Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2022
Characteristics of patients with COVID-19 hospitalised in South Australia during the first wave of the pandemic.
To describe the first wave of hospitalisations of patients testing positive for COVID-19 in South Australia. ⋯ The study sheds light on the characteristics of patients with COVID-19 hospitalised in South Australia.
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Emerg Med Australas · Feb 2022
The HEART score to identify emergency department patients suspected of an acute coronary syndrome who can be removed from cardiac monitoring: A retrospective chart review.
Continuous cardiac monitoring has been recommended for ED patients being evaluated for possible acute coronary syndrome (ACS) due to concern for arrhythmia, although evidence suggests this risk is low. Indiscriminate use of monitored beds restricts access for other critically unwell patients and contributes to overcrowding. The objective of the present study was to determine if a low/intermediate-risk HEART score identified patients at very low risk for a clinically important arrhythmia who could be removed from cardiac monitoring. ⋯ Among ED patients presenting with a possible ACS, a low/intermediate-risk HEART score identified those at very low risk for having a clinically important arrhythmia while in ED.
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Emerg Med Australas · Feb 2022
Pre-hospital intraosseous use in children: Indications and success rate.
Intraosseous (IO) needle insertion is an effective method to obtain circulatory access in unwell children. ⋯ While IO placement is uncommonly performed pre-hospital, in critical situations there is a high success rate.
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Emerg Med Australas · Feb 2022
Observational StudyImpact of lockdowns on critical care service demand in a metropolitan hospital in Melbourne, Australia.
There is a growing recognition of the impact of lockdowns on non-COVID-19 demand for critical care services. While a reduction in demand has been postulated, there remains a paucity of quantitative data on the extent and nature of this reduction. The present study aims to quantify the impact of lockdown on critical care services, namely ED, intensive care unit (ICU), medical emergency team (MET) and emergency theatre (ET) demand, during the lockdown in Victoria, Australia. ⋯ Lockdowns lead to a significant reduction in ICU, MET call and ED demand, and to a lesser extent ET demand. This pattern should be considered in surge capacity and workforce redeployment planning. There are also impacts on public health epidemiology, with potential adverse consequences on mental health and chronic disease management. Further research on the impact of lockdowns on long-term disease outcomes is needed.
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Emerg Med Australas · Feb 2022
Length of stay outcomes in patients receiving ketamine sedation versus Bier's block anaesthesia for procedural closed fracture reduction: A retrospective audit of paediatric emergency department patients.
To compare length of stay (LOS) for paediatric patients receiving ketamine sedation or Bier's block anaesthesia for procedural closed fracture reduction. ⋯ Bier's block anaesthesia is a safe alternative to ketamine sedation for paediatric patients presenting to the ED with closed fractures. It is associated with reduced LOS and need for post-procedural observation. However, ketamine may remain preferable for younger paediatric patients, on whom it places fewer demands for cooperation.