Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2022
Pre-hospital intraosseous use in children: Indications and success rate.
Intraosseous (IO) needle insertion is an effective method to obtain circulatory access in unwell children. ⋯ While IO placement is uncommonly performed pre-hospital, in critical situations there is a high success rate.
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Emerg Med Australas · Feb 2022
ReviewReview article: Diagnosing acute pancreatitis in diabetes mellitus.
Acute pancreatitis is a common reason for presentation to EDs. The criteria for diagnosis of acute pancreatitis are defined by the revised Atlanta classification. Patients with diabetes mellitus are at increased risk of acute pancreatitis. ⋯ Checkpoint inhibitors may also precipitate acute type 1 diabetes mellitus and be associated with elevated lipase and amylase. Finally, individuals with diabetes mellitus are at increased risk of hypertriglyceridaemic pancreatitis, which may be associated with falsely normal lipase and amylase because of laboratory interference. Awareness of these factors in individuals with diabetes mellitus presenting to EDs with symptoms suggestive of acute pancreatitis is important for accurate diagnosis.
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Emerg Med Australas · Feb 2022
Increased paediatric emergency mental health and suicidality presentations during COVID-19 stay at home restrictions.
Anecdotal reports indicate an increase in mental health presentations and acuity to EDs during the COVID-19 pandemic and associated stay at home restrictions. Paediatric and adolescent data to confirm this are unavailable in the Australian setting. ⋯ Despite an overall decrease in ED presentations, the absolute increase in mental health presentations for children and adolescents during the stay at home restriction period was pronounced. It is unclear how sustained this change and the impact on mental health resource use will be post-pandemic.
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Emerg Med Australas · Feb 2022
Observational StudyValidity and reliability of the Interagency Integrated Triage Tool in a regional emergency department in Papua New Guinea.
The Interagency Integrated Triage Tool (IITT) is a novel, three-tier triage system recommended by the World Health Organization. The present study sought to assess the validity and reliability of a pilot version of the tool in a resource-limited ED in regional Papua New Guinea. ⋯ There is limited published data regarding the predictive validity and inter-rater reliability of the IITT. In this pragmatic study, the pilot version of the tool demonstrated adequate performance. Evaluation in other emergency care settings is recommended.
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Emerg Med Australas · Feb 2022
The HEART score to identify emergency department patients suspected of an acute coronary syndrome who can be removed from cardiac monitoring: A retrospective chart review.
Continuous cardiac monitoring has been recommended for ED patients being evaluated for possible acute coronary syndrome (ACS) due to concern for arrhythmia, although evidence suggests this risk is low. Indiscriminate use of monitored beds restricts access for other critically unwell patients and contributes to overcrowding. The objective of the present study was to determine if a low/intermediate-risk HEART score identified patients at very low risk for a clinically important arrhythmia who could be removed from cardiac monitoring. ⋯ Among ED patients presenting with a possible ACS, a low/intermediate-risk HEART score identified those at very low risk for having a clinically important arrhythmia while in ED.