Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2019
Non-traumatic musculoskeletal pain in Western Australian hospital emergency departments: A clinical audit of the prevalence, management practices and evidence-to-practice gaps.
Musculoskeletal pain (MSP) conditions are a leading cause of morbidity worldwide and a common reason for ED presentation. Little is currently known about non-traumatic MSP (NTMSP) presenting to EDs. The present study described the prevalence and management practices of NTMSP in EDs. ⋯ NTMSP is a relatively common reason for ED presentation. Documented management practices are discordant with guideline recommendations. Strategies to improve the concordance between management and guideline recommendations are needed.
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Emerg Med Australas · Dec 2019
Comparative StudyComparison of emergency physiotherapy practitioner prescribers versus existing emergency department prescribers for musculoskeletal injuries.
The scope of selected emergency physiotherapy practitioners (EPP) in this Australian non-tertiary ED has recently extended to include the prescription of a limited drug formulary, including paracetamol, some NSAIDs and opioids, an anti-emetic, a benzodiazepine and nitrous oxide. Although there are large-scale studies investigating prescription errors made by doctors, there is a lack of data on prescribing practices of physiotherapists in the ED setting. The aim of present study is to compare the prescribing practices of EPP to their medical and nursing colleagues within the setting of treating musculoskeletal injuries in the ED. ⋯ In the management of ED patients with musculoskeletal complaints, prescription-trained EPP appear to perform similarly if not better than their medical and nursing colleagues with regards to NIMC audit tool results.
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Emerg Med Australas · Dec 2019
Role and impact of brain computed tomography in the management of drug overdoses and guideline recommendations.
Patients presenting with overdoses commonly receive computed tomography brain (CTB) scans in their assessment. There is no current guideline or validated decision support tool for neuroimaging in overdose patients. We investigated the proportion of overdose patients who received a CTB scan and its impact on management. ⋯ A high proportion of overdose patients received CTB scans. There was only a low yield in terms of management alteration. We propose that clinicians adopt a guided approach using a decision support tool to minimise unnecessary CTB scans.
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Emerg Med Australas · Dec 2019
Beta-blocker use is an independent risk factor for thunderstorm asthma.
To identify risk factors for thunderstorm asthma (TA) in subjects ≥15 years of age from information available in routine clinical records. ⋯ Oral beta-blocker medications, younger age and Asian-born heritage are risk factors for TA. Further study is required to explore the potential association between beta-blockers and TA.