Emergency medicine Australasia : EMA
-
Emerg Med Australas · Apr 2004
Mental health and alcohol and other drug training for emergency department workers: one solution to help manage increasing demand.
To evaluate a training course for ED staff aiming to improve knowledge and skills in working with mental health and drug/alcohol patients attending EDs. ⋯ The course has led to staff feeling more confident and competent to help mental health or drug/alcohol patients who attend the ED.
-
To investigate the incidence and describe the nature of non-motorized scooter related injuries in children presenting to the ED. ⋯ There has been no significant change in scooter injury presentations over the two summer periods of 2000 and 2001. Children presenting to the ED with a scooter related injury tend to be primary school aged, which may have implications on scooter design, age recommendations and safety guidelines.
-
The object of this review is to discuss the recognition and treatment of septic shock in children based on principles of resuscitation, antibiotic use and recent therapeutic advances. ⋯ Septic shock remains a leading cause of morbidity and mortality in children. Early administration of empirical antibiotic therapy reduces mortality. The keystone of resuscitation is aggressive volume replacement. Adjunctive therapies to modulate the inflammatory response may further enhance outcome, but do not replace principles of resuscitation.
-
The controversy regarding the role of hyperbaric oxygen (HBO) in the treatment of carbon monoxide (CO) poisoning has been re-ignited following the publication of a further randomized controlled trial by Weaver et al., the results of which appear to conflict with our findings. Comparative analysis suggests that the apparent outcome differences may be secondary to the design, analysis and interpretation of the results of the two studies. ⋯ This stratification may be aided by the evolving availability of biochemical markers of brain injury and the finding that patients with transient loss of consciousness and poor performance on neuropsychological tests of the supervisory attention system are at higher risk of neuropsychological sequelae. We propose that those patients most at risk be admitted and receive more prolonged normobaric oxygen therapy whilst those with more minor CO-poisoning should be provided with normobaric oxygen of no less than 6 h duration and certainly until sign and symptom free.
-
Emerg Med Australas · Apr 2004
Randomized Controlled Trial Clinical TrialCan serum mast cell tryptase help diagnose anaphylaxis?
We aimed to determine the utility of serum mast cell tryptase to diagnose anaphylaxis. ⋯ Clinicians should use caution when using serum tryptase to refute or support a diagnosis of anaphylaxis. Serial tryptase measurement increases sensitivity and specificity. Further studies using serial tryptase determinations in general emergency department practice, perhaps supplemented by histamine determinations, are warranted.