Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2022
ReviewReview article: Management of hyperemesis gravidarum and nausea and vomiting in pregnancy.
Nausea and vomiting in pregnancy (NVP) are common in early pregnancy but there is a wide spectrum of severity in terms of the duration and acuity of symptoms throughout gestation. Adverse maternal and fetal outcomes have been seen in women who experience severe symptoms, also known as hyperemesis gravidarum (HG). Evidence-based, assessment and management can reduce symptom severity, avoid physical and psychological deterioration and minimise the impact on quality of life and function. ⋯ Outpatient management is optimal but admission may be required for refractory symptoms, organ dysfunction or concurrent significant co-morbidities. Emergency management of NVP and HG requires an appropriate pathway of care to support women until the natural resolution of their condition. Both underuse of safe therapies and overuse of ineffective medication must be avoided.
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Emerg Med Australas · Feb 2022
Syndromic surveillance to detect disease outbreaks using time between ED presentations.
Early warning of disease outbreaks is paramount for health jurisdictions. The objective of the present study was to develop syndromic surveillance monitoring plans from routinely collected ED data with application to detecting disease outbreaks. ⋯ Outbreak detection models demonstrate the ability to quickly flag an outbreak based on clinician-assigned ED diagnoses. An implemented syndromic surveillance approach can pick up geographic outbreaks quickly so they can be contained. Such capability can help with surveillance related to the current COVID-19 pandemic and potential future pandemics.
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Emerg Med Australas · Feb 2022
The Emerging Drugs Network of Australia: A toxicosurveillance system of illicit and emerging drugs in the emergency department.
The unprecedented rise in synthetic drugs, many containing unknown toxic agents, has made timely analytical diagnosis more difficult, and has reduced the confidence of clinicians providing ED management to this population of patients. This has also impacted the quality of evidence informing harm reduction responses. The Emerging Drugs Network of Australia (EDNA) brings together emergency physicians, toxicologists and forensic laboratories to establish a standardised ED toxicosurveillance system in Australia. ⋯ Our work represents a collaborative response to calls for more sophisticated data on emerging drug trends in Australia. EDNA will improve coordination between clinicians and analytical services by way of its standardised approach to surveillance and reporting.