Emergency medicine Australasia : EMA
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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.
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Emerg Med Australas · Feb 2018
Realism in paediatric emergency simulations: A prospective comparison of in situ, low fidelity and centre-based, high fidelity scenarios.
To measure scenario participant and faculty self-reported realism, engagement and learning for the low fidelity, in situ simulations and compare this to high fidelity, centre-based simulations. ⋯ Some aspects of in situ simulations may be less 'real' than centre-based simulations, but there was no significant difference in self-reported engagement or learning by scenario participants. Low fidelity, in situ simulation provides adequate realism for engagement and learning.
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Emerg Med Australas · Feb 2018
Observational StudyInfluenza-associated delays in patient throughput and premature patient departure in emergency departments in New South Wales, Australia: A time series analysis.
Influenza outbreaks cause overcrowding in EDs. We aimed to quantify the impact of influenza on the National Emergency Access Targets and premature patient departure in New South Wales, Australia. ⋯ Circulating influenza was associated with sustained increases and peaks in delayed patient throughput and premature patient departures. Influenza surveillance information may assist with development of health system and hospital workforce planning and bed management activities.
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Emerg Med Australas · Feb 2018
ReviewReview article: Sepsis in the emergency department - Part 2: Investigations and monitoring.
Sepsis is characterised by organ dysfunction resulting from infection, with no reliable single objective test and current diagnosis based on clinical features and results of investigations. In the ED, investigations may be conducted to diagnose infection as the cause of the presenting illness, identify the source, distinguish sepsis from uncomplicated infection (i.e. without organ dysfunction) and/ or risk stratification. Appropriate sample collection for microbiological testing remains key for subsequent confirmation of diagnosis and rationalisation of antimicrobials. ⋯ New technologies for screening multiple genes and proteins are identifying unique network 'signatures' of clinical interest. Other future directions include rapid detection of bacterial DNA in blood, genes for antibiotic resistance and EMR-based computational biomarkers that collate multiple information sources. Reliable, cost-effective tests, validated in the ED to promptly and accurately identify sepsis, and to guide initial antibiotic choices, are important goals of current research efforts.