Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2009
ReviewReview article: indications for thoracolumbar imaging in blunt trauma patients: a review of current literature.
Thoracolumbar spine injury is a common complication of blunt multitrauma and up to one third of fractures are associated with spinal cord dysfunction. Delayed fracture diagnosis increases the risk of neurological complications. While validated screening guidelines exist for traumatic c-spine injury equivalent guidelines for thoracolumbar screening are lacking. ⋯ There is limited low level evidence guiding surveillance TL imaging in adult blunt trauma patients. Despite this, we propose and evaluate an algorithm with a high negative predictive value for TL fractures. This should be incorporated into spinal injury assessment protocols.
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Emerg Med Australas · Apr 2009
Reviewing deaths in the emergency department: deaths in the department or deaths within 48 h.
To investigate an ED death audit process that included deaths occurring within 48 h of admission in addition to deaths in the ED. ⋯ The present study demonstrates that auditing both ED deaths and 48 h deaths identifies additional issues relevant to the ED compared with auditing ED deaths alone or relying on standard hospital incident reporting.
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Emerg Med Australas · Apr 2009
Comparative StudyUse of ultrasound to facilitate accurate femoral nerve block in the emergency department.
To compare the accuracy of ultrasound (US)-assisted femoral nerve blocks (FNB) with the fascial pop (FP) technique, examining the rates of success and complications. ⋯ A more complete blockade is achieved earlier using the US-assisted technique. The US-assisted technique will become the technique of choice for FNB in this department.
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Emerg Med Australas · Apr 2009
Randomized Controlled TrialLaryngoscope illumination grade does not influence time to successful manikin intubation.
Endotracheal intubation is an important, time-critical, life-saving emergency medicine procedure. Laryngoscope characteristics might influence time to successful intubation. The objective of the present study was to determine whether laryngoscope light of variable intensity would influence the length of time required to achieve successful endotracheal intubation. ⋯ The intensity of laryngoscope light across a clinically plausible range does not affect time to intubation.
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Emerg Med Australas · Apr 2009
Use of invasive mechanical ventilation in Australian emergency departments.
There are few published reports describing the use of invasive mechanical ventilation in EDs. We explored the characteristics of patients receiving mechanical ventilation, the ventilator modes and parameters used as well as the duration of ventilation and the nature of ventilator decision-making in Australian ED. ⋯ The application of mechanical ventilation was similar to descriptions reported in the critical care literature both in Australia and internationally. Decision-making responsibilities were shared by ED medical and nursing staff.