Emergency medicine Australasia : EMA
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The shocked neonate often causes anxiety in the ED. This article aims to provide a systematic, practical approach to recognition and initial management of these patients. ⋯ Practical tips for intravenous access and the rationale behind choice of inotrope and anaesthetic induction agent are discussed. The major underlying causes - sepsis, cardiac disease, metabolic disease and non-accidental injury - along with their investigation and management are considered.
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Emerg Med Australas · Feb 2013
Intern underperformance is detected more frequently in emergency medicine rotations.
To determine the frequency and nature of intern underperformance as documented on in-training assessment forms. ⋯ The prevalence of underperformance among interns is low, although higher than previously suggested. Emergency medicine detects relatively more interns in difficulty than other rotations.
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Emerg Med Australas · Feb 2013
Improvement in the accuracy of references in the journal Emergency Medicine Australasia.
To study any change in reference accuracy in the Australasian emergency medicine journal (now known as Emergency Medicine Australasia), in the 10 years since a previous analysis was undertaken. ⋯ This paper demonstrates a significant improvement in the accuracy of references in the journal Emergency Medicine Australasia over the past decade. This paper did not identify the reasons for this improvement, but potential causes might include the introduction of a web-based peer review and manuscript submission process, as well as improved reference bibliography systems by authors. In addition, an increase in the overall standard of paper submitted to the journal might have contributed to this improvement.
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Emerg Med Australas · Feb 2013
Introduction of an N-acetylcysteine weight-based dosing chart reduces prescription errors in the treatment of paracetamol poisoning.
Under- or overdosing of N-acetylcysteine (NAC), when used to treat paracetamol toxicity, is associated with significant morbidity and mortality. This study evaluated the effect of a weight-based dosing chart (WBDC) introduced to decrease NAC prescription errors. ⋯ The introduction of a WBDC did not produce a clinically significant reduction in major NAC prescription error rates (as pre-defined in this study); however, there was a clear trend towards a reduction. The WBDC significantly reduced total and minor NAC prescription error rates.
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To describe the mechanism, injury pattern and management of women who present to the ED with non-obstetric vulval trauma. ⋯ Non-obstetric vulval injuries are uncommon (incidence 3.7%). All cases require assessment for vaginal, urethral, anal and bony pelvis injuries. This might require examination under anaesthesia. Conservative management of haematomas in the absence of acute haematoma expansion is favoured. The need to screen for sexually transmissible infections and pregnancy is important. Social worker and psychological support is important to reduce the incidence of long-term psychological problems.