Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2016
Point of care testing for group A streptococci in patients presenting with pharyngitis will improve appropriate antibiotic prescription.
History, clinical examination and throat culture may be inadequate to rule in or out the presence of group A streptococci (GAS) infection in patients with sore throat in a remote location. We correlated the diagnostic accuracy for guiding antibiotic prescription of clinical decision and physiological scoring systems to a rapid diagnostic point of care (POC) test result in paediatric patients presenting with sore throat. ⋯ Clinician judgement and Centor score are inadequate tools for clinical decision-making for children presenting with sore throat. Adjunctive POC testing provides sufficient accuracy to guide antibiotic prescription on first presentation.
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Emerg Med Australas · Apr 2016
Parent perspectives and reasons for lower urgency paediatric presentations to emergency departments.
The age band with, by far, the greatest number of ED presentations is children 0-4 years, with other paediatric age bands also among the highest. As the majority of these presentations are for lower urgency conditions, we sought to determine why parents seek ED care for their child for lower urgency conditions. ⋯ The current magnitude and the growth of lower urgency paediatric ED presentations is a strain on the health care system. Efforts to educate parents regarding the suitability and availability of GP appointments can be the cornerstone of an initial strategy to address this issue. However, efforts to address the high rates of GP referral to EDs for low urgency presentations will be more vexing to develop, yet no less important. They will require addressing fundamental issues in both current GP care for children and the training of GP registrars.
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Emerg Med Australas · Apr 2016
Observational StudyTrends in computed tomography utilisation in the emergency department: A 5 year experience in an urban medical centre in northern Taiwan.
Steady increase in computed tomography (CT) utilisation in the ED was observed in countries such as the USA, Canada, China and Korea; however, limited empirical data are available regarding Taiwan. ⋯ ED CT utilisation has increased at a rate far exceeding the growth in ED patient volume. This may be attributed to the improved utility of CT in diagnosing serious pathology, more diagnostic indications for CT, ready availability and the necessity for diagnostic certainty in the ED.
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Several health, social and professional factors are forcing Emergency Physicians to rethink their role in the health system. Despite these challenges, there are a number of ways that we can evolve, including an increasing role for academic and subspecialty emergency medicine, which will ensure our specialty, remains vital and viable in the 21st century and beyond.