Emergency medicine Australasia : EMA
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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.
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Emerg Med Australas · Feb 2007
Experience in adverse events detection in an emergency department: nature of events.
The study was performed to determine the nature of adverse events in an ED. ⋯ In conclusion, the data demonstrate that events fall into two sets: prior events which are associated with errors of commission, drug reactions and lower preventability; and ED events which are associated with errors of omission, diagnostic issues and high preventability.
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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
Multicenter StudyImproving asthma discharge management in relation to emergency departments: The ADMIRE project.
The present paper describes the process, outcomes and lessons learned from a federally funded, multicentre action research project aimed at improving discharge practices for asthma patients who attend ED and are discharged home. Thirty-two ED participated and worked locally to improve discharge practices using previously published best-practice guidelines. Although they achieved some improvements, major barriers to best-practice discharge outside ED control were identified, including access to GP, hospital policies regarding supply of medications and access to appropriate asthma education. The ED developed some useful tools to assist with improving asthma management that have been compiled as a toolkit and are available online.
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Commercial aviation in-flight emergencies are relatively common, so it is likely that a doctor travelling frequently by air will receive a call for help at some stage in their career. These events are stressful, even for experienced physicians. The present paper reviews what is known about the incidence and types of in-flight emergencies that are likely to be encountered, the international regulations governing medical kits and drugs, and the liability, fitness and indemnity issues facing 'Good Samaritan' medical volunteers. ⋯ Medical volunteers may find assisting with an in-flight emergency stressful, but should acknowledge that they play a vital role in successful outcomes. The medico-legal liability risk is extremely small, and various laws and industry indemnity practices offer additional protection to the volunteer. In addition, cabin crew receive training in a number of emergency skills, including automated defibrillation, and are one of several sources of help available to the medical volunteer, who is not expected to work alone.