Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2020
Multicenter Study Observational StudyThe Australasian Resuscitation In Sepsis Evaluation: Fluids or vasopressors in emergency department sepsis (ARISE FLUIDS), a multi-centre observational study describing current practice in Australia and New Zealand.
To describe haemodynamic resuscitation practices in ED patients with suspected sepsis and hypotension. ⋯ Current resuscitation practice in patients with sepsis and hypotension varies widely and occupies the spectrum between a restricted volume/earlier vasopressor and liberal fluid/later vasopressor strategy.
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Wong briefly summarises COVID pharmaceutical therapies that are currently in trial, and importantly have received media attention.
Highlighting that off-label use of these drugs may be important causes of future toxicological presentations to emergency departments, especially for those widely used in the community for other indications (eg. Plaquenil, Kaletra, colchicine...).
Briefly discussed are:
- Chloroquine/hydroxychloroquine
- Azithromycin
- Kaletra (Lopinavir/ritonavir)
- Colchicine
- Ivermectin
- Tocilizumab
- Thaildomide
- Remdesivir
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Emerg Med Australas · Aug 2020
Domestic and family violence, non-lethal strangulation and social work intervention in the emergency department.
To review domestic and family violence (DFV) and non-lethal strangulation (NLS) presentations to an ED with 24-h social work. ⋯ Social work referral for DFV is regularly missed despite 24-h access. Assessment of NLS in ED requires improvement and standardised national guidelines.
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Emerg Med Australas · Aug 2020
Epidemiology and clinical features of emergency department patients with suspected COVID-19: Initial results from the COVED Quality Improvement Project (COVED-1).
The COVID-19 Emergency Department (COVED) Quality Improvement Project aims to provide regular and real-time clinical information to ED clinicians caring for patients with suspected and confirmed COVID-19. The present study summarises data from the first 2 weeks of the study. ⋯ Among patients presenting to a tertiary ED with suspected COVID-19, only a small proportion tested positive for SARS-CoV-2. Although the low incidence of positive cases currently precludes the development of predictive tools, the COVED Project demonstrates that the rapid establishment of an agile clinical registry for emergency care is feasible.
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COVID-19 has massively changed the health landscape around the world. Wide-ranging changes to healthcare delivery have occurred, especially in hospitals and EDs. ⋯ In Australia, civil liability Acts provide protection for professionals when the criterion of having undertaken 'competent' practice that would be 'widely accepted' 'in the circumstances' is met. There is doubt how courts, and the medical experts who advise them, will evaluate clinical care provided during the pandemic when health services have developed local care pathways and there is no nationally accepted standard.