Emergency medicine journal : EMJ
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This paper investigates the literature regarding the impact of shift work on prehospital emergency providers. While the issue of shift work has been thoroughly investigated in other health disciplines, this is not the case for the paramedic discipline, particularly in the Australian context. ⋯ Shift work can affect health and well-being on a variety of levels, both physiologically and psychologically, affecting aspects of work and personal life. Further research is warranted to prevent the issues of patient safety, work-related fatigue and the cumulative effects of shift work.
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A short cut review was carried out to establish whether capnography should be routinely used during procedural sedation in Emergency Departments. 206 papers were found using the reported searches, of which nine presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. It is that capnography may provide early warning of ventilatory changes that could result in hypoxia.
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Randomized Controlled Trial
Slow infusion metoclopramide does not affect the improvement rate of nausea while reducing akathisia and sedation incidence.
To compare the effects of metoclopramide infusion in emergency department (ED) patients complaining of nausea to determine the changes in its therapeutic effect and prevention of side effects such as akathisia and sedation. ⋯ Even though slowing the rate of infusion of metoclopramide does not affect the rate of improvement in nausea, it may be an effective strategy for reducing the incidence of akathisia and sedation in patients with nausea.
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Patients often establish initial contact with healthcare institutions by telephone. During this process they are frequently medically triaged. ⋯ Medical telephone counselling is a demanding task requiring competent specialists with dedicated training in communication supported by suitable computer technology. Provided these conditions are in place, computer-assisted telephone triage can be considered to be a safe method of assessing the potential clinical risks of patients' medical conditions.
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Acute allergic reactions often occur in out-of-hospital settings, and some of these reactions may cause death in the short term. However, initial diagnosis, management and processing of acute allergic reactions by Medical Emergency Dispatch Centres are not documented. The aim of the present study was to describe acute allergic reactions and their management by a Medical Emergency Dispatch Centre. ⋯ Only moderate agreement is highlighted between the initial severity assessed by the dispatching physician and the final severity assessed by the physician later examining the patient. This demonstrates the need to develop a tool for assessing severity of acute allergic reactions for dispatching physicians in Medical Emergency Dispatch Centres.