Emergency medicine Australasia : EMA
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Lung ultrasound (LUS) plays a critical role in the SARS-CoV-2 pandemic. Evidence is mounting on its utility to diagnose, assess the severity and as a triage tool in the ED. ⋯ In this article, we have described a step-by-step approach to LUS in COVID patients and the CLUE (COVID-19 LUS in the ED) protocol, which involves an anatomical parameter, the severity of lung changes, objectively scored using the validated LUS scoring system and a physiological parameter, oxygen requirement. We believe this CLUE protocol can help risk-stratify patients presenting to ED with suspected COVID-19 and aid clinicians in making appropriate disposition decisions.
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Emerg Med Australas · Aug 2020
Observational StudyAre expiratory radiographs more sensitive than inspiratory radiographs for the diagnosis of pneumothorax in the emergency department? A retrospective observational study.
Expiratory radiographs are sometimes performed in addition to inspiratory radiographs when a diagnosis of pneumothorax is suspected. There is little published evidence to support this practice and most studies suggest the additional radiograph does not confer any benefit in terms of increased sensitivity. The present study is the first to assess if specialist emergency physicians are more likely to detect a pneumothorax on an inspiratory radiograph compared to an expiratory radiograph. ⋯ When reviewed by emergency physicians the present study found expiratory radiographs confer an increase in sensitivity for the diagnosis of pneumothorax compared with inspiratory radiographs. In certain patients where the clinical suspicion for pneumothorax is high performing an expiratory radiograph may increase the likelihood of the diagnosis being made in the ED.
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Addressing and limiting burnout and its significant impacts on emergency physicians is an important and ongoing challenge, requiring much more than a focus on individual resilience. This is a key understanding which guides and informs the Australasian College for Emergency Medicine's holistic approach and advocacy efforts when it comes to the wellness of emergency physicians and the health systems in which they operate.
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Emerg Med Australas · Aug 2020
Observational StudyRetrospective observational cohort study of out-of-hospital cardiac arrest outcomes in Tasmania 2010-2014.
This study aims to present overall survival rates to hospital discharge for out-of-hospital cardiac arrest (OHCA) in Tasmania and to identify predictors of survival. ⋯ Time to defibrillation for witnessed arrests, other than paramedic witnessed arrest was associated with better overall survival rates than unwitnessed OHCA. Further factors such as the event being of cardiac aetiology, bystander cardio-pulmonary resuscitation performed, initial presenting cardiac rhythm of ventricular fibrillation or ventricular tachycardia and decreasing age were all associated with increased probability of survival.