Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2014
Letter Case ReportsTASERed during training: An unusual scapular fracture.
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Emerg Med Australas · Apr 2014
ReviewReview article: What makes a good healthcare quality indicator? A systematic review and validation study.
Indicators measuring aspects of performance to assess quality of care are often chosen arbitrarily. The present study aimed to determine what should be considered when selecting healthcare quality indicators, particularly focusing on the application to emergency medicine. Structured searches of electronic databases were supplemented by website searches of quality of care and benchmarking organisations, citation searches and discussions with experts. ⋯ Although using the tool took more time than implicit gestalt decision making: median (interquartile range) 190 (43-352) min versus 17.5 (3-34) min, their rankings changed after using the tool. To inform the appraisal of quality improvement indicators for emergency medicine, a comprehensive list of indicator attributes was identified, validated, developed into a tool and piloted. Although expert consensus is still required, this tool provides an explicit basis for discussions around indicator selection.
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Emerg Med Australas · Apr 2014
Limited utility of exercise stress testing in the evaluation of suspected acute coronary syndrome in patients aged less than 40 years with intermediate risk features.
National guidelines for management of intermediate risk patients with suspected acute coronary syndrome, in whom AMI has been excluded, advocate provocative testing to final risk stratify these patients into low risk (negative testing) or high risk (positive testing suggestive of unstable angina). Adults less than 40 years have a low pretest probability of acute coronary syndrome. The utility of exercise stress testing in young adults with chest pain suspected of acute coronary syndrome who have National Heart Foundation intermediate risk features was evaluated. ⋯ Routine exercise stress testing has limited value in the risk stratification of adults less than 40 years with suspected intermediate risk of acute coronary syndrome.