Emergency medicine (Fremantle, W.A.)
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Emerg Med (Fremantle) · Sep 2001
ReviewEthical relationships in paediatric emergency medicine: moving beyond the dyad.
Most areas of health-services research concentrate on a dyadic relationship between doctor and patient. In paediatric emergency medicine it may be necessary to focus on a more complicated relationship because the parents of the child play an important role in the delivery of medical services. ⋯ Such models allow the inclusion of the parents and possibly other family members, medical providers and community members. If the paediatric setting is considered in such a framework, it may be possible to deliver a more socially beneficial medical service.
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Emerg Med (Fremantle) · Sep 2001
Comparative StudyThe use of emergency contraception in Australasian emergency departments.
To review the prescribing of emergency contraception by emergency departments in Australasia and compare it with other providers. ⋯ Emergency departments are accessed by patients requesting contraception following unprotected intercourse or contraceptive failure. The prescribing of emergency contraception in Australasian emergency departments is comparable with other providers but substantial improvements could be made. Suggestions to assist this improvement include written clinical guidelines and patient information and purpose-made medication packs.
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Emerg Med (Fremantle) · Sep 2001
Case ReportsAcute opioid withdrawal in the emergency department: inadvertent naltrexone abuse?
From July 1999 it became evident that a rising number of heroin users were presenting to the Dandenong Hospital Emergency Department with a rapid onset, florid opioid withdrawal syndrome following the intravenous injection of what they had believed to be heroin. We suspect that the injected substance was in fact naltrexone. This paper describes two such cases and reviews the literature on naltrexone. Recommendations regarding the management of the acute opioid withdrawal syndrome are made.
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Emerg Med (Fremantle) · Sep 2001
Comparative StudyHow valuable is a lumbar puncture in the management of patients with suspected subarachnoid haemorrhage?
The aim of the study was to determine the range of cerebrospinal fluid findings associated with emergency department disposition and treatment of patients with headache suspicious of subarachnoid haemorrhage but a negative or equivocal computed tomography head scan, in particular the role of xanthochromic index. ⋯ In the study institution, cerebrospinal fluid results appeared to have a variable influence on clinical decision-making for patients with suspected subarachnoid haemorrhage and a non-diagnostic computed tomography head scan. Of particular concern is the lack of validation of the tests used in this investigative approach, the frequency of patients having a lumbar puncture where the results did not influence their management, the inconsistency in the laboratory's technique for performing tests on cerebrospinal fluid and the very low yield of detecting patients with subarachnoid haemorrhage and a potentially treatable causative lesion.
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Emerg Med (Fremantle) · Sep 2001
Comparative StudyEmergency department triage of indigenous and non-indigenous patients in tropical Australia.
To examine the relationship between ethnicity and triage at a tertiary hospital emergency department. ⋯ Indigenous patients are more likely to present with illness rather than injury and are more likely to require admission than non-indigenous patients. Indigenous patients are triaged in accordance with Australasian triage guidelines. Many non-indigenous patients should be triaged to lower urgency categories to allow resource allocation towards higher acuity indigenous and non-indigenous patients.