Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2016
ReviewReview article: The utility of flexion-extension radiography for the detection of ligamentous cervical spine injury and its current role in the clearance of the cervical spine.
Detecting the presence of injuries to the cervical spine is an important component of the initial assessment of patients sustaining blunt trauma. A small proportion of cervical spine injuries consists of ligamentous disruption. Accurate detection of ligamentous injury is essential as it may result in sequelae including radiculopathy, quadriplegia and death. ⋯ There are studies that call into question the diagnostic accuracy of FE, the high proportion of inadequate FE images due to muscle spasm and the adverse effects of prolonged cervical collar immobilisation while awaiting FE. Other literature indicates that FE provides no additional diagnostic information following a multi-detector helical computed tomography. This review evaluates the literature on the utility of FE for the detection of ligamentous injury and explores alternate strategies for clearing the cervical spine of ligamentous injury.
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Emerg Med Australas · Apr 2016
Chest pain risk assessment in Indigenous and non-Indigenous Australians using HEART Score.
The objectives of this study were to investigate factors that correlate to cardiac events within 30 days in Indigenous and non-Indigenous Australians who present to ED with chest pain and to describe the predictive ability of the HEART Score in these groups. ⋯ The HEART Score is a reliable predictor of patient outcome in both Indigenous and non-Indigenous Australians. Modification of the HEART Score may not be required for use in the Indigenous Australian population who present to the ED with chest pain.
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Emerg Med Australas · Apr 2016
Qualitative study of patients' choice between public and private hospital emergency departments.
The aim of this study was to gather patients' perceptions regarding their choice between public and private hospital EDs for those who hold private health insurance. The findings of this study will contribute to knowledge regarding patients' decision-making processes and therefore may contribute to the development of evidence based public policies. ⋯ Patients who choose to attend public EDs appear to value financial concern over waiting time; those who choose to attend private EDs appear to value waiting time ahead of financial concerns.
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Emerg Med Australas · Apr 2016
Use of serum lactate levels to predict survival for patients with out-of-hospital cardiac arrest: A cohort study.
We examined the association of serum lactate levels and early lactate clearance with survival to hospital discharge for patients suffering an out-of-hospital cardiac arrest (OHCA). ⋯ In OHCA patients who had serum lactate levels measured, both lower initial serum lactate and early lactate clearance in the first 48 h following OHCA were associated with increased likelihood of survival. However, the use of lactate in isolation as a predictor of survival or neurological outcome is not recommended. Prospective studies that minimise selection bias are required to determine the clinical utility of serum lactate levels in OHCA patients.