Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2009
Clinical TrialIntranasal fentanyl in 1-3-year-olds: a prospective study of the effectiveness of intranasal fentanyl as acute analgesia.
The primary objective of the present study was to determine the effectiveness of intranasal fentanyl analgesia in children aged 1-3 years with acute moderate to severe pain presenting to the ED. We also aimed to gather information on the safety and acceptability of intranasal fentanyl in this age group. Two paediatric ED enrolled children aged 1-3 years, with acute moderate or severe pain. ⋯ Intranasal fentanyl delivery using a mucosal atomiser was well tolerated by all children. There were no adverse drug reactions or adverse events detected. Intranasal fentanyl is an effective, safe and well-tolerated mode of analgesia for children aged 1-3 years with moderate to severe pain.
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Emerg Med Australas · Oct 2009
International Federation for Emergency Medicine model curriculum for medical student education in emergency medicine.
There is a critical and growing need for emergency physicians and emergency medicine resources worldwide. To meet this need, physicians must be trained to deliver time-sensitive interventions and life-saving emergency care. Currently, there is no internationally recognized, standard curriculum that defines the basic minimum standards for emergency medicine education. ⋯ It is designed, not to be prescriptive, but to assist educators and emergency medicine leadership in advancing physician education in basic emergency medicine content. The content would be relevant, not just for communities with mature emergency medicine systems, but also for developing nations or for nations seeking to expand emergency medicine within current educational structures. We anticipate that there will be wide variability in how this curriculum is implemented and taught, reflecting the existing educational milieu, the resources available, and the goals of the institutions' educational leadership.
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Emerg Med Australas · Oct 2009
Malnutrition associated with increased risk of frail mechanical falls among older people presenting to an emergency department.
To identify associations between malnutrition falls risk and hospital admission among older people presenting to ED. ⋯ Older people presenting to ED should be nutritionally screened. Malnutrition prevalence of 15% was documented and was associated with an increased risk of frail mechanical falls and hospital admission. The Malnutrition Screening Tool was a simple and practical screen for ED.
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Emerg Med Australas · Oct 2009
Injuries significantly associated with thoracic spine fractures: a case-control study.
To determine injuries significantly associated with traumatic thoracic spine (T-spine) fractures ⋯ Cervical and lumbar spine injuries and rib fractures are significantly associated with T-spine fracture. The presence of these injuries should raise suspicion of concomitant T-spine injury.
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Emerg Med Australas · Oct 2009
ReviewReview article: inotrope and vasopressor use in the emergency department.
Shock is a common presentation to the ED, with the incidence of septic shock increasing in Australasia over the last decade. The choice of inotropic agent is likely dependent on previous experience and local practices of the emergency and other critical care departments. ⋯ Delays in transfer to inpatient facilities means that patients receive advanced critical care within the ED for longer, requiring initiation and titration of vasoactive agents in the ED. This article discusses the general concepts of shock and the indicators for inotrope and vasopressor use, revises the various agents available and reviews the current evidence for their use.