Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2007
Profiling adverse respiratory events and vomiting when using propofol for emergency department procedural sedation.
To evaluate the rate of adverse respiratory events and vomiting among ED patients undergoing procedural sedation with propofol. ⋯ Seventy per cent of patients undergoing ED procedural sedation are not fasted. No patient had a clinically evident adverse outcome. Transient respiratory events occur but can be managed with basic airway interventions making propofol a safe alternative for emergency physicians to provide emergent procedural sedation.
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Emerg Med Australas · Oct 2007
Identifying severe community-acquired pneumonia in the emergency department: a simple clinical prediction tool.
To identify independent predictors of severe pneumonia in a local population, and create a simple severity score that would be useful in the ED. ⋯ This provides a practical tool that can be used to 'flag' impending patient demise. Its advantages are that it is simple, uses predictive variables, does not require invasive testing, and removes bias regarding patient age. Like other tools, its accuracy is not perfect, and it should only be used to augment clinical judgement.
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Emerg Med Australas · Oct 2007
Multicenter StudyHandover in the emergency department: deficiencies and adverse effects.
To determine problems resulting from ED handover, deficiencies in current procedures and whether patient care or ED processes are adversely affected. ⋯ Deficiencies in handover processes exist, especially in communication and disposition information. These affect doctors, the ED and patients adversely. Recommendations for improvement include guideline development to standardize handover processes, the greater use of information technology facilities, ongoing feedback to staff, and quality assurance and education activities.
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Emerg Med Australas · Oct 2007
Clinical TrialOptimization of propofol dose shortens procedural sedation time, prevents resedation and removes the requirement for post-procedure physiologic monitoring.
To examine the effect of propofol dosing (total dose and number of doses) on patient sedation time and likelihood of resedation. ⋯ Shorter sedation times are seen with lower doses of propofol. Patients do not need prolonged post-procedure monitoring because the occurrence of spontaneous resedation associated with propofol use is a rare event. This has implications for patient flow and staff resource allocation in a busy ED.