Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2010
Comparative StudyManagement guideline in haemodynamically unstable patients with pelvic fractures: Outcomes and challenges.
Clinical practice guidelines for haemodynamically unstable patients with pelvic fractures were initiated in February 2005 at our level 1 trauma centre. The purpose of the present study was to evaluate guideline adherence and outcome of guideline performance. In a retrospective clinical study all patients admitted with a pelvic fracture from August 2003 to March 2007 were identified from a prospective trauma registry database. ⋯ The introduction of guidelines has influenced the approach to haemodynamically unstable patients with pelvic fractures. Multiple factors can potentially influence the strict adherence to the guideline. Care provided can still be improved by addressing the challenges in guideline performance.
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Emerg Med Australas · Dec 2010
Case ReportsSpontaneous pneumoperitoneum: diagnostic and management difficulties.
Acute abdominal pain is a common presentation to the ED. Most patients undergo a chest radiograph as part of their initial investigations, which occasionally reveals pneumoperitoneum. ⋯ Some cases of pneumoperitoneum might be managed conservatively thus avoiding unnecessary laparotomy. We present a case of recurrent spontaneous pneumoperitoneum with abdominal pain that was managed conservatively and discuss the possible aetiologies and management issues of spontaneous pneumoperitoneum.
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Emerg Med Australas · Dec 2010
Assessment and feedback in emergency medicine training: views of Australasian emergency trainees.
The aim of the present study is to describe ACEM trainees' perspectives on assessment and feedback during their training. From May to July 2009, an anonymous Web-based survey on training and supervision in emergency medicine was conducted, addressing trainees' perceptions of mandatory assessments (primary examination, fellowship examination and mandatory trainee research requirement) and feedback at work. Qualitative data were analysed using grounded theory methodology--themes were identified by close examination of full text responses. ⋯ The fellowship examination was overall thought to be fair; however, there were concerns with the time pressures and restrictions to the written component of the examination. Additionally, the structured clinical examination was popular, whereas short cases and long cases were very unpopular. ACEM trainees' views of training may help inform curriculum development, and might assist those providing education to improve local training programs.