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
Emergency department knowledge management in the age of Web 2.0: evaluation of a new concept.
The objective of the present study was to describe the implementation of an organizational learning model and evaluate the effectiveness and usability of an application used to facilitate it in an ED setting. ⋯ We demonstrate the implementation of an organizational learning model based on independent online sites networking together within an organization. This appears to be both usable and acceptable to staff members working in a large ED as a means of knowledge management.
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Emerg Med Australas · Feb 2011
The Emergency Medicine Capacity Assessment Study: perceived resource requirements to support a major increase in intern numbers in Australian emergency departments.
A 70% increase in graduating interns is projected in Australia from 2007 to 2012. Emergency medicine is a key term in the intern year. There is little information on the preparedness of EDs for this increase, and what resources will be required. ⋯ We recommend attention to ED communications infrastructure, an increase in rostered supervisory time for senior ED medical staff, and the provision of additional ED medical educators to teach interns.
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Emerg Med Australas · Feb 2011
Using 0.45% saline solution and a modified dosing regimen for infusing N-acetylcysteine in children with paracetamol poisoning.
N-acetylcysteine (NAC) administration is recommended to all patients judged to be at risk of developing hepatotoxicity following paracetamol overdose. However, it has been shown that standard i.v. dosing can cause symptomatic hyponatraemia in children. We describe a case series using 0.45% NaCl plus 5% dextrose for infusing i.v. NAC in children with paracetamol poisoning. ⋯ These findings support the use of saline-containing solutions to administer NAC as an alternative to 5% dextrose, and suggest that a two-stage infusion regimen should be further investigated with prospective studies.
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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.