Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2012
How useful are the Heart Foundation risk criteria for assessment of emergency department patients with chest pain?
To investigate the prognostic utility of Heart Foundation (Australia) risk stratification table in an ED chest pain population. ⋯ The Heart Foundation risk classification shows only fair predictive performance for MI, 7 and 30 day MACE. With specificity of approximately 50%, the recommendation for coronary care admission for all high-risk patients is hard to justify.
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Emerg Med Australas · Jun 2012
Venous thromboembolism in emergency department patients with rigid immobilization for lower leg injury: Incidence and risk factors.
To determine the incidence and risk factors for symptomatic venous thromboembolism (VTE) in adults who are discharged from the ED with rigid immobilization for lower limb injury. ⋯ The estimated VTE incidence was between 3% and 7% in this ED population with age and diagnosis of Achilles tendon rupture increasing risk. Prospective research to more accurately determine incidence, severity and risk stratification is required before firm recommendations on the likely risk versus benefit profile of thromboprophylaxis can be made for this population.
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Emerg Med Australas · Jun 2012
Prevalence and characteristics of patients with risky alcohol consumption presenting to emergency departments in rural Australia.
This study measures the prevalence of problematic alcohol consumption in patients of EDs in rural areas of Australia, relative to the general population in the same rural communities. It also identifies the characteristics associated with risky drinking in rural ED patients. ⋯ Risky drinking, across a number of measures, is overrepresented in patients of rural Australian EDs relative to the general community, and this type of consumption is not limited to certain subgroups of patients. There is a need for interventions that address both heavy single occasion drinking and excessive regular consumption in patients of rural Australian EDs, with universal interventions recommended rather than targeted programmes.
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Emerg Med Australas · Jun 2012
Case ReportsEmergency presentation of emboli to multiple sites from an atrial myxoma.
A middle aged man presented to our ED with back pain and confusion, had evidence of acute arterial insufficiency to his lower limbs and myocardial infarction on initial ECG. His workup included an urgent CT, which revealed a filling defect in his dilated left atrium, renal and splenic infarcts, and an embolism in his left internal iliac artery. Urgent embolectomy and fasciotomy could not save his left lower limb, and emergency cardiac surgery was required to excise an atrial myxoma. A brief narrative review of the literature is also presented, with this case being unusual in causing such widespread concurrent multiple organ damage, including stroke and myocardial infarct.
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Emerg Med Australas · Jun 2012
Case ReportsEcstasy-induced acute coronary syndrome: something to rave about.
Ecstasy or 3,4-methylenedioxymethamphetamine is a commonly used illicit recreational drug, enjoying popularity for its stimulant effects. Although acute coronary syndrome is recognized after cocaine and methamphetamine use, association with Ecstasy use has rarely been reported. We report three cases of significantly delayed acute coronary syndrome and ST elevation myocardial infarction related to ingestion of Ecstasy.