Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2010
Comparative StudyExHALED study: prevalence of smoking and harm levels in an emergency department cohort.
To determine the prevalence of smoking among ED patients compared with the general New Zealand (NZ) smoking prevalence. Secondary outcomes were to determine smokers' level of nicotine dependence, readiness to quit and engagement with primary health care. ⋯ The prevalence rates of smoking are higher among patients attending Wellington Hospital ED than the general NZ population and the majority would like to quit smoking. One in four ED smokers have a high FTND score and are considered nicotine-dependent. Many patients who were not registered with a general practitioner smoked, and the majority wanted to quit. Finally, there is significant interest from ED patients in receiving quit smoking packs from the ED.
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Emerg Med Australas · Aug 2010
Obesity significantly increases the difficulty of patient management in the emergency department.
To determine which aspects of ED management are adversely affected by patient obesity, to determine the level of obesity above which management is made more difficult and to make recommendations on how these effects might be mitigated. ⋯ Patient obesity significantly increases the difficulty of ED patient management. Staff recommendations to mitigate these effects were few but may inform changes in ED practice.
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Emerg Med Australas · Aug 2010
Analysis of junior doctor supervision in Australasian emergency departments.
Supervision of junior doctors in ED is vital but limited literature exists on how it is provided. ⋯ There are significant differences between supervision requirements for PGY1 and PGY2. A minority of ED in Australasia do not have 24 h supervision by PGY3 or higher. Few ED have written guidelines for supervising PGY1 and PGY2. The majority of registrar supervision occurs without consultant oversight. Legislature requirements for supervision in ED are variable between regions.
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Emerg Med Australas · Aug 2010
Case ReportsAcute coronary syndrome mimicked by acute cholecystitis.
Various aetiologies have been reported that cause severe trauma segment and T-wave abnormalities that are not related to acute coronary syndromes. However, the reports of transient ECG abnormalities associated with acute cholecystitis are limited in the literature. We describe a 42-year-old man presented with abdominal pain and hypertensive episode that developed dynamic ECG changes mimicking acute coronary syndrome and was diagnosed acute cholecystitis eventually. Emergency physicians should keep in mind dynamic T-wave changes mimicking acute myocardial ischaemia in patients with acute cholecystitis.
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Emerg Med Australas · Aug 2010
Chest pain in pacemaker patients, the answer is not always antiplatelets and anticoagulants: a four-case series.
Chest pain in pacemaker patients can be difficult to evaluate due to alterations in QRS and ST segments on the surface ECG. A high prevalence of ischaemic heart disease in this population also serves to influence the differential diagnosis. We highlight four cases, all with simple yet informative imagery, in an attempt to alert clinicians of worrying signs.