Emergency medicine Australasia : EMA
-
Emerg Med Australas · Apr 2012
Pandemic (H1N1 influenza 2009 and Australian emergency departments: implications for policy, practice and pandemic preparedness.
To describe the reported impact of Pandemic (H(1)N(1) ) 2009 on EDs, so as to inform future pandemic policy, planning and response management. ⋯ This paper describes the breadth of the impact of pandemics on ED operations. It identifies a need to address a range of industrial, management and procedural issues. In particular, there is a need for a single authoritative source of information, the re-engineering of EDs to accommodate infectious patients and organizational changes to enable rapid deployment of alternative sources of care.
-
Emerg Med Australas · Apr 2012
Pain management in Australian emergency departments: current practice, enablers, barriers and future directions.
To explore current pain management practice in Australian EDs and identify enablers and barriers for best-practice pain management. ⋯ Effective and sustainable system change requires a strategy that is initiated within the ED, targets opinion leaders, is supported by evidence, and engages all levels of ED staff.
-
Emerg Med Australas · Apr 2012
Comparative StudyComparison of intubation performance by junior emergency department doctors using gum elastic bougie versus stylet reinforced endotracheal tube insertion techniques.
Endotracheal intubation is a challenging procedure in emergency medicine. Junior doctors lack experience and confidence in this task. The use of a gum elastic bougie (GEB) to facilitate intubation may improve success rates, especially in difficult situations. ⋯ The use of a GEB marginally increases the time taken to perform endotracheal intubation. Success rates for junior doctors attempting endotracheal intubation were not significantly different between the two techniques. Success rates for novice practitioners using a GEB were high after even limited instruction and practice.
-
Emerg Med Australas · Apr 2012
Prosthetic hip dislocations: is relocation in the emergency department by emergency medicine staff better?
Prosthetic hip dislocation is common. This study compares prosthetic hip relocations attempted within the ED by emergency doctors and those under orthopaedic care in the ED or operating theatre (OT). ⋯ There was no difference between EM and orthopaedics in the proportion of hips successfully relocated or complications in the ED; however, EM patients were discharged much sooner, with important resource implications. Procedures carried out in the OT were more successful than in the ED but resulted in prolonged hospital stays and were associated with more complications.
-
Emerg Med Australas · Apr 2012
Cardiac troponin I does not independently predict mortality in critically ill patients with severe sepsis.
Patients with sepsis often have elevated cardiac troponin I even in the absence of coronary artery disease. The prognostic value of cardiac troponins in critically ill patients with sepsis remains debatable. Our objective was to evaluate the prognostic value of cardiac troponin I in critically ill patients with severe sepsis. ⋯ Critically ill patients with severe sepsis who had elevated troponin had increased hospital and intensive care mortality. However, cardiac troponin I did not independently predict hospital mortality.