancement of the individual and our specialty. In the United States of America, such formal training following completion of specialist qualification in emergency medicine is referred to as 'Fellowship' training. While other authors have discussed the general areas of overseas work and emergency medicine Fellowships, this paper specifically addresses the area of prehospital care, known in the United States as 'emergency medical services'. ⋯ A typical curriculum is outlined, and the steps in selecting and arranging such a programme are discussed. Some potential pitfalls are also mentioned. Given the paucity of formal training in prehospital care in this country, such fellowship programmes are an excellent means of obtaining a very solid understanding of this important aspect of emergency medicine.
-
Emerg Med (Fremantle) · Jun 2001
Same-day X-ray reporting is not needed in well-supervised emergency departments.
To evaluate the efficacy of a missed radiological abnormality follow-up system in a teaching hospital emergency department. ⋯ Missed radiological abnormalities in an emergency department with extended-hours emergency physician supervision can be managed non-urgently on an outpatient basis. Same-day reporting of radiographs is not required if adequate follow-up mechanisms for missed abnormalities exist.