Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2018
Community attitudes to emergency research without prospective informed consent: A survey of the general population.
To give voice to the general public's views of prospective and retrospective (deferred) consent in the emergency research setting. ⋯ This research provided the first opportunity for the community to contribute to discourse about prospective and retrospective (deferred) consent in the emergency research setting in Australia. Further work is needed to determine community expectations of how this process can be optimised and implemented, and to identify potential situations where this may not be acceptable.
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Emerg Med Australas · Aug 2018
Observational StudyDoes respiratory variation of inferior vena cava diameter predict fluid responsiveness in spontaneously ventilating children with sepsis.
The intent of fluid bolus therapy (FBT) is to increase cardiac output and tissue perfusion, yet only 50% of septic children are fluid responsive. We evaluated respiratory variation of inferior vena cava (IVC) diameter as a predictor of fluid responsiveness. ⋯ IVC collapsibility has poor test characteristics for predicting fluid responsiveness in spontaneously ventilating children with sepsis.
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Emerg Med Australas · Aug 2018
Is it time for a culture change? Blood culture collection in the emergency department.
To describe how frequently blood cultures (BCs) are obtained in the ED and to describe the incidence of true- and false-positive BC results. ⋯ BCs are a common investigation in the ED with a high false-positive rate. Strategies are required to reduce false positives, including reducing inappropriate collection and improving collection techniques.
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Emerg Med Australas · Aug 2018
Deliberate clinical inertia: Using meta-cognition to improve decision-making.
Deliberate clinical inertia is the art of doing nothing as a positive response. To be able to apply this concept, individual clinicians need to specifically focus on their clinical decision-making. ⋯ Strategies to mitigate common biases are outlined, with an emphasis on reversing a 'more is better' culture towards more temperate, critical thinking. To incorporate such an approach in medical curricula and in clinical practice, institutional endorsement and support is required.
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Emerg Med Australas · Aug 2018
Emergency demand, repeat and frequent presentations by older patients in metropolitan Melbourne: A retrospective cohort study using routinely collected hospital data.
To describe patterns for potentially avoidable general practice (PAGP)-type and non-PAGP-type ED presentations by older patients during 2008 and 2012. ⋯ The rate of repeat and frequent PAGP-type presentations by older people decreased in 2012 compared with 2008, suggesting that initiatives implemented to reduce avoidable presentations may have had an effect. However, an increase in the rate of frequent non-PAGP-type presentations, predominately for acute exacerbation of cardiovascular and respiratory conditions, has important implications for planning future healthcare delivery; hence, the importance of initiatives such as the Health Care Home.