Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2010
Randomized Controlled Trial Comparative StudyIs homatropine 5% effective in reducing pain associated with corneal abrasion when compared with placebo? A randomized controlled trial.
To compare the change in visual analogue scale (VAS) pain ratings over 24 h following mechanical corneal abrasion between patients receiving sixth hourly drops of either 5% homatropine or placebo. ⋯ We found no significant difference in pain score reductions between the two groups but some level of therapeutic benefit is not excluded.
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Emerg Med Australas · Dec 2010
ReviewReview article: Can venous blood gas analysis replace arterial in emergency medical care.
The objectives of the present review are to describe the agreement between variables on arterial and venous blood gas analysis (in particular pH, pCO(2) , bicarbonate and base excess) and to identify unanswered questions. MEDLINE search of papers published from 1966 to January 2010 for studies comparing arterial and peripheral venous blood gas values for any of pH, pCO(2) , bicarbonate and base excess in adult patients with any condition in an emergency department setting. The outcome of interest was mean difference weighted for study sample size with 95% limits of agreement. ⋯ There is insufficient data to determine if these relationships persist in shocked patients or those with mixed acid-base disorders. For patients who are not in shock, venous pH, bicarbonate and base excess have sufficient agreement to be clinically interchangeable for arterial values. Agreement between arterial and venous pCO(2) is too poor and unpredictable to be clinically useful as a one-off test but venous pCO(2) might be useful to screen for arterial hypercarbia or to monitor trends in pCO(2) for selected patients.
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Emerg Med Australas · Dec 2010
Case ReportsSuccessful drainage of a traumatic haemopericardium with pericardiocentesis through an intercostal approach.
A case of traumatic haemopericardium, sustained after blunt thoracic trauma, is described in a paediatric patient that was successfully drained by needle pericardiocentesis under 2D-echocardiographic guidance, via an intercostal approach, in the Children's Intensive Care Unit. The patient was haemodynamically unstable with obvious signs of cardiac tamponade. ⋯ There were no complications as a result of the pericardiocentesis. No further surgical intervention was required.
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Emerg Med Australas · Dec 2010
Randomized Controlled Trial Comparative StudyThe comparative pharmacokinetics of modified-release and immediate-release paracetamol in a simulated overdose model.
Panadol Extend (PEx) is an over-the-counter, modified-release formulation of paracetamol. Each 665 mg tablet contains 69% slow-release and 31% immediate-release paracetamol. In simulated human overdose, PEx exhibits lower and later peak serum concentrations and a lower area-under-the-curve (AUC) than comparable doses of immediate-release paracetamol (APAP-IR). The lower AUC might result from incomplete absorption of paracetamol or simultaneous metabolism with absorption. ⋯ There were minor differences between the PK parameters of the two major paracetamol metabolites of these two preparations in simulated overdose. The variability in paracetamol AUC seen between the two preparations in moderate overdose might be explained by concurrent metabolism of paracetamol during slower absorption with PEx.
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Emerg Med Australas · Dec 2010
ReviewReview article: debriefing critical incidents in the emergency department.
The impact of work related stressors on emergency clinicians has long been recognized, yet there is little formal research into the benefits of debriefing hospital staff after critical incidents, such as failed resuscitation. This article examines current models of debriefing and their application to emergency staff through a review of the literature. The goal being, to outline best practice, with recommendations for guideline development and future research directives. ⋯ However evidence presents both benefits and disadvantages to debriefing interventions. In the absence of evidence based practice guidelines, any development of models of debriefing in the emergency healthcare setting should be closely evaluated. And future research directives should aim towards large randomized control trials.