Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2022
Peer support work for people experiencing mental distress attending the emergency department: Exploring the potential.
This study explored the benefits and limitations of employing peer support workers, who utilise their own lived experience of mental distress and recovery, to support people experiencing mental distress who are attending the ED. ⋯ This study identified that peer support workers would bring important skills to an ED (e.g. empathetic support, de-escalation). However, significant workforce and organisational support would be required.
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Emerg Med Australas · Feb 2022
ReviewReview article: Management of hyperemesis gravidarum and nausea and vomiting in pregnancy.
Nausea and vomiting in pregnancy (NVP) are common in early pregnancy but there is a wide spectrum of severity in terms of the duration and acuity of symptoms throughout gestation. Adverse maternal and fetal outcomes have been seen in women who experience severe symptoms, also known as hyperemesis gravidarum (HG). Evidence-based, assessment and management can reduce symptom severity, avoid physical and psychological deterioration and minimise the impact on quality of life and function. ⋯ Outpatient management is optimal but admission may be required for refractory symptoms, organ dysfunction or concurrent significant co-morbidities. Emergency management of NVP and HG requires an appropriate pathway of care to support women until the natural resolution of their condition. Both underuse of safe therapies and overuse of ineffective medication must be avoided.
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Emerg Med Australas · Feb 2022
Reframing leadership: Leader identity challenges of the emergency physician.
Emergency medicine (EM) leadership is often conceptualised as either administrative leadership within the structure (e.g. head-of-committee leader) or operational/functional leadership within a group (e.g. resuscitation-scenario team leader). While these bases of identity are practically useful, they often do not take into account the intricate, underlying challenges to one's leader identity presented by the dynamic, fluid and transient context of EM leadership. ⋯ Similarly, at an organisational level, there is an opportunity for formal and emergent leaders to create psychologically safe identity workspaces. The co-creation of EM leadership by leaders and followers would help emergent leaders navigate their leader identity, allowing them to simultaneously inspire confidence and exert influence as future-fit health professionals and leaders.
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Emerg Med Australas · Feb 2022
Magnetic resonance imaging cervical spine in trauma: A retrospective single-centre audit of patient outcomes.
Magnetic resonance imaging (MRI) is often used in practice to investigate for cord or discoligamentous injury following blunt trauma and a normal computed tomography (CT). This study investigates the MRI findings and surgical outcomes of patients in this cohort. ⋯ No alert neurologically intact patient with 'persistent tenderness only' received operative management following a normal CT examination. While MRI is sensitive for detecting soft tissue injuries, the prevalence for detecting clinically significant cervical spine injury in blunt trauma patients in the absence of neurology is low. The utility of MRI in this cohort is questionable considering prolonged spinal immobilisation is not without harm.