Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2008
Comparative StudyHow fast is the focused assessment with sonography for trauma examination learning curve?
Although accuracy for focused assessment with sonography for trauma (FAST) examination interpretation has been widely reported, the learning curve for FAST interpretation by emergency medicine (EM) residents who are novice to ultrasound has not been well described. The present study's objective was to analyse EM resident FAST interpretation accuracy over 18 months. ⋯ Over 18 months, EM resident FAST interpretation accuracy steadily increased. By 12 months (or 35 examinations), the accuracy of EM residents novice to ultrasound approximated previously reported accuracy rates.
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Emerg Med Australas · Feb 2008
Total access block time: a comprehensive and intuitive way to measure the total effect of access block on the emergency department.
Access block refers to delayed transfer of admitted patients in the ED to wards from lack of an inpatient bed. Existing measures are crude indicators of its impact on ED function. Our aim was to devise measures of the total burden of access block on ED function which better measured the impact on ED function, yet were intuitive and easy to communicate. ⋯ TABT is a comprehensive, sensitive indicator of total impact of access block on ED function. Unlike current access block measures, TABT is reflective of long-stay ED patients. Descriptive statistics derived from TABT, in terms of effective beds and bed-days lost, will likely improve the communication and comprehension of access block issues.
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Emerg Med Australas · Feb 2008
Australasian emergency physicians: a learning and educational needs analysis. Part two: confidence of FACEM for tasks and skills.
To determine the degree of confidence perceived by Fellows of the Australasian College for Emergency Medicine for a variety of procedural, patient management, educational and research skills, and tasks that may be required of them. ⋯ This information may assist in the planning of future educational interventions for EP.
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Emerg Med Australas · Feb 2008
Case ReportsEndovascular treatment of an acute left middle cerebral artery >6 h post stroke in a patient presenting with dysphasia and dense right hemiplegia.
This paper describes the case of a 32-year-old man presenting with dense right hemiplegia and global aphasia caused by an acute left middle cerebral artery infarct that underwent successful endovascular therapy after being determined ineligible for intravenous tissue plasminogen activator. Clot transversion and balloon disruption followed by intra-arterial Alteplase resulted in successful re-canalization of his middle cerebral artery at 7 h 30 min. At 3 months post stroke, the patient had moderately severe expressive dysphasia but was mobilizing independently with normal right upper and lower limb strength. In conclusion, the 3 month outcome suggests that the therapeutic time window for endovascular therapy might exceed 6 h post stroke.