Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2022
Unplanned blood use within 24 hours of emergency department presentation: A cohort study in an ageing population.
This research aims to elucidate drivers of blood use in an older population, with a focus on unplanned transfusions following ED presentation. ⋯ Unplanned blood use accounted for 28% of annual hospital blood consumption. Blood component use increased with age and was greatest in older men. A significant burden of anaemia treatment was identified by the ED.
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Emerg Med Australas · Apr 2022
Impact on patient management of non-mydriatic fundus photography compared to direct ophthalmoscopy in a regional Australian emergency department.
To investigate the management impact of non-mydriatic fundus photography (NMFP) implementation for appropriate ED patients; compare the diagnostic accuracy of direct ophthalmoscopy (DO) and NMFP, and determine the prevalence of fundus pathology in a regional Australian ED. ⋯ The addition of NMFP images can significantly impact the management of ED patients requiring fundus examination, facilitating expedited and optimised patient care. NMFP improves ECs diagnostic acumen for fundus pathology over DO examination and telehealth specialist review is important for diagnostic accuracy. There is a clinically important prevalence of fundus pathology in this regional ED setting.
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Emerg Med Australas · Apr 2022
Redback spider bites in children in South Australia: A 10-year review of antivenom effectiveness.
To describe the South Australian paediatric redback spider bite experience and to examine the hypothesis that redback antivenom (RBAV) treatment in children is clinically effective. ⋯ This retrospective review of redback spider envenomation in South Australian children over a 10-year period has demonstrated clinical effectiveness of RBAV in paediatric patients across all age groups, observed in both clinician perceived results and measurable outcomes. RBAV remains an effective treatment for redback envenomation in children.
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Emerg Med Australas · Apr 2022
Observational StudyVascular injury is an infrequent finding following non-fatal strangulation in two Australian trauma centres.
Non-fatal strangulation assessment is challenging for clinicians as clear guidelines for evaluation are limited. The prevalence of non-fatal strangulation events, clinical findings, frequency of injury on computed tomography angiogram (CTA) and outcomes across two trauma centres will be used to improve this assessment process. ⋯ In non-fatal strangulation presentations, the majority have subtle signs of neck injury on examination with inconsistent documentation of findings. Low rate of vascular injury overall (0.7%), and entirely in hanging events. No longer-term vascular sequalae identified. Improving documentation focusing on hypoxic insult and evidence of airway trauma is warranted, rather than a reliance on computed tomography imaging to delineate a traumatic event in non-fatal strangulation.
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Emerg Med Australas · Apr 2022
Conservative management of traumatic pneumothoraces: A retrospective cohort study.
Traumatic pneumothoraces (T-PTXs) are traditionally managed with an intercostal catheter (ICC), despite little evidence for this. Success with conservative management of primary spontaneous PTX has been demonstrated, and our ED has adopted a conservative approach where safe for all PTX. ⋯ Our data support conservative management of selected T-PTXs and shows a need for a prospective randomised trial to further examine this intervention.