Emergency medicine Australasia : EMA
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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.
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Twenty-five years on from the first fellowship examination of the College, it is timely to reflect on the issue of clinical longevity. The pressures of the emergency medicine workplace are relatively unique among the medical specialties, and might require unique solutions if emergency physicians are to continue clinical practice in the latter stages of their careers.
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Emerg Med Australas · Apr 2012
Case ReportsCase report on vertebral artery dissection in mixed martial arts.
A 41-year-old man presented to the ED with severe vertigo 2 days after a grappling injury while training in mixed martial arts. Imaging revealed a cerebellar infarct with complete occlusion of the right vertebral artery secondary to dissection. Management options are discussed as is the ongoing controversy regarding the safety of the sport.
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Emerg Med Australas · Apr 2012
Randomized Controlled TrialButylscopolammonium bromide does not provide additional analgesia when combined with morphine and ketorolac for acute renal colic.
To evaluate the effect of adding butylscopolammonium bromide (BB) to morphine and ketorolac in the treatment of acute renal colic in the ED. ⋯ Although the addition of BB to morphine and ketorolac appeared to show a statistically significant reduction in pain compared with morphine and ketorolac alone, a reduction of 1.2 cm on VAS is unlikely to be clinically significant.