Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2018
CommentTaming the zebra: Unravelling the barriers to diagnosing aortic dissection.
Aortic dissection is a lethal cardiovascular emergency that continues to pose a diagnostic dilemma to the emergency physician. The condition is rare, can present atypically and is associated with a cumulative mortality for every hour that passes. While it is a recognised differential of acute chest pain, its prevalence in comparison to other causes often leads to the diagnosis being overlooked. ⋯ This increases susceptibility to cognitive bias and error-producing conditions that can lead to delayed or missed diagnosis. In reported cases where aortic dissection has been missed, clinician awareness of the disease was not the primary issue but failure to respond to clinical cues suggestive of aortic dissection was. To improve patient outcomes for this condition, it is important for clinicians to be aware of pertinent cognitive bias and error-producing conditions.
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Emerg Med Australas · Feb 2018
Antiemetic treatment in the emergency department: Patient opinions and expectations.
To determine patient expectations of antiemetic treatment in the ED. ⋯ Most patients expected antiemetic treatment to make symptoms at least 'a lot less'. Most also believe treatment should be reserved for moderate or severe nausea, and should take effect by 30 min.
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Emerg Med Australas · Feb 2018
Do instability markers predict satisfactory reduction and requirement for later surgery in emergency department patients with wrist fracture?
Research suggests that the presence of instability markers in patients with displaced distal radial fractures is associated with poorer outcome. Our aims were to determine whether the presence of previously defined instability markers could predict the likelihood of successful ED reduction and requirement for a secondary procedure after ED reduction. ⋯ Instability risk factors are common in patients with wrist fractures requiring reduction in ED. The number of instability factors is not a strong predictor of the performance of secondary procedures.