Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2024
Observational StudyRetrospective observational study of aged care facility residents presenting to ED post fall: A case for person-centred shared decision making.
Identify the incidence of intracranial haemorrhage in people from residential aged care facilities following falls who had a CT head performed. The secondary objectives were to identify predictor variables for intracranial haemorrhage to inform person-centred shared decision making. ⋯ Deviation from neurological baseline or external signs of head injury may be predictors of intracranial haemorrhage. Vomiting, headache, anticoagulation or antiplatelets were not associated with intracranial haemorrhage. A person-centred decision-making approach, that is informed by treatment options could better guide clinicians on when to order a CT head after a fall.
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Emerg Med Australas · Aug 2024
Using ambulance surveillance data to characterise blood-borne viral infection histories among patients presenting with acute alcohol and other drug-related harms.
Preventable transmission of blood-borne viruses (BBV), including human immunodeficiency virus (HIV), hepatitis C virus (HCV) and hepatitis B virus (HBV), continue in at-risk populations, including people who use alcohol and drugs (AODs). To our knowledge, no studies have explored the use of ambulance data for surveillance of AOD harms in patients with BBV infections. ⋯ Our study describes the utility of ambulance data to identify a sub-population of patients with a BBV history and complex medical and social characteristics. Repeat attendances of BBV history patients to paramedics could present an opportunity for ongoing surveillance using ambulance data and possible paramedic intervention, with potential linkage to appropriate BBV services.
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Emerg Med Australas · Aug 2024
Clinical significance of an elevated on-admission beta-hydroxybutyrate in acutely ill adult patients without diabetes.
To determine the relationship between point-of-care β-hydroxybutyrate (BHB) concentration and outcomes in adult patients without diabetes admitted through ED. ⋯ Routine BHB measurement in patients without diabetes does not add to clinical bedside assessment and use should be limited to when required to confirm a clinical impression.
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Emerg Med Australas · Aug 2024
Reducing medication errors on emergency department discharge: Evaluation of a collaborative pharmacist-medical officer discharge prescription planning model in a tertiary hospital emergency short stay unit.
To implement and evaluate the impact of a collaborative pharmacist-medical officer model of planning discharge prescriptions, Partnered Pharmacist Discharge Prescription Planning (PPDPP) on the safe use of medicines on discharge in an ED short stay unit (SSU). ⋯ The PPDPP model improved medications safety on discharge from the ED SSU. The PPDPP did not impact patient flow parameters as measured in this study.
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Emerg Med Australas · Aug 2024
Observational StudyVentilator-assisted preoxygenation in an aeromedical retrieval setting.
Ventilator-assisted preoxygenation (VAPOX) is a method of preoxygenation and apnoeic ventilation which has been tried in hospital setting. We aimed to describe VAPOX during intubation of critically unwell patients in aeromedical retrieval setting. ⋯ VAPOX can be considered for pre-intubation optimisation in the retrieval environment. The incidence of post-intubation critical hypoxia was low, and hypotension was high. Pre-intubation respiratory physiology can be optimised by delivering variable pressure supported minute ventilation, achieving a low incidence of critical hypoxia.