Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2005
Occult pneumothorax in trauma patients: should this be sought in the focused assessment with sonography for trauma examination?
At present, CT scan is the gold standard for detecting occult traumatic pneumothorax not apparent on supine chest X-ray radiograph. Recently there were suggestions to expand focused assessment with sonography for trauma (FAST) to include thoracic ultrasound for detecting pneumothorax. The aim of the present study is to determine the incidence of occult pneumothorax (as shown by CT) in the subgroup of trauma patients undergoing FAST. ⋯ The incidence of occult pneumothorax in the subgroup of trauma patients undergoing FAST is low. It implies that routine screening for its presence by adding thoracic ultrasound to FAST is unnecessary. Identifying those at risk of occult pneumothorax for further investigation appeared feasible.
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Emerg Med Australas · Oct 2005
Comparative StudyPrehospital intubation and chest decompression is associated with unexpected survival in major thoracic blunt trauma.
Application of the Trauma and Injury Severity Score (TRISS) to a trauma population identifies patients with 'unexpected survival'. This study used TRISS analysis to identify 'unexpected survivors' suffering major thoracic trauma, who survived to hospital discharge. Further analysis determined prehospital interventions that appeared to contribute to 'unexpected survival'. ⋯ For patients sustaining severe thoracic blunt trauma, prehospital intubation and chest decompression appear to be associated with unexpected survival. A low GCS at scene is not predictive of 'unexpected survival' or 'expected death'.
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Emerg Med Australas · Oct 2005
Factors associated with walkout of patients from New South Wales hospital emergency departments, Australia.
To explore the association between daily patient numbers, sociodemographic, clinical and system characteristics and walkout rates of patients from New South Wales (NSW) public hospital ED (without seeing a medical officer). ⋯ After adjusting for triage category (urgency of presentation) and triage time, patients from lower socioeconomic backgrounds and those without private health insurance coverage were more likely to leave ED without treatment. These results have important implications for Health Services. Future strategies aimed at minimizing walkouts from public hospital ED should prioritize and target factors identified in the present study.
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Emerg Med Australas · Oct 2005
Historical ArticleProfessional issues in emergency medicine: UK perspective.
The present paper describes the history, the professional development and current state of the specialty of emergency medicine in the UK, and outlines the role of parent bodies that administer the specialty.
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Emerg Med Australas · Oct 2005
Comparative StudyImpact on patients triage distribution utilizing the Australasian Triage Scale compared with its predecessor the National Triage Scale.
To assess the impact of the change from the National Triage Scale (NTS) to the Australasian Triage Scale (ATS) within a hospital ED. ⋯ The revision of the ATS has had a significant impact on the triage distribution of patients who present to ED. The change of distribution might have implications for meeting performance criteria and assessing casemix.