Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2019
Observational StudyStructured Interdisciplinary Bedside Rounds in an Australian tertiary hospital emergency department: Patient satisfaction and staff perspectives.
To compare patient satisfaction levels, staff perspectives and the time required using Structured Interdisciplinary Bedside Rounds (SIBR; Emory University, Atlanta, GA, USA) versus traditional medical ward rounds (TR) in the ED. ⋯ Our study highlights the benefits that could be gained through SIBR technique over the TR method. Better workforce and resource planning is needed to support the sustainable implementation of SIBR in ED.
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Emerg Med Australas · Jun 2019
ReviewReview article: Accelerated starvation of childhood: Have I judged ketones?
Acute ketosis is an important physiological mechanism to prevent irreversible neurological damage from hypoglycaemia during starvation, and represents a significant metabolic stress. A cohort of children adapt to relatively short periods of reduced caloric intake by generating large quantities of ketone bodies. When excessive, the gastrointestinal symptoms of starvation ketosis such as nausea and pain may create a vicious cycle that delays spontaneous resolution. ⋯ Identification and appropriate management of ketosis may alleviate the distressing gastrointestinal symptoms associated with many minor illnesses, and potentially prevent hypoglycaemia in some children. Appropriate advice to carers may be helpful to prevent further episodes. Illustrative case examples from our own practice are provided.
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Emerg Med Australas · Jun 2019
Neurocognitive testing in the emergency department: A potential assessment tool for mild traumatic brain injury.
Despite mild traumatic brain injury (mTBI) accounting for 80% of head injury diagnoses, recognition of individuals at risk of cognitive dysfunction remains a challenge in the acute setting. The objective of this study was to evaluate the feasibility and potential role for computerised cognitive testing as part of a complete ED head injury assessment. ⋯ Computerised neurocognitive testing in the ED is feasible and can be utilised to detect deficits in cognitive performance in the mTBI population as part of a routine head injury assessment.
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Emerg Med Australas · Jun 2019
Impact of the Four-Hour Rule/National Emergency Access Target policy implementation on emergency department staff: A qualitative perspective of emergency department management changes.
It has been 10 years since the ACEM Access Block Solutions Summit and 5 years since the introduction of the Four-Hour Rule/National Emergency Access Target (4HR/NEAT) policy. The impact of this policy on ED management and on ED staff has been poorly understood. The aim of the present study was to identify changes in ED management resulting from the policy based on ED staff experiences. ⋯ Policy implementation is a complex process that had both positive and negative consequences on how ED staff managed the implementation of the 4HR/NEAT policy and how it changed their work environment. Understanding the perceptions of staff involved in policy implementation has significance for the design of future implementation strategies. The biggest insight from the present study is that ED management is very complex and the policy generated multiple positive and negative changes demonstrating the wide range of processes involved in this area of health services research.
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Emerg Med Australas · Jun 2019
ReviewReview article: Postoperative bariatric patients in the emergency department: Review of surgical complications for the emergency physician.
With the rise of obesity in adult populations in the western world there has been a concurrent rise in bariatric procedures to address this problem. Although the safety of bariatric procedures has improved significantly over the past 20 years, there are still a number of serious surgical complications that can occur in the postoperative period that emergency physicians need to be familiar with. ⋯ This review will cover the more common bariatric procedures that are being performed today. It will discuss the complications, clinical presentations and management of these patients that emergency physicians should be familiar with.