Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2023
From signal to alert: A cluster of exposures to counterfeit alprazolam tablets containing five novel benzodiazepines.
To illustrate the toxicosurveillance role of the Emerging Drugs Network of Australia - Victoria (EDNAV) project in informing timely harm minimisation interventions. ⋯ Toxicosurveillance projects, such as EDNAV, are critical to the continued monitoring and reporting of illicit substance use in the community.
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Emerg Med Australas · Feb 2023
Observational StudyImpact of COVID-19 Pandemic on Emergency Department Patient Volume and Flow: Two Countries, Two Hospitals.
COVID-19 greatly disrupted the provision of emergency care across the globe. ED service delivery was urgently redesigned as human and material resources were mobilised, and patients with respiratory symptoms were isolated. This study aimed to compare ED patient volume and flow metrics before and during the COVID-19 pandemic. ⋯ Total daily presentations varied considerably according to government mandated social restrictions and testing requirements in both EDs. The reductions in waiting and admission delay times corresponded with improvements in hospital capacity.
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Emerg Med Australas · Feb 2023
Observational StudyClinical Characteristics and Predictors for Hospitalisation During the Initial Phases of the Delta Variant Covid-19 Outbreak Sydney, Australia.
The COVID-19 Delta variant of concern continues to pose significant challenges to health systems globally, with increased transmissibility and different patient populations affected. In Sydney, a virtual model of care was implemented in response to the COVID-19 pandemic and Special Health Accommodation (SHA) was made available for community patients with COVID-19 who could not isolate at home or needed health support. ⋯ Initial symptoms and vital signs were just as predictive for short-term deterioration as age and pre-existing comorbidities and should be included in future risk prediction models for COVID-19. Based on this, we derive a proposed risk prediction score that incorporates these predictors with further validation required.
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Emerg Med Australas · Feb 2023
ReviewReview article: Early steroid administration for traumatic haemorrhagic shock: A systematic review.
Haemorrhagic shock after trauma is a leading cause of death worldwide, particularly in young individuals. Despite advances in trauma systems and resuscitation strategies, mortality from haemorrhagic shock has not declined over the previous two decades. A proportion of shocked trauma patients may experience a deficiency of cortisol relative to the severity of their injury. ⋯ Both studies were at risk of bias. There are no high quality or recent studies in the English literature investigating the use of steroids for haemorrhagic shocked trauma patients. PROSPERO: CRD42021239656.
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Emerg Med Australas · Feb 2023
ReviewReview article: Acute superior mesenteric vessel ischaemia: A review of clinical practice and biomarkers.
A patient with acute occlusion of the superior mesenteric vessels resulting in superior mesenteric vessel ischaemia (SMVI) who presents to the ED with abdominal pain and unremarkable abdominal examination risks delay in diagnosis and treatment with adverse outcome. A comprehensive literature search was performed, and the evidence was reviewed. To-date, there are no accurate biomarkers of SMVI and so, heightened awareness among ED staff and rapidly actioning diagnostic imaging and surgical referral will help fast-track the patient with SMVI to surgical management. ⋯ Prompt surgical intervention may help reduce mortality and morbidity in SMVI. SMVI is associated with significant mortality and morbidity. With the lack of accurate biomarkers, diagnosis and management is challenging and requires heightened awareness among ED staff for prompt surgical referral and intervention.