Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2021
Multicultural presentation of chest pain at an emergency department in Australia.
To investigate differences in presenting patient characteristics, investigation, management and related outcomes between culturally and linguistically diverse (CALD) and non-CALD chest pain (CP) patients presenting to the ED. ⋯ Both CALD and non-CALD ED CP patients had similar test ordering, medication administration and clinical outcomes, but this was in the context of CALD patients being 10 years older together with a small study sample size. A larger cohort, matched for age, would provide further insights into potentially important differences.
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Emerg Med Australas · Jun 2021
Discordance between patient-reported and actual emergency department pain management.
To determine patient knowledge of the nature of their pain management in the ED. ⋯ Patients are often unaware of the nature of their pain management. They are most often unaware of management other than analgesia. Patients with chest pain and lower triage pain scores had the least knowledge of their pain management.
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Emerg Med Australas · Jun 2021
Implementation of point-of-care ROTEM® into a trauma major haemorrhage protocol: A before and after study.
The aim of the present study was to assess transfusion practices with the implementation of a targeted viscoelastic haemostatic assay (VHA) (ROTEM®) guided coagulation management programme into a major haemorrhage protocol for trauma patients requiring ICU admission, starting from time of arrival in the ED. ⋯ Although there was no overall reduction of packed red blood cell usage, a change in the pattern of administration of other blood products was observed with the implementation of a targeted VHA (ROTEM®) guided coagulation management programme. Larger studies are needed to further define the role of early VHA testing to guide correction of trauma-induced coagulopathy and the effect on clinical outcomes.
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To describe Australian ED workload over the period 2017-2020 using data from twice annual Access Block Point Prevalence Studies, and to identify any impact of the COVID-19 pandemic. ⋯ Occupancy increased by more than demand 2017-2019, with some decrease in 2020: in June presentations were 12.7% lower than 2019, in September back to the normal range outside Victorian and Major Paediatric Referral hospitals. Future research needs to consider locality, role delineation and work practice change in comparing ED pandemic responses.
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Emerg Med Australas · Jun 2021
External validation of the Canadian Syncope Risk Score for patients presenting with undifferentiated syncope to the emergency department.
To validate the accuracy and safety of the Canadian Syncope Risk Score (CSRS) for patients presenting with syncope. ⋯ Syncope patients in our study were predominantly very low to low risk (72%). The prevalence of 30-day SAE was low, majority occurring following hospital discharge. Sensitivity estimates for CSRS was lower than the derivation study but lacked robustness with wide CIs because of a small sample size and number of events observed. However, the CSRS did not miss any clinically relevant outcomes in low risk patients making it potentially useful in aiding their disposition. Larger validation studies in Australia are encouraged to further test the diagnostic accuracy of the CSRS.