Emergency medicine Australasia : EMA
-
Emerg Med Australas · Feb 2020
Observational StudyDoes fluid bolus therapy increase blood pressure in children with sepsis?
To describe the effect of fluid bolus therapy (FBT) on blood pressure in children with sepsis. Secondary outcomes included the effect of FBT on systemic vascular resistance, shock index and shock phenotype (warm or cold). ⋯ MBP initially decreased following FBT for paediatric sepsis, returning towards baseline over the subsequent 60 min. The utility of FBT for increasing MBP and its effect on patient-centred outcomes in children with sepsis warrants further exploration.
-
Emerg Med Australas · Feb 2020
Observational StudyUtility of calcium, magnesium and phosphate testing in the emergency department.
To determine how frequently calcium (Ca), magnesium (Mg) and phosphate (PO4 ) tests change ED patient management. ⋯ Ca, Mg and PO4 testing is common. However, the yield of clinically significant abnormal levels is low and patient management is rarely changed. Testing of these electrolytes needs to be rationalised.
-
Emerg Med Australas · Feb 2020
Letter Case ReportsWhen fantasy fades: A case of severe delirium due to GHB withdrawal.
-
Emerg Med Australas · Feb 2020
Anxiety and alcohol in the working-age population are driving a rise in mental health-related emergency department presentations: 15 year trends in emergency department presentations in Western Australia.
To evaluate age, gender and disease-specific trends in ED for mental health presentations over 15 years. ⋯ The present study demonstrates that increased rates of mental health-related ED presentations are driven by increased rates of presentation for stress and anxiety-related and alcohol-related presentations in both genders across the working-age population.
-
Emerg Med Australas · Feb 2020
Comparative StudyImpact of a ketamine sedation protocol on intubation rates and undesirable outcomes in the transport of patients with acute behavioural disturbance.
To identify the effects of the introduction of a ketamine sedation protocol on the rates of intubation and adverse events associated with retrieval of patients with acute behavioural disturbance. Transport of patients with acute behavioural disturbance poses clinical and logistical management difficulties, as well as risks. Remote Australian communities are separated by vast distances. Risks to aircraft and crew, and patient and community must be balanced. Ketamine has received increasing attention in recent years for pre-hospital sedation of behaviourally disturbed patients, predominantly with psychiatric illness. This paper explores the benefits and suitability of ketamine in undifferentiated presentations, using data from the retrieval service in Alice Springs, Australia. ⋯ The introduction of a ketamine protocol is associated with a decrease in intubation, and accordingly, a decrease in adverse events, though it is not without its risks. Further analysis is required to establish the likely cost saving to health systems.