Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2019
ReviewReview article: Antiemetics in the pre-hospital setting: A systematic review of efficacy and safety.
Antiemetics are medications that are frequently used in the pre-hospital setting. However, recent evidence indicates that antiemetics are ineffective in reducing undifferentiated nausea scores and vomiting rates. The aim of this study is to evaluate the efficacy and safety of antiemetics administered in the pre-hospital setting. ⋯ Further rigorous studies, preferably randomised and double blinded control trials are required to establish the efficacy of antiemetics in the pre-hospital setting. Consequently, antiemetics should be used more selectively and reserved for severe nausea and intractable vomiting in the pre-hospital setting. PROSPERO registration number: CRD42016044090.
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Emerg Med Australas · Apr 2019
ReviewReview article: Do inferior vena cava filters prevent pulmonary embolism in critically ill trauma patients and does the benefit outweigh the risk of insertion? A narrative review article.
Venous thromboembolic disease (VTE) increases the risk of mortality in trauma patients. To decrease the occurrence of VTE, low dose anticoagulants are commonly prescribed. This may be unacceptable in trauma patients who have a high risk of bleeding. ⋯ The clinical question posed was does prophylactic IVC filter insertion decrease the risk of PE in trauma patients? The available evidence was low level and unable to definitively answer this question. The majority of articles infer that IVC filter insertion is safe and may decrease the risk of PE. However, there is a need for well-designed randomised controlled trials to be conducted in this area.
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Emerg Med Australas · Apr 2019
Review Case ReportsReview article: Isolated proximal tibiofibular joint dislocation.
Proximal tibiofibular joint (PTFJ) dislocations are relatively rare injuries and this paper provides an up-to-date review and practical management approach for the assessment and management of these cases. Isolated PTFJ dislocations are a rare injury, accounting for less than 1% of all knee injuries. ⋯ This paper provides a review of the literature, anatomical analysis of the PTFJ in the dislocated state, and a technique for reduction. In the majority of cases, PTFJ dislocations are an injury that can be identified with simple imaging modalities and treated in the ED with manipulation under procedural sedation.
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Emerg Med Australas · Apr 2019
ReviewReview article: Common emergency department presenting complaints of prisoners: A systematic review.
Prisoners are a particularly vulnerable minority group whose healthcare needs and management differ substantially from the general population. The overall burden of disease of prisoners is well documented; however, little is known regarding the aetiology and frequency of prisoners' acute medical complaints requiring an ED visit. Objectives of the review were to identify, review and appraise existing literature regarding prisoners' presentations to EDs. ⋯ Apart from two European studies in the past 5 years, there is a scarcity of literature primarily addressing the common presenting complaints to EDs by prisoners. Existing studies demonstrated that prisoners have a disproportionately high burden of traumatic, infectious and psychiatric disease requiring emergency treatment. With the increasing number of emergency presentations made by prisoners each year, it is vital that further research is undertaken to identify trends of these acute medical complaints in order to ensure optimal therapeutic outcomes for prisoners.
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Emerg Med Australas · Apr 2019
Multicenter StudyKetamine use for rapid sequence intubation in Australian and New Zealand emergency departments from 2010 to 2015: A registry study.
This study aimed to quantify the proportion of patients undergoing rapid sequence intubation using ketamine in Australian and New Zealand EDs between 2010 and 2015. ⋯ Ketamine use increased between 2010 and 2015. Lower systolic blood pressure, the presence of an emergency medicine team leader, trauma and a higher Glasgow Coma Scale were associated with increased odds of ketamine use. Intubation occurring in a major referral centre was associated with lower odds of ketamine use.