Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2019
Burden of primary care-type emergency department presentations using clinical assessment by general practitioners: A cross-sectional study.
To compare methods of assessment of the burden of primary care-type ED (PCTED) presentations against clinical assessment by general practitioners (GPs) in ED. ⋯ Previous methods determining the burden of PCTED presentations have not been validated. Many presentations excluded by previous methods were identified as manageable in general practice by GPs clinically assessing patients in ED. Improved validation of criteria used to identify PCTED presentations will enable appropriately designed interventions to reduce such events.
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Emerg Med Australas · Oct 2019
Predictors of in-hospital cardiac arrest within 24 h after emergency department triage: A case-control study in urban Thailand.
This study describes the predictors of in-hospital cardiac arrest (IHCA) within 24 h of ED triage and evaluates their ability to predict patients at risk of IHCA. ⋯ We conclude that a combination of NEWS and four independent predictors identify patients at risk of IHCA more effectively than NEWS alone.
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Emerg Med Australas · Oct 2019
Older age is associated with a reduced likelihood of ambulance transport to a trauma centre after major trauma in Perth.
To describe the characteristics and outcomes of older adult (≥65 years) major trauma patients in comparison with younger adults (16-64 years). To determine whether older age is associated with a reduced likelihood of transport (directly or indirectly) to a major trauma centre and whether this is associated with in-hospital mortality. ⋯ Older adults who were not transported to the trauma centre had an increased odds of in-hospital mortality. However, older age was associated with a significantly reduced likelihood of trauma centre transport. With the aging population, the development of specific prehospital triage criteria to enable the complexities of this higher-risk population to be identified is important.
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Emerg Med Australas · Oct 2019
The World Health Organization trauma checklist versus Trauma Team Time-out: A perspective.
Time-out protocols have reportedly improved team dynamics and patients' safety in various clinical settings - particularly in the operating room. In 2016, the World Health Organization (WHO) introduced a Trauma Care checklist, which outlines steps to follow immediately after the primary and secondary surveys and prior to the team leaving the patient. ⋯ The WHO Trauma Care checklist, while likely to be successful in reducing errors of omission related to hospital admission, may be limited in its ability to reduce errors that occur in the initial 30 min of trauma reception - when most of the life-saving decisions are made. To address this limitation a Trauma Team Time-out protocol is proposed for initial trauma resuscitation, targeting the critical first 30 min of hospital reception.
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Emerg Med Australas · Oct 2019
Utility of weight-bearing radiographs compared to computed tomography scan for the diagnosis of subtle Lisfranc injuries in the emergency setting.
The goal of the present study was to compare the diagnostic yield of weight-bearing radiographs with non-weight-bearing computed tomography (CT) scan for subtle Lisfranc (LF) injuries in the ED. ⋯ CT provides limited benefit in the diagnosis and initial management of suspected subtle LF injuries in the ED. We advocate for the use of bilateral weight-bearing radiographs as a first-line investigation.