Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2011
Simple clinical targets associated with a high level of patient satisfaction with their pain management.
We aimed to determine factors that are significantly associated with a high level of patient satisfaction with their pain management. ⋯ Our 'adequate analgesia' definition might provide a useful clinical target, which, combined with adequate communication, might help maximize patient satisfaction.
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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
Performance of a sensitive troponin assay in the early diagnosis of acute myocardial infarction in the emergency department.
Troponin assays have high diagnostic value for myocardial infarction (MI), but sensitivity has been weak early after chest pain onset. New, so-called 'sensitive' troponin assays have recently been introduced. Two studies report high sensitivity for assays taken at ED presentation, but studied selected populations. Our aim was to evaluate the diagnostic performance for MI of a sensitive troponin assay measured at ED presentation in an unselected chest pain population without ECG evidence of ischaemia. ⋯ Sensitive TnI assay at ED presentation has insufficient diagnostic accuracy for detection of MI. Serial biomarker assays in patients with negative initial TnI are required.
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We present the cases of two infants with complications following accidental button battery ingestion with delayed presentations to medical care. Both cases had button batteries recognized as oesophageal foreign bodies and removed appropriately but the time delay resulted in significant morbidity as they developed spinal erosion and tracheo-oesophageal fistula, respectively. Close follow up is required of all children with delayed removal of button batteries as the injury initiated by the battery can lead to a chronic inflammation with significant injury to the surrounding structures.
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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.