Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2025
SAFE: Safety of procedural sedation and analgesia administration in the fast-track area of the emergency department.
To determine whether undertaking procedural sedation in the low-acuity fast-track area is safe and effective in improving patient flow. ⋯ The sedation of patients outside a high-acuity area is safe and significantly improves patient flow.
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Emerg Med Australas · Feb 2025
Evaluating accuracy of cervical spine computed tomography interpretation by emergency trainees with the use of a structured protocol.
Radiological evaluation of cervical spine injury with computed tomography (CT) scanning is a fundamental component of the assessment of major trauma. Accurate interpretation of scans is essential for safe clearance or diagnosis of injuries. However, delays in radiologist reporting often result in prolonged spinal immobilisation. The aim of the present study was to evaluate a simple, structured reporting tool to improve assessment of CTs of the cervical spine by emergency medicine trainees. ⋯ Interpretation of cervical spine CT scans by trainees was inferior compared to radiologists and did not improve with a structured reporting template. Other innovative strategies towards timely reporting of CT scans by radiologists of the cervical spine are indicated for earlier definitive diagnosis.
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Emerg Med Australas · Feb 2025
Low-acuity emergency department presentation characteristics and their association with Medicare-subsidised general practitioner services across New South Wales: A data linkage study.
Identify clinical and demographic characteristics of low-acuity presentations (LAPs) to the ED and analyse correlations between population rates of LAPs to ED and rates of Medicare-subsidised general practitioner (GP) services across statistical areas. ⋯ A relationship between LAPs to ED and Medicare-subsidised GP episodes of care exists for non-metropolitan but not metropolitan areas.
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Emerg Med Australas · Feb 2025
Skeletal radiograph interpretation discrepancies in the emergency department setting: A retrospective chart review.
To determine the frequency and clinical consequences of discrepancies in skeletal radiograph interpretation between emergency and radiology doctors in an Australian ED. ⋯ The rate of clinically significant discrepancies in the interpretation of skeletal radiographs by emergency medicine doctors is low. This data support using the ED interpretation of radiographs to guide initial management as safe practice.
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Emerg Med Australas · Feb 2025
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.