Articles: emergency-services.
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Case Reports
Ultrasound-Guided Clavipectoral Plane Block for Analgesia of Acute Clavicular Fracture in the Emergency Department.
Clavicle fractures are commonly encountered in the emergency department and require effective analgesia to facilitate appropriate management and disposition. ⋯ We present the case of a 52-year-old man who presented with an acute, mildly displaced midshaft fracture of his right clavicle. After minimal improvement in pain from oral and topical analgesics, he underwent an ultrasound-guided clavipectoral plane block which completely relieved his pain. He did not require additional analgesics for 36 hours after the block. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: The ultrasound-guided CPB may be a safe and effective analgesic strategy for uncomplicated clavicle fractures in the ED.
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Emerg Med Australas · Feb 2025
Somatic symptom and related disorders in a tertiary paediatric hospital: Characteristics of ED use prior to admission.
Somatic symptom and related disorders (SSRDs) are complex disorders that are commonly encountered in tertiary paediatric settings. Despite this, little is known about ED use prior to hospital admission. We aimed to describe the pattern of ED use in a cohort of children and adolescents who were subsequently admitted to hospital with SSRD and to identify factors associated with ED presentations. ⋯ Children and adolescents with SSRD who go on to have a hospital admission present frequently to EDs, especially in the setting of pain symptoms. Training of ED clinicians in diagnosing SSRD appears indicated, as is the development of local care pathways that may obviate the need for hospital admission in at least some patients.
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Ambulance ramping, the delay to transfer of a patient arriving at an ED by ambulance into an ED treatment space and handover of care to ED clinicians, is a problem in all Australian states and territories and New Zealand. It is a symptom of ED overcrowding and access block and has been associated with adverse health outcomes for some patient groups. The questions arise, who might be legally responsible for the care of patients who are ramped and does their physical location matter? The short answers are 'everyone' and 'no', however, whether there will be a breach of duty depends on the reasonableness of responses and resource allocation considerations.
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Emerg Med Australas · Feb 2025
Impact of the XVII Pacific Games on the National Referral Hospital Emergency Department, Solomon Islands.
The XVII Pacific Games was held in Honiara, Solomon Islands in 2023 and was attended by competitors from 24 Pacific nations. The National Referral Hospital (NRH) is the sole tertiary hospital and largest emergency department (ED) in the Solomon Islands, located in the capital city, Honiara, and was the designated referral hospital for the Pacific Games. ⋯ Planned mass gathering events can provide opportunities for EDs to increase workforce capacity and strengthen systems, but proper preparedness is required to minimise additional strain on already busy departments.
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To identify clinical and sociodemographic characteristics of frequent use of emergency departments by persons of advanced age. ⋯ Frail elderly patients with more comorbid conditions are at higher risk for frequent use of emergency departments. These patients should be identified early so that management of their conditions can be adjusted.