Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2025
Risk-benefit analysis of a multi-site radiographer comment model for emergency departments.
Critical/urgent X-ray findings are not always communicated in an appropriate time frame to ED physicians. The practice of radiographers alerting referrers to clinically significant image findings (verbally, via image flags or written comment) is noted internationally but risk assessment data is unavailable in the literature. A hybrid radiographer comment and alert model was piloted in New South Wales and a risk-benefit assessment conducted for timely and safe communication of abnormal X-ray appearances to ED physicians. ⋯ The provision of radiographer alerts with a written comment for ED was found to be low risk to patients in the pilot study. Radiographers communicating directly with the emergency team when abnormal image appearances are detected can reduce diagnostic error and improve patient safety and health outcomes.
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Emerg Med Australas · Feb 2025
Observational StudyImpact of the Astra Zeneca COVID-19 vaccine on an emergency department.
To assess the impact of the AstraZeneca (AZ) vaccine roll-out on an ED. Primary outcomes are ED length of stay (LOS), investigation ordering and costs. Secondary measures are compliance with the Thrombosis and Haemostasis Society of Australia and New Zealand (THANZ) Vaccine-Induced Thrombotic Thrombocytopaenia Syndrome (VITT) guidelines. ⋯ A high number of young, low acuity patients presented to the ED with AZ vaccine concerns and were associated with financial and workload implications. The quantity of ED presentations appears to be associated with vaccine administration rates. There was poor compliance with the THANZ guidelines, and they appear to have contributed to the high volume of investigations.
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Emerg Med Australas · Feb 2025
Randomized Controlled TrialSuperior efficacy of intramuscular diclofenac compared to intravenous tramadol for acute renal colic in northern Thai patients: A randomised double-blind, sham-controlled trial.
The present study aimed to compare time to effective pain relief between diclofenac 75 mg intramuscular (IM) and tramadol 50 mg intravenous (IV) for ED patients with acute renal colic. ⋯ Diclofenac 75 mg IM provides faster effective pain relief compared with tramadol 50 mg IV.
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Emerg Med Australas · Feb 2025
ReviewReview article: Efficacy of cyproheptadine in the management of serotonin toxicity following deliberate self-poisoning - A systematic review.
Serotonin toxicity is a potentially fatal condition caused by increased serotonergic activity in the central nervous system. Cyproheptadine, a serotonergic antagonist, is recommended for treatment; however, there is a lack of evidence to support its use. The present study aimed to evaluate the evidence for the use of cyproheptadine in the management of serotonin toxicity following deliberate self-poisoning. ⋯ Few reports commented on clinical resolution and therefore efficacy was not established. All studies were graded as being of very low evidence and at high risk of bias. There is a lack of evidence to support the efficacy of cyproheptadine or its recommendation in clinical guidelines pertaining to the management of serotonin toxicity.