Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2011
Case ReportsSuccessful resuscitation from bupivacaine-induced cardiovascular collapse with intravenous lipid emulsion following femoral nerve block in an emergency department.
We report a case of a 69-year-old woman with femoral neck fracture undergoing bupivacaine femoral nerve block for preoperative analgesia in an ED. Seizure and cardiovascular collapse developed immediately after instillation of local anaesthetic. ⋯ No adverse sequelae of lipid administration were observed. We recommend the immediate availability of lipid emulsion in emergency room settings where local anaesthetics are used.
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Emerg Med Australas · Apr 2011
Editorial CommentIntravenous lipid emulsion: why wait to save a life?
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Emerg Med Australas · Apr 2011
Clinical TrialDelays in presentation with acute coronary syndrome in people with coronary artery disease in Australia and New Zealand.
To report time from the onset of symptoms to hospital presentation in Australian and New Zealand patients with subsequently confirmed acute coronary syndrome, and to identify factors associated with prehospital delay time in these patients. ⋯ The time from the onset of symptoms to hospital presentation was too long for maximal benefit from treatment in most patients. Further efforts are needed to reduce treatment-seeking delay in response to symptoms of acute coronary syndrome.
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Emerg Med Australas · Apr 2011
Case ReportsPainless aortic dissection presenting with acute ischaemic stroke and multiple organ failure.
Acute aortic dissection is an uncommon, life-threatening catastrophe, and early diagnosis is essential for the best chance of survival. Although acute onset of severe chest or back pain is the most common presenting symptom, some patients might present with atypical symptoms and findings such as acute stroke and mesenteric ischaemia related to the involving arterial segment. Establishing the diagnosis of aortic dissection can be difficult in the presence of atypical symptoms, especially in the absence of pain. Here, we report a case of acute, painless aortic dissection presenting with multiple organ failure and neurological deficits suggesting acute ischaemic stroke.
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Emerg Med Australas · Apr 2011
Treatment and assessment of emergency department nausea and vomiting in Australasia: a survey of anti-emetic management.
To describe the treatment and assessment of emergency department nausea and vomiting (EDNV) in Australasia by Fellows of the Australasian College for Emergency Medicine (FACEM). To determine the influence of various factors on FACEM anti-emetic choice. To compare the influence of drug effectiveness, side effects, cost and pharmacy directives on adult EDNV anti-emetic choice between FACEM choosing the two most common first-line agents. ⋯ Fellows of the Australasian College for Emergency Medicine anti-emetic choice in Australasian ED has been described. The main influences on anti-emetic choice were patient age, perceived drug efficacy and drug side-effect profiles.