Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2019
Clinical decision rule for non-traumatic computed tomography of the brain.
The aims of the present study were to derive and validate a clinical decision rule (CDR) to rule out the need for computed tomography of the brain (CTB) in non-traumatic patients who present to the ED. ⋯ The CDR derived in the present study achieved the highest sensitivity and a moderate specificity when compared with four other pre-existing CDRs for non-traumatic brain injury patients.
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Emerg Med Australas · Dec 2019
The Pacific Emergency Medicine Mentoring Program: A model for medical mentoring in the Pacific region.
To describe the development and implementation of a Pacific medical mentoring programme and to evaluate the programme after the first year. ⋯ The present study suggests a new model of Pacific mentoring that recognises the centrality of the mentoring relationship, and allows for flexible communication, shared responsibility of mentors and mentees as co-drivers and a broad understanding of goals and timelines. Future programmes should incorporate funding for in-person meetings and educational opportunities to enhance contextual and cultural understanding. These lessons can inform future medical mentorship programmes across the Pacific.
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Emerg Med Australas · Dec 2019
Characteristics of short-term re-presentations to a regional emergency department.
The present study aims to describe the characteristics of early ED re-presentations in a regional hospital in New South Wales, Australia. ⋯ Re-presentations were common, but did not lead to increased admissions. The regional hospital in the present study had a higher 72 h ED re-presentation rate than the comparative major city hospital. In particular, paediatric and psychiatric re-presentations were a greater burden to the regional ED. This may be secondary to a lack of alternative services, particularly for these patient groups. Improving these outpatient services may help to reduce the burden of 72 h ED re-presentations.
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Emerg Med Australas · Dec 2019
Prehospital extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest: A retrospective eligibility study.
We sought to identify out-of-hospital cardiac arrest (OOHCA) patients who might benefit from a future prehospital extracorporeal cardiopulmonary resuscitation (ECPR) programme in a moderately sized city. We described the 2014 OOHCA data and identified those who fulfilled hypothetical prehospital ECPR eligibility criteria. ⋯ Sixty-three (30.6%) patients could have derived benefit from a prehospital ECPR programme. Further analyses of prehospital ECPR logistics and economics are necessary to ensure that any future prehospital ECPR programme is effective and efficient.
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Emerg Med Australas · Dec 2019
Multicenter Study Observational StudyHeterogeneous emergency department management of published recommendation defined hypotension in patients with acute traumatic spinal cord injury: A multi-centre overview.
Evidence-based management for patients with acute traumatic spinal cord injury (TSCI) in the ED has a critical impact on long-term outcomes. Acute hypotension post-injury may compromise spinal cord perfusion and extend neurological damage. Published guidelines recommend mean arterial blood pressure (BP) maintenance between 85 and 90 mmHg for 7 days post-injury; the extent to which this is followed in Australia is unknown. ⋯ Hypotensive patients' post-TSCI experienced heterogeneous ED care discordant with published guidelines; varying by hospital type. Specialist care and more severe injury increased likelihood of guideline adherence. Lack of adherence may influence patient outcomes. Level 1 evidence is needed along with consistent guideline implementation and clinician training to likely improve TSCI management and outcomes.