Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2013
Sensitivity and specificity of three-point compression ultrasonography performed by emergency physicians for proximal lower extremity deep venous thrombosis.
The present study aims to quantify the sensitivity and specificity of three-point compression ultrasonography for diagnosing proximal lower extremity deep venous thrombosis when performed by Australian consultant emergency physicians with limited specific training. Secondary aims included quantifying rapidity, technical adequacy, predictability of equivocal results and relationships between emergency physician experience and proficiency. ⋯ Abbreviated ultrasonography performed by emergency physicians for proximal lower extremity deep venous thrombosis could be valuable. However, more precise estimates for sensitivity and greater understanding of relationships between emergency physician experience and proficiency are required.
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Emerg Med Australas · Dec 2013
Alcohol-related violence presenting to the emergency department: Is 'glassing' the big issue?
The study aims to describe the characteristics of patients presenting to EDs within Queensland, Australia with injuries because of assault with a glass implement ('glassing') and to set this within the broader context of presentations because of alcohol-related violence. ⋯ Contrary to public perception generated by media, 'glassing' incidents, particularly at licensed venues, constitute a relatively small proportion of all alcohol-related violence. The current study highlights the predominance of young men injured following alcohol-related violence, demonstrating a key focus area within the population for aiming prevention strategies.
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Emerg Med Australas · Dec 2013
Evaluation and outcomes of patients admitted to a tertiary medical assessment unit with acute chest pain of possible coronary origin.
The study aims to (i) profile clinical characteristics, risk estimates of acute coronary syndrome (ACS), use and yield of non-invasive cardiac testing, discharge diagnosis and 30-day outcomes among patients admitted with acute chest pain of possible coronary origin; and (ii) construct a risk stratification algorithm that informs management decisions. ⋯ In patients with indeterminate chest pain, clinical features and risk scores identify most with myocardial ischaemia. An algorithm is presented that might inform triaging, early discharge, choice of testing and need for telemetry.
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Emerg Med Australas · Dec 2013
Implementation and performance evaluation of an emergency department primary practitioner physiotherapy service for patients with musculoskeletal conditions.
The study aims to describe the implementation of a primary practitioner physiotherapy service within a large regional ED and to evaluate its impact on waiting time and length of stay. ⋯ The current study found that patients with musculoskeletal problems seen by a primary practitioner physiotherapy service had improved waiting times and length of stay relative to ACEM and Victorian Department of Health targets, and though constrained by a retrospective non-randomised design, to a similar group of patients seen by medical staff. Further evaluation of the physiotherapy practitioner service is required.
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Emerg Med Australas · Dec 2013
New emergency department quality measure: From access block to National Emergency Access Target compliance.
The study aims to investigate the effect of time of day and ED occupancy on the ability of EDs to admit or discharge patients within 4 h in accordance with the National Emergency Access Target (NEAT), and to compare this with corresponding levels of access block, the measure for ED performance before NEAT. ⋯ EDs face rising levels of NEAT non-compliance at times when corresponding access block levels have traditionally not been a concern. A higher proportion of patients breach the target during periods that would intuitively not be flagged as flow bottlenecks. The findings support the need for service level analysis and new solutions to guide workflow reform and maximise NEAT compliance.