Internal medicine journal
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Internal medicine journal · Apr 2014
Multicenter StudyCare of the dying cancer patient in the emergency department: findings from a National survey of Australian emergency department clinicians.
Patients with cancer are presenting to emergency departments (ED) for end-of-life care with increasing frequency. Little is known about this experience for patients and ED clinicians in Australia. ⋯ Our findings provide important new insights into a growing area of care for ED. Barriers and enablers to optimal care of the dying patient in ED were identified, and especially the reported high occurrence of futile care, likely a result of these barriers, is detrimental to both optimal patient care and allocation of valuable healthcare resources.
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Internal medicine journal · Apr 2014
Comparative StudySuboptimal management of unfractionated heparin compared with low-molecular-weight heparin in the management of pulmonary embolism.
Both low-molecular-weight heparin (LMWH) and unfractionated heparin (UFH) have been shown to be equivalent in efficacy and safety profiles for the management of pulmonary embolism (PE). ⋯ PE was predominantly managed with LMWH. UFH was suboptimally managed when used, although there was no impact on mortality rate.
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Internal medicine journal · Apr 2014
Emergency department lengths of stay: characteristics favouring a delay to the admission decision as distinct from a delay while awaiting an inpatient bed.
A prolonged stay for a patient within the emergency department (ED) can adversely affect the outcome of their ensuing hospital admission. ⋯ Outside of working hours, patients presenting to ED have longer triage-to-admit times while patients for admission have shorter boarding times. ED congestion delays admission decisions only slightly and prolongs patients' boarding times to a greater extent. Strategies to reduce the time patients spend in ED should differ depending on whether a decision to admit the patient has been reached.
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Internal medicine journal · Apr 2014
Internal medicine in the bush: a clinical audit of a rural and remote outreach programme.
Provision of internal medicine services in rural Australia is always problematic. ⋯ In providing an outreach service to a mixed community, flexibility in both setting and personnel are essential. Diabetes and liver disease are highly prevalent in indigenous patients, but the low numbers presenting for hepatitis C requires further study.