Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2020
Initiation of vasopressor infusions via peripheral versus central access in patients with early septic shock: A retrospective cohort study.
To assess whether the initiation of vasopressor infusions via peripheral venous catheters (PVC) compared to central venous catheters (CVC) in ED patients with early septic shock was associated with differences in processes of care and outcomes. ⋯ The practice of commencing a vasopressor infusion via a PVC was common in the ARISE trial and more frequent in trial participants with higher severity of illness. Commencement of a vasopressor infusion via a PVC was associated with some improvements in processes of care and, after adjustment, was not associated with an increased risk of death.
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Emerg Med Australas · Apr 2020
Observational StudyEmergency healthcare delivery for young adults during a planned mass gathering: A retrospective observational study.
To describe patient presentation characteristics and outcomes for people aged 16-18 years pre, during and post a planned youth mass gathering event (MGE): 'Schoolies week' on the Gold Coast, Queensland, Australia. ⋯ Establishment of an in-event model of care for 1 week during Schoolies served as an effective hospital avoidance strategy for a planned youth MGE. Such in-event models of care may be considered for other similar future MGE.
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Emerg Med Australas · Apr 2020
Comparison of the Victorian Emergency Minimum Dataset to medical records for emergency presentations for acute cardiovascular conditions and unspecified chest pain.
The Victorian Emergency Minimum Dataset (VEMD) collects administrative and clinical data for all presentations to Victorian public ED. The present study aimed to examine the level of agreement between the VEMD data and the medical record for a sample of patients coded as having acute cardiovascular conditions (acute coronary syndrome, stroke and transient ischaemic attack [TIA]) and unspecified chest pain in the VEMD. ⋯ When compared to the medical record, our data suggest there is likely variation in the accuracy of some VEMD items, and suggests a larger prospective validation of the VEMD is warranted. For researchers using existing VEMD data, combining of some codes may be necessary.
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Emerg Med Australas · Apr 2020
Observational StudyRisk variables associated with abnormal calcium, magnesium and phosphate levels among emergency department patients.
The utility of calcium, magnesium and phosphate measurement in the ED is limited. We aimed to determine clinical risk variables for abnormal levels of these electrolytes in order to inform the development of an ordering guideline. ⋯ A range of demographic, comorbid, medication and clinical variables are associated with abnormal calcium, magnesium and phosphate levels. These findings will inform the development of clinical guidelines to rationalise calcium, magnesium and phosphate testing. Justification may be required for testing patients with no risk variables.