Emergency medicine Australasia : EMA
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A trauma patient with orbital compartment syndrome may lose vision within hours of the injury. This article describes an approach to decompressing the orbit which may be sight-saving.
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Emerg Med Australas · Jun 2021
ReviewReview article: Has the implementation of time-based targets for emergency department length of stay influenced the quality of care for patients? A systematic review of quantitative literature.
Time-based targets (TBTs) for ED stays were introduced to improve quality of care but criticised as having harmful unintended consequences. The aim of the review was to determine whether implementation of TBTs influenced quality of care. Structured searches in medical databases were undertaken (2000-2019). ⋯ The evidence for associations was mostly low certainty and confidence in the findings is accordingly low. Quality of care generally improved after targets were introduced and when compliance with targets was high. This depended on how targets were implemented at individual sites or within jurisdictions, with important implications for policy makers, health managers and clinicians.
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Emerg Med Australas · Jun 2021
External validation of the Canadian Syncope Risk Score for patients presenting with undifferentiated syncope to the emergency department.
To validate the accuracy and safety of the Canadian Syncope Risk Score (CSRS) for patients presenting with syncope. ⋯ Syncope patients in our study were predominantly very low to low risk (72%). The prevalence of 30-day SAE was low, majority occurring following hospital discharge. Sensitivity estimates for CSRS was lower than the derivation study but lacked robustness with wide CIs because of a small sample size and number of events observed. However, the CSRS did not miss any clinically relevant outcomes in low risk patients making it potentially useful in aiding their disposition. Larger validation studies in Australia are encouraged to further test the diagnostic accuracy of the CSRS.