Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2008
Comparative StudyRapid risk stratification in suspected acute coronary syndrome using serial multiple cardiac biomarkers: a pilot study.
To determine the feasibility of using a biomarker panel of myoglobin, creatinine kinase MB (CK-MB) and cardiac troponin I (cTnI) to identify patients with suspected acute coronary syndrome (ACS) who are suitable for discharge within 2 h. ⋯ Serial myoglobin, CK-MB and cTnI have the potential to identify patients who are suitable for early discharge and outpatient work-up. A large multicentre study is required.
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Emerg Med Australas · Oct 2008
Computerized tomography of the brain for elderly patients presenting to the emergency department with acute confusion.
Confusion is a common reason for presentation of elderly patients to the ED. There are many potential causes of confusion, which include acute neurological events. Computerized tomography (CT) scans are often routinely ordered to investigate confusion, despite the recommendation of guidelines against routine use. The aim of the present study was to determine the usefulness of CT brain scans in a prospective cohort of confused elderly patients presenting to an ED. ⋯ The results add further support to guidelines that suggest that CT scans of the brain for confused elderly patients should only be performed for those with acute neurological findings, head trauma or a fall.
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Emerg Med Australas · Oct 2008
Junior doctor strike model of care: Reduced access block and predominant Fellow of the Australasian College for Emergency Medicine staffing improve emergency department performance.
To describe the response and analyse ED performance during a 5-day junior doctor strike. ⋯ FACEM staffing and reduced access block were significant factors in improved ED performance.
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Emerg Med Australas · Oct 2008
Implementation of a guideline for computed tomography head imaging in head injury: a prospective study.
To improve appropriate ordering of head computed tomography (CT) in patients presenting with a head injury by applying an evidence-based head injury guideline. ⋯ The Southernhealth Head Injury Guideline is safe and easy to apply to minor and major head injuries.
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Recent articles have described the increasing frequency of use of propofol as a sedating agent in the ED, and praise the safety profile of propofol when used in this manner. We describe a patient who developed torsade de pointes followed by ventricular fibrillation while undergoing propofol sedation for closed reduction of a mid-shaft fracture of the tibia and fibula. Possible reasons for the event are discussed, and suggestions are made for areas of further research.