Emergency medicine Australasia : EMA
-
Emerg Med Australas · Dec 2011
ReviewReview article: Prehospital fluid management in traumatic brain injury.
The early management of patients who have sustained traumatic brain injury is aimed at preventing secondary brain injury through avoidance of cerebral hypoxia and hypoperfusion. Especially in hypotensive patients, it has been postulated that hypertonic crystalloids and colloids might support mean arterial pressure more effectively by expanding intravascular volume without causing problematic cerebral oedema. ⋯ None has reported better survival and functional outcomes over the use of isotonic crystalloids. The only trial of restrictive resuscitation strategies was underpowered to demonstrate its safety compared with aggressive early fluid resuscitation in head injured patients, and maintenance of cerebral perfusion remains the top priority.
-
Emerg Med Australas · Dec 2011
Randomized Controlled TrialNitrous oxide/oxygen compared with fentanyl in reducing pain among adults with isolated extremity trauma: a randomized trial.
To compare the effectiveness of nitrous oxide/oxygen (N(2)O/O(2)) and fentanyl in relieving pain among patients with an isolated long bone fracture or main joint dislocation of the limbs. ⋯ Neither nitrous oxide/oxygen or fentanyl appeared to be superior to the other in relieving moderate to severe pain among emergency patients presenting with isolated limb fracture or dislocation. In an ED, increased use of nitrous oxide might reduce the overall need for opiate analgesia, and in our setting, the need for constant monitoring.
-
Emerg Med Australas · Dec 2011
Increasing impact of mental health presentations on New South Wales public hospital emergency departments 1999-2006.
The percentage of mental health (MH) presentations to New South Wales (NSW) EDs in recent years has not been described at the statewide level. Evidence from other states suggests this burden might be increasing. The present study aims to evaluate recent trends in MH presentations to NSW EDs, including geographic variations and the spectrum of MH disorders encountered. ⋯ Mental health presentations to NSW EDs are increasing. There is a need to review emergency services to accommodate these changes. The reasons for this growth remain unclear and require formal prospective evaluation.
-
Emerg Med Australas · Dec 2011
Sedation assessment tool to score acute behavioural disturbance in the emergency department.
The objective of the study was to evaluate the effectiveness of the sedation assessment tool (SAT) in assessing patient response to treatment for acute behavioural disturbance (ABD). ⋯ The SAT is a simple, rapid and useful measure of the level of agitation/sedation in patients with ABD. Increases in the score reliably indicated the need for further sedation.