Emergency medicine (Fremantle, W.A.)
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The Glasgow Coma Scale (GCS) was first introduced in the 1970s to provide a simple and reliable method of recording and monitoring change in the level of consciousness of head injured patients. Since its introduction, the GCS has been widely utilized in the trauma community and its use expanded beyond the original intentions of the score. In the context of traumatic injury, this paper discusses the use of the GCS as a predictor of outcome, the limitations of the GCS, the reliability of the GCS and potential alternatives through a critical review of the literature. The relevance to Australian trauma populations is also addressed.
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Eclampsia and severe pre-eclampsia are rare, but potentially life-threatening conditions that emergency physicians must be able to diagnose and treat promptly, because initial presentations to the ED are real possibilities. The treatment of the major complications of this disorder, hypertension and seizures, have been the focus of much research. Magnesium sulphate is now the first line agent for acute treatment and prophylaxis of seizures in eclampsia and pre-eclampsia. ⋯ Severe hypertension requires treatment with an intravenous antihypertensive agent familiar to the clinician. No single antihypertensive has been proven to be better than another, although in Australia, hydralazine is probably the initial intravenous agent of choice. Routine use of invasive haemodynamic monitoring and volume expansion is not recommended and consultation with obstetric colleagues is essential.
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Emerg Med (Fremantle) · Aug 2003
Information sources accessed by parents following childhood poisoning.
To ascertain the sources of information accessed by parents/caregivers following an incident of child poison ingestion, prior to their presentation to an ED. ⋯ Poisons Information Centres are under-utilized as the first point of contact after childhood poisoning but in nearly all cases of poison ingestion that presented to the ED, information was sought prior to presentation and in most cases this was from direct contact with a health professional.
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Emerg Med (Fremantle) · Aug 2003
The heaviest repeat users of an inner city emergency department are not general practice patients.
To test the hypothesis that frequent attenders to the ED are suitable for diversion to general practice. ⋯ The majority of the presentations by the heaviest users of an ED in a city teaching hospital are not suitable for general practice. Attempting diversion of the heaviest repeat ED users to a general practice in this setting may not be successful due to the severity, acuity and nature of casemix of the presentations and would have minimal impact on crowding in similar emergency departments.
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Emerg Med (Fremantle) · Aug 2003
Inpatient mortality as related to triage category in three New South Wales regional base hospitals.
To establish the incidence of death after admission via the ED for each of the five categories of the Australasian Triage Scale in three New South Wales base hospitals, and to compare this with published data from an adult tertiary referral hospital in Victoria. To examine the causes of death in each category. ⋯ This study has established the mortality rates per ED presentation and admission for each of the five categories of the Australasian Triage Scale in three New South Wales rural base hospitals. Significant differences were found between these rates and the published rates for an adult tertiary referral hospital.