Emergency medicine Australasia : EMA
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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.
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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.
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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.
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Emerg Med Australas · Apr 2004
Clinical TrialPracticality of performing medical procedures in chemical protective ensembles.
To determine whether certain life saving medical procedures can be successfully performed while wearing different levels of personal protective equipment (PPE), and whether these procedures can be performed in a clinically useful time frame. ⋯ A significantly greater time to complete procedures was documented in Level A PPE (fully encapsulated suits) compared with Levels C and D. There was however, no significant difference in times between Level B and Level C. The common practice of equipping hospital and medical staff with only Level C protection should be re-evaluated.
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Emerg Med Australas · Apr 2004
Case ReportsCongenital diaphragmatic hernia masquerading as pneumonia.
Patients with congenital diaphragmatic hernia usually present in the immediate neonatal period with respiratory distress. However, presentation beyond the neonatal period has sporadically been reported. ⋯ Fortunately, after performing ultrasound, suspicion was raised and she was later diagnosed to have left congenital diaphragmatic hernia of Bochdalek type. Although rare, this entity should form one of the differential diagnoses of unresolving pneumonia in children.