Emergency medicine Australasia : EMA
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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
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
Randomized Controlled TrialThe CO₂ GAP Project--CO₂ GAP as a prognostic tool in emergency departments.
To determine whether CO₂ GAP [(a-ET) PCO₂] value differs consistently in patients presenting with shortness of breath to the ED requiring ventilatory support. To determine a cut-off value of CO₂ GAP, which is consistently associated with measured outcome and to compare its performance against other derived variables. ⋯ The CO₂ GAP [(a-ET) PCO₂] differs significantly in patients requiring assisted ventilation when presenting with shortness of breath to EDs and further research addressing the prognostic value of CO₂ GAP in this specific aspect is required.
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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.