Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2014
ReviewReview article: Shock Index for prediction of critical bleeding post-trauma: A systematic review.
Early diagnosis of haemorrhagic shock (HS) might be difficult because of compensatory mechanisms. Clinical scoring systems aimed at predicting transfusion needs might assist in early identification of patients with HS. The Shock Index (SI) - defined as heart rate divided by systolic BP - has been proposed as a simple tool to identify patients with HS. ⋯ An association between higher SI and bleeding was demonstrated in all studies. The SI is a readily available tool and may be useful in predicting CB on arrival to hospital. The evaluation of improved utility of the SI by performing and recording at earlier time-points, including the pre-hospital phase, is indicated.
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Human psychology, neuroscience and behavioural economics study the human mind, brain and behaviour. Scientific research has discovered a great deal about the factors that influence human perception, judgment and activity in the real world. ⋯ I propose that meta-cognition, or thinking-about-thinking, has the potential to inform how we practice emergency medicine. By accommodating human traits rather than trying to defy them, we can ultimately benefit our patients.
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Emerg Med Australas · Jun 2014
Satisfaction with emergency department service among non-English-speaking background patients.
The present study aims to investigate non-English-speaking background (NESB) patients' satisfaction with hospital ED service and compare it with that of English-speaking background (ESB) patients. ⋯ The NESB patients were significantly less satisfied than the ESB patients with the ED service. Use of an interpreter improved the NESB patients' level of satisfaction. Further research is required to examine what NESB patients' expectations of ED service are.
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Emergency healthcare is a high profile component of modern healthcare systems, which over the past three decades has fundamentally transformed in many countries. However, despite this rapid development, and associated investments in service standards, there is a high level of concern with the performance of emergency health services relating principally to system wide congestion. ⋯ The aim of this article is to stimulate a conversation about the future design and functioning of emergency healthcare systems; examining what we understand about the problem and proposing a rationale that may underpin future strategic approaches. This is also an invitation to join the conversation.
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Emerg Med Australas · Jun 2014
Ultrasound use in Australasian emergency departments: A survey of Australasian College for Emergency Medicine Fellows and Trainees.
To describe current practice of EDUS by ACEM Trainees and Fellows; to describe potential barriers to US use in the Australasian setting; to determine compliance with current college guidelines regarding US credentialing. ⋯ The present study showed that only a minority of ACEM Trainees and Fellows are credentialed to perform routine ED scans. Many non-credentialed ACEM Trainees and Fellows are performing scans, many without independent confirmation of their findings.