Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2014
ReviewReview article: Maxillofacial emergencies: Oral pain and odontogenic infections.
Oral pain and odontogenic infections are common reasons for patients to present to EDs and general medical practice in Australia. Although most odontogenic infections can be managed on an outpatient basis, because of their proximity to the airway, infections in this region can be life threatening, requiring urgent surgical intervention and ICU management. This article focuses on the emergency assessment, triage and non-specialist management of oral pain and odontogenic infections.
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Emerg Med Australas · Aug 2014
Overdose with modified-release paracetamol (Panadol Osteo®) presenting to a metropolitan emergency medicine network: A case series.
There are currently no large cases series documenting poisoning with paracetamol modified-release (Panadol Osteo®, GlaxoSmithKline, Sydney, NSW, Australia). Management guidelines recommend at least two serum paracetamol concentrations 4 h apart and initiating treatment with N-acetylcysteine (NAC) if more than 10 g is ingested. ⋯ Most patients presenting with Panadol Osteo® poisoning requiring NAC treatment had an initial serum paracetamol concentration indicating need for treatment. A small number of late treatment nomogram line-crossers was seen on repeat paracetamol estimation. The current guideline for Panadol Osteo® poisoning would have detected all cases requiring NAC treatment.
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Emerg Med Australas · Aug 2014
Prehospital management of supraventricular tachycardia in Victoria, Australia: Epidemiology and effectiveness of therapies.
The present study examined patient demographics, characteristics and the effectiveness of current prehospital supraventricular tachycardia (SVT) management by ambulance paramedics in Victoria, Australia. ⋯ Patient characteristics associated with SVT are more likely to be middle-aged women with a history of hypertension and hypercholesterolaemia. Therapies were underutilised leading to reduced clinical guideline effectiveness. Where therapies were instigated, reversion rates are greater than previously reported.
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Emerg Med Australas · Aug 2014
Busted! Management of paediatric upper limb fractures: Not all that it's cracked up to be.
The primary objective was to assess use of splinting prior to X-ray in paediatric ED patients with deformed upper limb fractures. Secondary objectives were to evaluate pharmaceutical analgesia use and the impact of demographic, hospital and clinical variables on splint and analgesia provision. ⋯ This study identified significant shortcomings in ED management of children with deformed upper limb fractures. Only a minority were splinted prior to X-ray, and a quarter did not receive any analgesia in the first hour after presentation. Future study should investigate methods to improve ED management of these patients.