Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2020
Emergency presentation of new onset versus recurrent undiagnosed seizures: A retrospective review.
To identify clinical factors that may assist emergency physicians to delineate between patients with new onset seizures (NOS) versus patients with recurrent undiagnosed seizures (RUS) among those presenting with apparent 'first seizures' to EDs. In addition, to provide a summary of current evidence-based guidelines regarding the workup of seizure presentations to ED. ⋯ Emergency physicians should be wary of patients presenting with non-motor 'first seizures': they are more likely to have experienced prior seizures (the 'recurrent untreated seizure' group), and thus meet epilepsy diagnostic criteria. Almost half of those with actual NOS may also meet epilepsy criteria, largely driven by abnormal neuroimaging. Distinguishing RUS from NOS patients in the ED allows accurate prognostication and timely initiation of appropriate therapy.
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Emerg Med Australas · Jun 2020
Does prescribing of immediate release oxycodone by emergency medicine physicians result in persistence of Schedule 8 opioids following discharge?
To identify the prevalence of oxycodone immediate release (IR) prescribed during an ED admission and the persistence of Schedule 8 (S8) opioids following an ED admission. ⋯ These findings suggest that prescribing of IR oxycodone within ED is lower than previous studies. Additionally, the progression to regular chronic opioid use following an ED admission where IR oxycodone was given was relatively low with 3.0% of opioid naïve patients being approved for indications related to chronic non-cancer pain in the following 6 months.
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Emerg Med Australas · Jun 2020
Clinical TrialEffect of the Geriatric Emergency Department Intervention on outcomes of care for residents of aged care facilities: A non-randomised trial.
As the population of Australia ages, EDs will experience an increasing frequency of presentations of older adults from residential aged care facilities (RACFs). These presentations are often complex and time consuming in the chaotic and potentially hazardous ED environment. The Geriatric Emergency Department Intervention (GEDI) model was developed to optimise the care of frail older adults, especially RACF residents, in the ED. The aim of the present study was to evaluate the effectiveness of the GEDI model on the primary outcomes of disposition (admission, discharge or death) and ED length of stay for residents of RACFs, presenting to an ED in regional Queensland, Australia. ⋯ There is a paucity of evidence to support the implementation of nurse-led teams in EDs designed to target older adults living in RACFs. The GEDI model was effective in reducing ED length of stay while increasing the likelihood of safe discharge for RACF residents.
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Emerg Med Australas · Jun 2020
Variations in the care of agitated patients in Australia and New Zealand ambulance services.
The objective of the present study is to examine variations in paramedic care of the agitated patient, including verbal de-escalation, physical restraint and sedation, provided by ambulance services in Australia and New Zealand. ⋯ There were wide variations across the ambulance services in terms of the assessment of agitation, as well as the use of physical restraint and sedation.