Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2024
Observational StudyThe burden and prognostic significance of suspected sepsis in the prehospital setting: A state-wide population-based cohort study.
Despite high in-hospital mortality, the epidemiology of prehospital suspected sepsis presentations is not well described. This retrospective cohort study aimed to quantify the burden of such presentations, and to determine whether such a diagnosis was independently associated with longer-term mortality. ⋯ The burden of prehospital suspected sepsis in the Australian setting is significant, with paramedics identifying patients at high-risk of poor longer-term outcomes. This implies the need to consider improved care pathways for this highly vulnerable group.
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Emerg Med Australas · Jun 2024
Observational StudyCore temperature following pre-hospital induction of anaesthesia in trauma patients.
Hypothermia is a well-recognised finding in trauma patients, which can occur even in warmer climates. It is an independent predictor of increased morbidity and mortality. It is associated with pre-hospital intubation, although the reasons for this are likely to be multifactorial. Core temperature drop after induction of anaesthesia is a well-known phenomenon in the context of elective surgery, and the mechanisms of this are well established. ⋯ Our data do not show a decrease in the core temperatures of patients who receive pre-hospital anaesthesia, unlike patients who are anaesthetised without pre-warming, in operating theatres. The lack of a change could relate to patient, anaesthetic or environmental factors.
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Emerg Med Australas · Jun 2024
Infectious and sepsis presentations to, and hospital admissions from emergency departments in Victoria, Australia.
To investigate the frequency and outcomes of adult infectious and sepsis presentations to, and hospital admissions from, Emergency Departments (EDs) in Victoria, Australia. ⋯ Infections and sepsis are common causes of presentation to, and admission from the ED in Victoria. Such patients experience higher mortality than non-infectious patients, even after adjusting for age. There is a need to identify modifiable factors contributing to these outcomes.
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Emerg Med Australas · Jun 2024
Naloxone use by Aotearoa New Zealand emergency medical services, 2017-2021.
Emergency medical services (EMS) use of naloxone in the prehospital setting is indicated in patients who have significantly impaired breathing or level of consciousness when opioid intoxication is suspected. The present study characterised naloxone use in a nationwide sample of Aotearoa New Zealand road EMS patients to establish a baseline for surveillance of any changes in the future. ⋯ A national rate of EMS naloxone patients was established; measured clinical effects of naloxone were modest, suggesting many patients had reasons other than opioid toxicity contributing to their symptoms. Naloxone administration rates provide indirect surveillance information about suspected harmful opioid exposures but need to be interpreted with care.
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Emerg Med Australas · Jun 2024
Randomized Controlled Trial Comparative StudyFibrinogen levels in severe trauma: A preliminary comparison of Clauss Fibrinogen, ROTEM Sigma, ROTEM Delta and TEG 6s assays from the FEISTY pilot randomised clinical trial.
To describe the relationships between different methods of measuring functional fibrinogen levels in severely injured, bleeding trauma patients across multiple timepoints during hospitalisation. ⋯ The present study revealed acceptable agreement between four different assays measuring functional fibrinogen, with current- and previous-generation ROTEM® machines (Sigma, Delta) performing similarly measuring functional fibrinogen via FIBTEM assay. This suggests that haemostatic resuscitation algorithms designed for the ROTEM® Delta can be applied to the ROTEM® Sigma to guide fibrinogen replacement.