Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2011
Comparative StudyValidation of the Luscombe weight formula for estimating children's weight.
Several paediatric weight estimation methods have been described for use when direct weight measurement is not possible. A new age-based weight estimation method has recently been proposed. The Luscombe formula, applicable to children aged 1-10 years, is calculated as (3 × age in years) + 7. Our objective was to externally validate this formula using an existing database. ⋯ The Luscombe formula is among the more accurate age-based weight estimation formulae. When more accurate methods (e.g. parental estimation or the Broselow tape) are not available, it is an acceptable option for estimating children's weight.
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Emerg Med Australas · Feb 2011
Variation in the management of hypothetical cases of acute agitation in Australasian emergency departments.
To describe the prescribing practice of emergency medicine clinicians in the management of highly agitated patients and to identify perceived barriers to management and the gaps in training. ⋯ There is considerable variation in the management of hypothetical cases of acute agitation in Australasian EDs. Benzodiazepines and antipsychotics, either alone or in combination, are commonly used. An ACEM-endorsed, Australasian CPG was perceived as useful.
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Emerg Med Australas · Feb 2011
ReviewA systematic review: The role and impact of the physician assistant in the emergency department.
This systematic review describes the role and impact of physician assistants (PAs) in the ED. It includes reports of surveys, retrospective and prospective studies as well as guidelines and reviews. Seven hundred and twelve studies were identified of which only 66 were included, and many of these studies were limited by methodological quality. ⋯ The evidence indicates that PAs are reliable in assessing certain medical complaints and performing procedures, and are well accepted by ED staff and patients alike. There is limited evidence as to whether PAs improve ED flow or are cost-effective. Future studies on work processes, cost-effectiveness, unfamiliar patients' willingness to be treated by non-physician providers, and ED physicians' acceptability of PAs are needed to inform and guide the integration of PAs into EDs.
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Toxic cardiac arrest is an uncommon manifestation of poisoning. Patients might benefit from resuscitative measures that are over and above those recommended in standard ACLS resuscitation guidelines. ⋯ Treating medical staff should seek expert advice from a toxicologist or from their Poisons Information Centre network (Australia 13 11 26; New Zealand 0800 764 766) at the earliest opportunity when managing patients with cardiac arrest or intractable shock from known or suspected poisoning. Ideally, toxicological expertise should be sought before the withdrawal of active treatment in cardiac arrest or shock from known or suspected poisoning.