Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2009
Multicenter StudyPain management practices in paediatric emergency departments in Australia and New Zealand: a clinical and organizational audit by National Health and Medical Research Council's National Institute of Clinical Studies and Paediatric Research in Emergency Departments International Collaborative.
To audit pain management practices and organization in paediatric ED across Australia and New Zealand. ⋯ We found a notable lack of pain assessment documentation and delays to analgesia. There is a need to improve pain assessment and management, although a majority of paediatric ED surveyed had important organizational and educational structures in place. Issues to explore include use of opioids in migraine and the underuse of femoral nerve blocks.
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Emerg Med Australas · Jun 2009
Randomized Controlled Trial Comparative StudyNebulized fentanyl versus intravenous morphine in children with suspected limb fractures in the emergency department: a randomized controlled trial.
To compare the efficacy of nebulized fentanyl (NF) with i.v. morphine (IVM) in paediatric patients presenting to the ED with clinically suspected limb fractures. ⋯ NF in a dose of 4 microg/kg given via a standard nebulizer provided clinically significant improvements in pain scores, comparable to IVM. NF should be considered as a treatment option for use in children presenting in acute pain.
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Emerg Med Australas · Jun 2009
Structured team approach to the agitated patient in the emergency department.
Behavioural disturbance and aggression in the ED is an increasing problem. The present study describes the characteristics of patients with acute behavioural disturbance and their emergent treatment in an ED with a structured team approach. ⋯ Acute behavioural disturbance was common in the present study, and underlying causes were predominantly organic in nature. A team approach appears to be valuable in managing these incidents.
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Emerg Med Australas · Jun 2009
Frequent attenders with mental disorders at a general hospital emergency department.
To define the clinical and demographic characteristics of frequent attenders with mental disorders at a general hospital ED; to determine whether those persons had additional attendances at other ED in the same city; and to assess the documented care of those frequent attenders. ⋯ The documented management of frequent attenders with mental disorders at a general hospital ED appeared to be less than optimal. Furthermore, the majority of those frequent attenders also attended other general hospital ED in the same city, and this did not appear to be recognized.