Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2014
Randomized Controlled TrialChest compression with kneeling posture in hospital cardiopulmonary resuscitation: A randomised crossover simulation study.
We suggest an alternative chest compression (CC) in kneeling posture using a 'kneeling stool' on which the performer kneels beside the patient on a bed in-hospital. In kneeling posture, we can maintain high quality cardiopulmonary resuscitation (CPR) without the bed height adjustment, which is necessary and inconvenient in standing posture. ⋯ A kneeling posture with a kneeling stool were preferred by participants, which have shown similar results in CC parameters and VAS with a standing posture on a stepstool with bed height adjustment during in-hospital CPR.
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Emerg Med Australas · Dec 2014
ReviewReview article: Maxillofacial emergencies: Maxillofacial trauma.
Fractures of the facial skeleton are a common reason for patients to present to EDs and general medical practice in Australia. Trauma to the maxillofacial region can lead to airway obstruction, intracranial injuries, loss of vision or long term cosmetic and functional deficits. This article focuses on the emergency assessment, triage and non-specialist management of traumatic injuries of the orbit and facial skeleton.
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Emerg Med Australas · Dec 2014
Observational StudyScribes in an Australian private emergency department: A description of physician productivity.
The study aims to determine if trained scribes in an Australian ED can assist emergency physicians (EPs) to work with increased productivity. ⋯ In this pilot study, scribe usage was feasible, and overall improvements in consultations per hour were seen. Overall income improved by AUD104.86 (95% CI AUD38.52, AUD171.21) per scribed hour. Further study is recommended to determine if results are sustained or improved over a longer period.
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Emerg Med Australas · Dec 2014
Psychological distress, burnout level and job satisfaction in emergency medicine: A cross-sectional study of physicians in China.
Chinese physicians are not only facing heavy work overloads, but also abuse and injury because of patient mistrust of physicians. The primary objective of the present study was to measure psychological distress, burnout levels and job satisfaction among Chinese emergency physicians. ⋯ Psychological distress is prevalent in this group of ED physicians, and it deserves attention from the whole society. Burnout and job satisfaction among ED physicians are at a 'moderate' level. Burnout is negatively associated with higher job satisfaction.
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Emerg Med Australas · Dec 2014
Sensitivity of proposed clinical decision rules for subarachnoid haemorrhage: An external validation study.
Subarachnoid haemorrhage (SAH) is an uncommon but important cause of sudden-onset headache. Three clinical decision rules (CDRs) for investigation in sudden headache have been proposed, but concerns were raised about the generalisability of some variables. Our aim was to determine what proportion of patients with confirmed SAH has the identified high-risk factors and the sensitivity of the proposed CDR in an Australasian cohort. ⋯ CDR 2, or the refinement of CDRs 1 and 3 with the inclusion of at least one episode of vomiting as a criterion, has very high sensitivity. Although unlikely to reduce CT scan rates for patients in whom there is a clinical suspicion of SAH, they might be useful in guiding which patients require further testing (e.g. lumbar puncture) after a negative CT scan.