Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2018
ReviewSecurity interventions for workplace violence in the emergency department.
Despite a policy of zero tolerance towards workplace violence (WPV) in Australian public hospital EDs, the incidence of WPV continues to increase. The aim of this study was to characterise security responses to WPV within an adult level 4 ED. ⋯ EDs should not rely on police response to prevent or handle violence. The finding of a high proportion of events being perpetrated by repeat offenders indicate that data sharing between EDs for identification of perpetrators of WPV can be useful for prevention of future episodes. ACEM policy for WPV in EDs should encompass further details on security credentialing and preventive strategies towards minimisation of WPV in the Australian EDs.
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Emerg Med Australas · Dec 2018
ReviewReview article: Investigations and the pregnant woman in the emergency department - part 2: Point-of-care ultrasound, electrocardiography, respiratory function tests and radiology.
Accurate assessment of the pregnant patient in the ED depends on knowledge of physiological changes in pregnancy, and how these changes may impact on pathology tests, appearance on point-of-care ultrasound, electrocardiography and respiratory function tests. In addition, the emergency physician needs to be cognisant of disorders that are unique to or more common during pregnancy. Part 2 of this review addresses the role of point-of-care ultrasound in pregnancy, physiological changes that may affect interpretation of point-of-care ultrasound, changes in electrocardiography and respiratory function tests, and the safety of radiological procedures in the pregnant patient. Part 1 addressed potential deviations in laboratory investigation reference intervals resulting from physiological alterations in pregnancy and the important causes of abnormal laboratory results in pregnancy.
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Emerg Med Australas · Dec 2018
Arterial to end-tidal carbon dioxide tension difference (CO2 gap) as a prognostic marker for adverse outcomes in emergency department patients presenting with suspected sepsis.
The arterial to end-tidal carbon dioxide tension difference (CO2 gap) correlates with physiologic dead space. The prognostic value of increased CO2 gap in trauma and respiratory distress patients is documented. Transpulmonary arteriovenous shunting is identified as a predictor of mortality in non-pulmonary sepsis. We set out to investigate the prognostic value of the CO2 gap in a pilot study of patients with suspected sepsis from non-respiratory causes. ⋯ In this pilot study of patients with suspected sepsis from non-respiratory causes, an increased CO2 gap demonstrates value in risk stratification and needs to be further evaluated and compared to other existent biomarkers.
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Emerg Med Australas · Dec 2018
Observational StudyExploring the feasibility of targeted chronic hepatitis B screening in the emergency department: A pilot study.
To explore the feasibility of an ED chronic hepatitis B (CHB) screening programme. ⋯ Targeted ED CHB screening is feasible but effectiveness and cost-effectiveness need further exploration.
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Emerg Med Australas · Dec 2018
Epidemiology of trauma patients attended by ambulance paramedics in Perth, Western Australia.
The aim of the study was to describe the epidemiology of trauma in adult patients attended by ambulance paramedics in Perth, Western Australia. ⋯ The trauma incidence rate increased over time and the majority of patients had low-acuity injuries. Focusing research, training and resources solely on high-acuity patients will not cater for the needs of the majority of patients.