Emergency medicine Australasia : EMA
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To describe the characteristics of adolescents presenting with deliberate self-poisoning (DSP) to a large Australian healthcare network. ⋯ Adolescent DSP presentations frequently involved impulsive ingestion of over-the-counter medications, suggesting less access to prescription medications. Additionally, pre-existing mental health history and re-presentation were common. Initiatives to prevent DSP might include an increased focus on the early identification and management of mental health problems in adolescents in the community.
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Emerg Med Australas · Dec 2016
Predicting and preventing peripheral intravenous cannula insertion failure in the emergency department: Clinician 'gestalt' wins again.
Failed attempts at peripheral i.v. cannula (PIVC) insertion in the ED are common. The psychological, physical and economic impact of these failures is significant. We sought to explore whether clinicians of differing experience levels can predict their own likelihood (clinician 'gestalt') of first-time cannula insertion success on any given patient. ⋯ When applied to our sample population, an algorithm relying on clinician gestalt to identify patients at high risk of PIVC failure had the greatest potential impact. These patients would be referred to expert PIVC inserters prior to, rather than after, failed attempts.
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Emerg Med Australas · Dec 2016
A human cadaveric workshop: One solution to competence in the face of rarity.
Competent performance of cricothyroidotomy, lateral canthotomy and resuscitative thoracostomy is an expected standard for Australasian emergency physicians, but infrequent exposure to these procedures could impair physician confidence, reducing the likelihood of their execution in a critical timeframe. Training to perform these procedures is a recognised challenge for non-surgeons, and cadaver-based training is one method of addressing this need. We describe a 1 day cadaver-based workshop for emergency medicine doctors and briefly report on its impact on physician confidence. This workshop appeared effective in increasing the confidence of emergency medicine physicians to carry out rarely performed life and sight-saving procedures and also provides an opportunity for senior clinicians to increase compliance with continuing profession development schemes.