Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2017
Comparison of four methods of endotracheal tube passage in simulated airways: There is room for improved techniques.
Endotracheal intubation requires laryngoscopy followed by passage of the endotracheal tube (ETT). Tube passage can be difficult, but there is little evidence to support which adjunct for tube passage is most effective. ⋯ The data show that tube passage with a stylet ETT or a preloaded bougie is superior in terms of higher first pass success, faster time-to-intubation and higher post-test preference. The naked ETT is clearly inferior to other methods. This research supports the recommendation to use a stylet ETT or bougie for every predicted difficult intubation.
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Emerg Med Australas · Dec 2017
Patterns of paediatric emergency presentations to a tertiary referral centre in the Northern Territory.
To describe epidemiological data concerning paediatric attendances at the ED of Royal Darwin Hospital (RDH). ⋯ This study provides important information regarding paediatric presentations to a major referral hospital in the Northern Territory. Overall, there was a disproportionate rate of presentation and admission among Indigenous children. Other key findings were higher proportions of cellulitis, head injury and adolescent presentations. These findings can assist in service planning and in directing future research specific to children in the Northern Territory.
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Time is integral to emergency medicine, but the importance of time is over-rated. Media promotes a focus on time over suffering. Terms such as the 'golden hour' and 'time is muscle' are embedded into our language, but is language that corrupts thought. ⋯ This highlights the importance of nuanced judgements. We need to get into the Goldilocks zone of the 'just right' balance between speed and accuracy. This essay challenges us to focus more on the suffering human subject, rather than on time-based metrics that reflect our hope bias.