Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2007
Comparative StudyEvidence-based implementation of adult asthma guidelines in the emergency department: a controlled trial.
To determine if an evidence-based implementation (EBI) strategy could lead to the successful implementation of guidelines for the management of adult asthma in a large rural ED. ⋯ An EBI significantly improved compliance at the study hospital with no improvement noted in the control hospital. These improvements were maintained at 12 month follow up. An EBI can lead to significant improvements in the management of asthma at a large rural referral hospital ED and might have implications for hospitals with similar roles and profiles.
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Emerg Med Australas · Feb 2007
Multifaceted education initiative minimizes pethidine prescribing in the emergency department.
Pain management experts have recommended a diminished role for pethidine because of lack of superiority for any indication and greater potential for adverse effects compared with morphine. ⋯ Our education initiative resulted in a sustained and significant reduction in pethidine prescribing in the ED. Sustainability requires ongoing in-services for ED staff, usually as part of the orientation programme.
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(i) To describe the clinical presentation of intussusception and determine features associated with earlier diagnosis; (ii) to describe outcomes of children diagnosed with intussusception; and (iii) to determine whether time to diagnosis is associated with poorer prognosis. ⋯ The 'classic' picture of intussusception might frequently not be present in children with intussusception. Reliance on 'classic' features alone might delay diagnosis. Delayed diagnosis is associated with poorer patient outcomes. Air enema has a high success rate for reduction of intussusception.
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Emerg Med Australas · Feb 2007
Randomized Controlled Trial Comparative StudyComparison between single-dose oral prednisolone and oral dexamethasone in the treatment of croup: a randomized, double-blinded clinical trial.
To compare the effectiveness of three corticosteroid regimens in children with mild to moderate croup. ⋯ Both prednisolone 1 mg/kg and low-dose dexamethasone (0.15 mg/kg) were found not to differ in efficacy from the currently recommended 0.6 mg/kg dexamethasone. The use of these corticosteroid regimens in treating patients with mild to moderate croup is thus supported.