Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2019
Affecting emergency department oxycodone discharge prescribing: An educational intervention.
To describe the impact of an educational intervention for ED prescribers on discharge oxycodone prescribing both for the number of oxycodone prescriptions per 1000 discharged patients, and the number of tablets per prescription. Secondary outcomes included the quality of general practitioner communication. ⋯ An ED prescriber-targeted intervention reduced overall prescribing of oxycodone and improved communication at discharge. The prescribing intervention is one strategy that may be used by ED medical staff to improve patient safety and opioid stewardship in Australia.
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Emerg Med Australas · Aug 2019
Methamphetamine presentations to an emergency department: Management and complications.
There is little recent published data characterising methamphetamine intoxication. The present study aims to describe the clinical effects, management, complications and disposition of patients with methamphetamine exposure. ⋯ The main toxicity seen with methamphetamines is acute behavioural disturbance, which is managed well with sedation. Complications, apart from rhabdomyolysis and acute kidney injury, are rare. Most patients are managed within the ED and discharged home.
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Emerg Med Australas · Aug 2019
Multicenter Study Observational StudyAccuracy of clinician gestalt in diagnosing appendicitis in children presenting to the emergency department.
Abdominal pain is a common paediatric presentation to the ED. Accurate diagnosis of acute appendicitis is challenging, with the best-performing clinical scoring systems having sensitivities between 72% and 100%. The aim of this study is to assess the diagnostic accuracy of clinician gestalt according to seniority in diagnosing paediatric acute appendicitis in ED. ⋯ The diagnostic accuracy of ED clinician gestalt in paediatric appendicitis is comparable to current clinical scoring systems irrespective of seniority.
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Emerg Med Australas · Aug 2019
Analysis of agriculture-related life-threatening injuries presenting to emergency departments of rural generalist hospitals in Southern Queensland.
Agricultural industries are among the most dangerous in Australia posing significant public health risks. This study analyses the nature and management of agriculture-related injuries presenting to EDs in selected hospitals in Southern Queensland. ⋯ Agricultural injuries are a significant group of primary care presentations to rural hospitals and training and resourcing for rural hospitals should reflect this. A better understanding of common injury types can lead to efficient allocation of available resources in rural hospitals and potentially improve ED practices. The delay in presentation must be considered in response planning both by farmers and hospital EDs.
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Emerg Med Australas · Aug 2019
Review Case ReportsReview article: Let us talk about snakebite management: A discussion on many levels.
We want to discuss antivenom use in snakebite clinical practice guidelines. Coronial reviews in Victoria of two cases of snakebite envenomation, one described in detail below, prompted us to submit this paper for a wider audience and debate. Venom and antivenom levels were measured in the case detailed below, but not in the other. ⋯ The Victorian Department of Health and Human Services and the Australasian College for Emergency Medicine were instructed to review snakebite management guidelines, particularly with respect to antivenom dosage. The discussion that took place among medical experts led to considerable media attention. We discuss the potential fallout when there is no consensus among medical experts.