Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2021
Analysis of the Australia and New Zealand referral criteria for transfer to a liver unit for paracetamol overdose.
Paracetamol overdose is common and can lead to fulminant hepatic failure. In cases that are not improving with standard medical therapy with N-acetylcysteine, some patients may require liver transplant. The Australia and New Zealand (ANZ) referral criteria for transfer to a liver unit have not been extensively studied for its predictive value. The aim of this study was to evaluate the ANZ referral criteria for predicting mortality in paracetamol overdose. ⋯ The ANZ referral criteria were highly sensitive for predicting the outcome of mortality and transplant. This is important for screening patients who may become unstable and difficult to transfer at a later stage of their admission.
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Emerg Med Australas · Dec 2021
'I'm not in GP pain, I'm in hospital pain': Qualitative study regarding patient decision-making factors in seeking care in the emergency department with non-specific low back pain.
To investigate factors contributing to the decision for a working age adult experiencing non-specific low back pain (NSLBP) to seek care at an Australian metropolitan tertiary ED. ⋯ Patient beliefs about NSLBP are important drivers of ED care seeking. Evidence-based guidelines recommend screening for red flags and then addressing pain and disability through engagement with patient concerns and providing a management plan/pathway. In the ED setting, addressing the anxieties of these patients and re-interpreting the significance of their pain may be a path to providing time efficient high-value care.
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Emerg Med Australas · Dec 2021
Fever phobia in caregivers presenting to New Zealand emergency departments.
To determine the prevalence of fever phobia among caregivers of children presenting to New Zealand EDs. ⋯ Fever phobia is prevalent among caregivers of children presenting to New Zealand EDs. Opportunistic caregiver education in the ED in conjunction with public health strategies are needed to dispel undue fears and misconceptions about fever.
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Emerg Med Australas · Dec 2021
Blood alcohol screening and outcomes in trauma team activation patients at a level 1 trauma centre in New Zealand.
A causal relationship between alcohol consumption and injury exists and the prevalence of harmful alcohol intakes in New Zealand adults is high. The present study investigates compliance to blood alcohol (BA) screening policy and the epidemiological profile and hospital-related outcomes of trauma team activation (TTA) patients with positive BA at a New Zealand level 1 trauma centre. ⋯ Between 2012 and 2019, Waikato Hospital demonstrated high compliance to BA screening policy for TTA patients. Appropriate alcohol awareness initiatives that focus on road safety and interpersonal violence are required to reduce the preventable prevalence and burden of alcohol-related trauma in the Waikato region.
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Australia is rapidly moving towards 'living with COVID-19', with relaxation of some public health measures. The number of severe cases of COVID-19 may be mitigated by vaccination, but 'living with COVID-19' will be associated with higher number of patients seeking emergency care. This impending impact on the emergency care system requires recognition, monitoring and co-ordinated management. ⋯ Effective monitoring systems are required for health systems to proactively detect and respond to stresses. Additional solutions include public health messaging and clinical innovation to facilitate care of the right patient in the right place at the right time. Optimising staff numbers and morale, and efficient patient flow, are integral steps to increasing capacity within the emergency care system.