Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2017
Randomized Controlled TrialEconomic evaluation of nasogastric versus intravenous hydration in infants with bronchiolitis.
Bronchiolitis is the most common lower respiratory tract infection in infants and the leading cause of hospitalisation. We aimed to assess whether intravenous hydration (IVH) was more cost-effective than nasogastric hydration (NGH) as a planned secondary economic analysis of a randomised trial involving 759 infants (aged 2-12 months) admitted to hospital with a clinical diagnosis of bronchiolitis and requiring non-oral hydration. No Australian cost data exist to aid clinicians in decision-making around interventions in bronchiolitis. ⋯ Intervention-specific costs account for <10% of total costs of bronchiolitis admissions, with NGH having a small cost saving across all sites.
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Emerg Med Australas · Jun 2017
Learning on the fly: How rural junior doctors learn during consultations with retrieval physicians.
This study explores how rural junior doctors learn while consulting retrieval physicians about critically ill and injured patients, as well as the tensions characterising teaching and learning in this setting. ⋯ Support provided by retrievalists extends the abilities of the junior doctors and often results in learning. When junior doctors are extended too far, they become overwhelmed and learning ceases. Junior doctors would like the retrievalists to spend more time explaining their actions and providing feedback. Even when both retrievalists and junior doctors are interested in teaching, it may not occur due to misunderstandings and differences in status.
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Emerg Med Australas · Jun 2017
Review Meta AnalysisReview article: Workplace violence in the emergency department: A systematic review and meta analysis.
Patient or visitor perpetrated workplace violence (WPV) has been reported to be a common occurrence within the ED. No universal definition of violence or recording of such events exists. In addition ED staff are often reluctant to report violent incidents. ⋯ WPV in the ED was commonly reported. There is wide heterogeneity across the study methodology, definitions and rates. More standardised recording and reporting may inform preventive measures and highlight effective management strategies.
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Emerg Med Australas · Jun 2017
Observational StudyTwo Hour Evaluation and Referral Model for Shorter Turnaround Times in the emergency department.
The objective of this study was to assess the implementation of a novel ED model of care, which combines clinical streaming, team-based assessment and early senior consultation to reduce length of stay. ⋯ A facilitated team leader role for senior doctors can help to reduce length of stay by via early disposition, without significant risks to the patient.
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Emerg Med Australas · Jun 2017
Paediatric lumbar punctures: How do paediatric and emergency doctors differ?
The objective of the study was to identify any differences between emergency physicians and emergency trainees and paediatricians and paediatric trainees in performing paediatric lumbar punctures (LPs). ⋯ Paediatricians and paediatric trainees are more likely to be confident in performing LP in very young children than are emergency physicians and emergency trainees. They are more likely to perform fundoscopy prior to the procedure, but are much less likely to encourage parental presence during the LP.