Emergency medicine Australasia : EMA
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The aims of this research were to characterise the injury patterns associated with nail guns, highlight their potential complications and review treatment options. ⋯ The present study characterises the injury patterns caused by nail guns. Treatment of these injuries should be based on clinical findings; however, the majority of cases should undergo surgical treatment. The required operation is a short and safe treatment modality that might allow a thorough assessment of the injury, removal of embedded material, repair of structural damage and a sterile washout to be performed.
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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
Design and roll out of standardised approach to paediatric procedural sedation in Victorian emergency departments.
Children sometimes require minor procedures in the ED for which sedation is needed. Information from Victorian EDs indicated that processes for paediatric procedural sedation were variable, both within and between health services. The aims of this project were to improve safety and reduce variation in practice with respect to paediatric procedural sedation in EDs by rolling out a standardised paediatric sedation programme in Victorian EDs. ⋯ This multi-modal implementation strategy has achieved clinical practice improvement across organisational boundaries.
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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.