Emergency medicine Australasia : EMA
-
Emerg Med Australas · Dec 2020
Randomized Controlled TrialBedside ultrasound in the emergency department for reduction and radial manipulation of distal radial fractures.
Distal radial fracture reduction is a common procedure in the ED. Previous studies have suggested that ultrasound (US)-guided reduction improves outcomes for patients who undergo manipulation and reduction of distal radial fractures in the ED. We aimed to investigate this with the first randomised controlled trial looking at US-guided distal radial fracture reduction. Our primary objective was to compare rates of operative intervention between the study groups. Rate of re-manipulation was compared as a secondary outcome. ⋯ US-guided reduction of dorsally displaced, distal radius fractures in the ED setting, did not improve measured clinical outcomes.
-
Emerg Med Australas · Dec 2020
Use of computed tomography and magnetic resonance imaging for occult neck of femur fractures: A single-centre study.
Neck of femur (NOF) fractures are common and serious injuries in the elderly. When a NOF fracture is suspected but is not clearly visible on radiographs, guidelines recommend magnetic resonance imaging (MRI), or computed tomography (CT) if MRI is not available/contraindicated. The aim of our study was to review the use of CT and subsequent MRI for suspected NOF fractures in patients with negative or equivocal radiographs. ⋯ Access to CT for evaluation of suspected occult NOF fractures is much quicker compared to MRI. When CT results are negative with on-going clinical suspicion of an occult fracture, MRI should be performed in a time efficient manner.
-
Emerg Med Australas · Dec 2020
Observational StudyImpact of COVID-19 State of Emergency restrictions on presentations to two Victorian emergency departments.
To determine if COVID-19 State of Emergency (SOE) restrictions were associated with a reduction in presentations to two urban EDs in Melbourne, Victoria. ⋯ SOE restrictions were associated with a significant reduction in ED presentations across a range of triage categories and diagnoses. Public health messaging should emphasise the importance of timely ED attendance for acute illness and injury.
-
Emerg Med Australas · Dec 2020
Review Meta AnalysisReview article: Pre-hospital provider clinical judgement upon arrival to the emergency department: A systematic review and meta-analysis.
Pre-hospital providers (PHPs) undertake initial patient assessment, often spending considerable time with patients prior to arrival at ED. However, continuity of this assessment with ongoing care of patients in the ED is limited, with repeated assessment in the ED, starting with the process of triage in hospital. A systematic review of the literature was conducted to assess the ability of PHPs to predict patient outcomes in the ED. ⋯ Triage score application had weighted kappa variables of 0.409 and 0.452 indicating moderate agreement on assessment priority between PHPs and triage nurses. The ability of PHPs to assign triage scores, predict clinical course and predict disposition from the ED have mild concordance with clinical assessment by ED staff. This is an area of potential expansion in PHPs' role; however, training would be required prior to implementation.