Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2016
Observational StudyThe Royal North Shore Hospital Emergency Department airway registry: Closing the audit loop.
We aim to investigate whether a bundle of changes made to the practice of endotracheal intubation in our ED was associated with an improvement in first pass success rate and a reduction in the incidence of complications. ⋯ We have shown that, through the introduction of a bundle of changes that spans the domains of staff training, equipment and practice standardisation, we have made significant improvements in the safety of patients undergoing endotracheal intubation in our ED.
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Emerg Med Australas · Feb 2016
Observational StudyVariables associated with parent satisfaction with their child's pain management.
The provision of 'adequate analgesia' (which reduces the pain score by ≥2 and to <4 [0-10 scale]) is significantly associated with high levels of satisfaction with pain management among adult patients. We aimed to determine the variables (including 'adequate analgesia') associated with parent satisfaction with their child's pain management. ⋯ Short times to analgesia are associated with parent satisfaction. There were non-significant trends towards high levels of satisfaction following the provision of NIA and 'adequate analgesia'. These findings will inform a well-powered study to confirm this association.
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Emerg Med Australas · Feb 2016
Reliability of the Abbreviated Westmead Post-traumatic Amnesia Scale in children: Impact of age on test results.
This study aimed to determine the reliability of the Abbreviated Westmead Post-traumatic Amnesia Scale (A-WPTAS) in children by examining the impact of age on A-WPTAS performance. ⋯ The A-WPTAS is reliable for use in children aged 7 years and older, while its use in children aged 6 years and under results in an unsatisfactory high false positive rate, limiting its clinical utility. The adult-level performance of children aged 7 years onwards provides strong support for using the tool in the early management of these children with mild traumatic brain injury in Australian EDs.
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Emerg Med Australas · Feb 2016
Can prehospital Modified Early Warning Score identify non-trauma patients requiring life-saving intervention in the emergency department?
We aim to investigate whether prehospital Modified Early Warning Score (MEWS) can identify non-trauma patients requiring life-saving intervention (LSI) within 4 h of presentation to the ED. ⋯ Prehospital MEWS is useful in identifying non-trauma patients requiring LSI within 4 h of ED presentation. This may in turn enhance the triage accuracy in the ED in addition to clinical assessment.
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Emerg Med Australas · Feb 2016
Controlled oxygen therapy at emergency department presentation increases the likelihood of achieving target oxygen saturations in patients with exacerbations of chronic obstructive pulmonary disease.
This study aimed to determine whether initiation of controlled oxygen therapy at ED presentation increased the proportion of patients with chronic obstructive pulmonary disease (COPD) achieving the COPD-X guideline target SpO2 range (88-92%) at 30 min and if it impacted total hospital length of stay or in-hospital mortality. ⋯ Patients with exacerbations of COPD receiving controlled oxygen therapy were more likely to achieve SpO2 within the COPD-X guideline target range without being more likely to be hypoxic. The proportion of patients with SpO2 within the target range was low, suggesting that further work on processes to optimise oxygenation in this group of patients is needed.