Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2024
Can rotational thromboelastometry rapidly identify theragnostic targets in isolated traumatic brain injury?
Coagulation assessment in traumatic brain injury (TBI) typically relies upon laboratory-based standard coagulation tests (SCTs), including the activated partial thromboplastin time (aPTT), INR and platelet count. Rotational thromboelastometry (ROTEM) sigma is an alternative point-of-care assay; however, its role in isolated TBI is under-evaluated. The present study aims to assess the prognostic utility of ROTEM sigma in isolated TBI. ⋯ ROTEM sigma expedites the detection of clinically significant coagulopathy in isolated TBI. EXTEM and FIBTEM CT values are more rapidly attainable than INR and comparable in predicting head injury-related death.
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Emerg Med Australas · Aug 2024
UnTWISTing the BALS: A study of predictive accuracy of clinical scoring tools for testicular torsion identification in adults.
Testicular torsion is an uncommon but time-critical condition in EDs. If the diagnosis is missed or delayed, there are significant medicolegal and patient fertility implications. Scoring tools are advocated for use in children but have limited validation in adults. The aim of the present study was to explore the predictive accuracy of the testicular torsion scoring tools, Testicular Workup for Ischemia and Suspected Torsion (TWIST) and Boettcher Alert Score (BALS), in adult patients with a final ED diagnosis of torsion. ⋯ A high TWIST score correlates to a high likelihood of torsion and can inform surgical decision-making in the absence of US.
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Emerg Med Australas · Aug 2024
Factors associated with difficult intravenous access in the paediatric emergency department: A prospective cohort study.
Although it is the most performed invasive procedure, peripheral intravenous catheter (PIVC) insertion in children can be difficult. The primary objective of the study was to identify the factors associated with difficult intravenous access (DIVA) in the paediatric ED, including patient, proceduralist and situational factors. ⋯ The present study identified multiple patient, proceduralist and situational factors that were associated with DIVA in the paediatric ED. Future studies should explore the development and implementation of a package to address DIVA in children, with the patient-centred goals of reducing pain and improving success.
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Emerg Med Australas · Aug 2024
Impact of the Southeast Melbourne Virtual Emergency Department on reducing transfers from residential aged care facilities.
To evaluate the impact of the Southeast Melbourne Virtual Emergency Department (SEMVED) on transfers from residential aged care facilities (RACFs) to traditional EDs. ⋯ SEMVED prevented unnecessary transfers and enabled in-facility care. Integration into community outreach programmes could enhance care delivery. Patient safety outcomes were not formally assessed by our methodology.
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Emerg Med Australas · Aug 2024
Ocular trauma in badminton: A 5-year review of badminton-related eye injury emergency department presentations.
To examine the nature and severity of badminton-related ocular injuries in Melbourne, Australia. ⋯ Hyphaema, commotio retinae and traumatic uveitis were the most commonly diagnosed injuries. The majority of patients with badminton-related eye injuries required medical treatment, and some necessitated surgical intervention. To mitigate these risks, there is a pressing need to develop an eye safety policy for Australian badminton players, and players should exercise caution when wearing spectacles during play to prevent potential penetrating eye injuries.