Emergency medicine Australasia : EMA
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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
ReviewReview article: Environmental heatstroke and long-term clinical neurological outcomes: A literature review of case reports and case series 2000-2016.
Global temperatures are rising; extreme environmental heat can result in adverse health effects including heatstroke. Acute effects of heat are well recognised, but there is less understanding of potential long-term adverse outcomes. Our aim was to review recent medical literature for clinical cases of environmental heatstroke with a focus on neurological outcome. ⋯ Cerebellar injury was common suggesting cerebellar structures are vulnerable to heat. These findings highlight that people of all ages and pre-morbid states are at risk of severe heat-related illness. In the face of climate change, effective interventions for heat-related illness, including both treatment and prevention are necessary.
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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: 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
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.